Knee Replacement Surgery - Procedure, Risks & Recovery

21 Apr,20

Knee Replacement Surgery is done to relieve severe knee pain and dysfunction caused by severely damaged knee joints. In this surgery, the damaged bone and cartilage from the thigh bone, shin bone and kneecap is either burred or cut and replaced with an artificial metal-made implant.  So, wondering about when one should opt for Knee Replacement Surgery? Well, only a joint or knee replacement surgeon can answer this question after assessing the motion, stability and health of the knee. They might take x-rays to determine the extent of knee damage and decide on which type of Knee Replacement Surgery will be the best for the patient. The decision of surgery also considers facts like patient’s age, weight, knee size & shape, activity level, and overall health.

Knee Replacement Surgery Procedure:

The surgery involves various steps, which have been explained in simple terms, so that all those who are considering it can understand the procedure with ease. 

Step 1: Starts with a knee incision

The Knee Replacement Surgeon starts the procedure by cutting an incision in the front knee area or kneecap. The incision can be as long as 4 inches to 10 inches depending upon the nature of the procedure.  

Step 2: Rotating the kneecap

Upon opening the kneecap, the surgeon will rotate the kneecap outside the knee area to view the damaged area that needs to be removed. 

Step 3: Preparing the thigh bone and implanting the artificial bone

The femur is the first bone that the Knee Replacement Surgeon will remove and will measure the damaged area before cutting it. The damaged bone and cartilage from the end of the femur are cut using special instruments. The femur is resurfaced to fit the first part of the artificial knee using bone cement so as to seal it into the right place.

Step 4: Preparing the tibia and implanting the tibial component

Tibia is the next bone that the Knee Replacement Surgeon will remove and then reshape it to fit the metal implant components. The artificial implant provides support for the body while bending and flexing the knee.

Step 7: Re-adjusting the kneecap

Once the implant is positioned correctly, the surgeon may flatten the kneecap and fit it with a plastic component to ensure a precise fit of the implant. The implant piece may be cemented to fix with the underlying bone.

Step 8: Final steps

The Knee Replacement Surgeon will ensure the knee function by bending and flexing the knee before closing the incision with stitches or staples. 

Risks of Knee Replacement Surgery 

Knee Replacement Surgery may carry some risks but usually, they are avoidable with proper medical care.

Anesthesia

To complete Knee Replacement Surgery, the patient requires to go under anesthesia which prevents them from feeling any pain that occurs during the operation. If general anesthesia is adminstered, the patient remains completely unconscious during the Knee Replacement Surgery until the process is over.

General anesthesia may cause side-effects, such as:

  • Headache & nausea
  • Drowsiness or sore throat
  • Heart attack in very rare cases

People with a serious health condition, such as a heart disease or lung issues may experience these side-effects. 

Alternatively, the patient may be given regional or local anesthesia where only the leg or lower body is made numb and the patient remains awake during the surgery. It causes fewer side effects.

Infection

The incision site may encounter bacterial infection; however, the knee replacement surgeon takes precautions to minimize this risk during surgery. The doctor always takes care of the signs of infection such as redness, swelling, fever or discharge from the surgical site and will prescribe antibiotics for it.

Bleeding & blood clots

Blood clots or bleeding are one of the severe side-effects of knee replacement surgery. It happens if the surgery damages any blood vessels. However, wearing compression devices and moving the legs help to prevent this issue.  

Pain and swelling

Pain and swelling are common side effects that occur after knee replacement surgery. However, the severity may vary from person to person. The knee replacement surgeon usually prescribes pain relief medications to manage such discomfort following the knee replacement surgery. 

Implant failure

In rare cases, the implants fail to fit within the body, but with the advancement in technology the quality of implants have also improved a lot. The new joint may get loose or lose its stability. If this occurs, then it may require another surgery to replace it.

Recovery after Knee Replacement Surgery

Post the Knee Replacement Surgery, the patient may need to stay in the hospital for 1 or 2 days typically. While a few patients are even discharged on the same day itself. If the patients require any extra attention than they may be transferred to a rehabilitation centre. This helps the patients to recover quickly. The knee replacement surgeon may also recommend some physical therapy to the patient which usually begins within a week after the surgery. 

The therapy may include:

  • Knee strengthening exercises

  • Knee exercises to restore motion range 

  • Knee exercises to reduce scar tissue

  • Advice on using assistive walking devices

Within 6 weeks, most patients go back to their normal lives and can even start to drive within 3 to 6 weeks, but they should always get a green signal from their doctor before doing so. For a complete recovery, it may take 4 to 6 months or even a year, depending on the patient’s age, health and individual case.