Total Knee Replacement

A journey to pain-free life

Total Knee Replacement (TKR), or total knee arthroplasty, is a surgical procedure that involves resurfacing the damaged weight-bearing surfaces of the knee joint. The damaged bone and cartilage are removed and replaced with prosthetic components typically made of metal and a high-grade plastic spacer.

Why is it needed?

The primary indication is chronic, severe knee pain and loss of function, most commonly due to osteoarthritis. It is necessary when pain significantly interferes with daily activities and has not responded adequately to conservative treatments like medication, injections, or physical therapy.

When is the right time?

Surgery is considered when imaging (X-rays) shows advanced joint damage and pain limits walking, bending, and stair climbing. The decision is made collaboratively, weighing the severity of symptoms against the patient's general health and lifestyle goals.

Expected Outcome?

The goal is to achieve substantial relief from debilitating knee pain, leading to improved joint stability and functional range of motion. Patients typically regain the ability to walk comfortably and participate in many daily activities, resulting in a significantly improved quality of life.

Rehabilitation

Rehabilitation is intensive and vital for TKR success. Physical therapy starts immediately after surgery, focusing on reducing swelling and regaining full knee extension and flexion (bending). Commitment to the prescribed exercise program is crucial, with functional recovery extending over several months.

Patient Preparation (Before Surgery)

Thorough preparation is essential for optimizing your outcome and ensuring a smooth recovery.

Pre-Surgical Clearance: Medical tests (blood work, ECG, physical exam) are performed to confirm you are fit for surgery and anesthesia.
Medication Review: Your surgeon must review all prescription and non-prescription medications, as some (like blood thinners) must be adjusted or stopped before the procedure.
Home Safety: Prepare your home by removing trip hazards, ensuring secure handrails on stairs, and potentially arranging necessary mobility aids (e.g., elevated toilet seat).
Physical Conditioning ("Pre-hab"): Specific exercises may be recommended to strengthen the leg muscles and improve overall stamina, aiding in a faster recovery post-surgery.
Support System: Arrange for reliable assistance with household chores, shopping, and transportation for the initial recovery period.

Immediate Post-Operative Care

The first 24-48 hours after your procedure are focused on pain management, monitoring, and initiating early movement.

Pain Management: A multi-modal approach (nerve blocks, oral, or IV medication) is used to control pain effectively, allowing you to participate in therapy.
Early Mobilization: The physical therapist will guide you to stand and walk short distances, often with an assistive device, on the day of surgery or the day after.
Clot Prevention: Measures such as leg pumps, compression stockings, and anti-clotting medication are used to mitigate the risk of DVT.
Range of Motion: Immediate focus is placed on bending (flexion) and straightening (extension) the new knee to prevent stiffness, often using a Continuous Passive Motion (CPM) machine.
Discharge Planning: Hospital stay typically lasts 1 to 3 days, concluding when you meet mobility milestones, manage pain effectively with oral medication, and are prepared for the next phase of rehabilitation.

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