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Knee Joint Replacement

Dr. Kunal Makhija

Knee joint replacement is a procedure that involves replacing an injured or ailing knee with an artificial joint, or prosthesis.

The procedure to remove your old knee and replace it with a prosthesis usually takes less than two hours, but recovery and rehabilitation can last months.

Sometimes, either the socket of the hip or the thighbone is injured or becomes diseased. This can result in pain, trouble with walking, or difficulty with everyday tasks. You may have already tried pain relief methods such as medications, physical therapy, supports, or braces. If the pain doesn’t subside, your doctor may recommend hip replacement surgery.

There are four basic steps to a knee replacement procedure.

  • Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
  • Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or "press-fit" into the bone.
  • Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
  • Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.

After surgery your surgeon and a physiotherapist or physical therapist will work together to set recovery and movement guidelines. Initially these include passive exercises, before progressing to gentle knee-bending exercises and walking. Ongoing exercises are designed to increase the range of motion of the new joint and to strengthen the surrounding muscles, particularly the thigh muscle (quadricep). Strength in the quadricep will help to keep the knee joint stable, therefore protecting the new joint.

The success of the surgery depends on following the recovery and movement instructions while in hospital and on carrying out the prescribed exercises when at home.

The time spent in hospital can vary from about 5 to 7 days. The healthcare team (surgeon, physiotherapist or physical therapist and nurses) will make an ongoing assessment of recovery and will recommend when going home is appropriate. A part of the healthcare team’s assessment will be to discuss if special equipment needs to be installed to assist at home or if home help needs to be arranged.