Total Knee replacement
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Total knee replacement (TKR) surgery was first performed in 1968. The surgical technique and the quality and design of the prosthetic implants have evolved over the years, making this one of the most successful orthopaedic procedures today. TKR offers a reliable solution to patients with symptomatic arthritis which has not responded to non-surgical treatment. Studies have shown that knee replacement surgery dramatically improves the quality life of patients.
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Total knee replacement surgery involves removing worn out, damaged cartilage from the end of the bones and inserting a artificial prosthetic implants. These implants are fixed to the bone with surgical bone cement. The prosthesis covering the lower end of the thigh bone (femur) is called the 'femoral component' and the one covering the upper end of the shin bone (tibia) is called the 'tibial component'. These 2 components are made of metal, usually cobalt-chrome. A plastic insert made of very high quality polyethylene fits at the top of the tibial component and the highly polished surface of the femoral component glides over it. Depending on the surgeon's preference, the knee cap (patella) might also be resurfaced. The prosthetic components are generally made of metal and plastic surfaces which are designed to glide smoothly against each other.
The entire surgery can take between 1 to 2 hours. Patients are encouraged to start range of motion exercises early. The physiotherapists will review you regularly and explain the rehabilitation programme. Majority of the patients spend 2-4 days in the hospital. A large proportion of pain and swelling is expected to settle down in 6- 8 weeks. Patients can usually start driving between 6- 8 weeks and resume playing Golf and swimming in 8-10 weeks. Sometimes the swelling can take a bit longer to settle down.
The longevity of a total knee replacement depends on a variety of factors including the patient' age and level of activity, patient's weight and mechanical properties of the implants. Studies have shown that over 85% of the knee replacements will function well for 20 years.
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