Total Knee Replacement Surgery, also known as total knee arthroplasty, is a surgical procedure aimed at relieving pain and restoring function in patients with severe knee arthritis or significant knee joint damage. This surgery involves replacing damaged or diseased parts of the knee joint with artificial components made of metal and plastic.
Dr Shales typically chooses to use the following knee prosthesis
Under anaesthetic Dr Shales will make an incision to the front of the knee. Using specialised instruments he will remove the diseased cartilage off the ends of both the femur (thigh bone) and tibia (shin). If required the undersurface of the patella (knee cap) will also be resurfaced. A prosthesis is then implanted and once stability and range of motion is checked the knee is then sutured closed.
There are a number of tools available to help with planning the bony cuts and implant position. These include:
- Navigation
- Robotic assisted
Dr Shales will discuss these options with you at the time of your appointment.
There are two robots Dr Shales uses in TKR surgery
Before surgery, patients may be required to undergo medical evaluations and further testing to ensure a safe procedure. Specialised imaging may also be requested to accurately plan for the surgery. You will be advised about stopping certain medications that may increase the risk of bleeding. In the weeks leading up to surgery it is IMPORTANT to keep your skin clean and free from any cuts or scratches. If there are any wounds on the limbs please notify Dr Shales. depending on the severity of the cuts surgery may need to be postponed due to the increased infection risk. You will need to arrange assistance at home during the recovery period.
After surgery, patients can expect to stay in hospital for 2 to 4 days. Medications will be prescribed to manage pain and discomfort. Physiotherapy starts soon after surgery to improve strength and range of motion. Patients may initially require a walker or cane for support. Once discharged from hospital you may require some home care.
Rehabilitation plays a crucial role in the recovery process:
1. Exercise Program: A tailored exercise regimen to strengthen muscles and improve mobility.
2. Assistance Devices: Proper use of walking aids to aid mobility.
3. Home Modifications: Necessary adjustments to the home environment for safety and accessibility.
4. Follow-up Care: Regular appointments with the surgeon and physical therapist to monitor progress.
While total knee replacement surgery is generally safe, potential risks and complications include:
- Infection
- Blood clots
- Knee stiffness or instability
- Nerve or blood vessel damage
- Persistent pain
Most patients experience significant pain relief and improved function after total knee replacement surgery. However, individual outcomes may vary depending on factors such as age, overall health, and adherence to rehabilitation.
Total knee replacement surgery can provide relief and restore mobility for individuals suffering from severe knee arthritis or joint damage. With proper preparation, rehabilitation, and follow-up care, patients can achieve favorable outcomes and resume an active lifestyle.
The AOA National Joint Registry reports that for in Total Knee Replacements performed for Osteoarthritis over 90% are still implanted after 20 years.
Here are a number of the questions we often get asked.
The duration of a total knee replacement procedure typically varies, but on average, the surgery itself lasts approximately 1 to 2 hours. Factors influencing the time include the complexity of the case, the patient's overall health, and the surgical approach chosen by the surgeon. It's important to note that the time in the operating room is just one part of the overall process. Preoperative preparations, anaesthesia induction, and postoperative recovery in the operating room and the recovery area contribute to the entire timeframe spent in the medical facility.
The recovery period after a total knee replacement varies for each individual, but in general, patients can expect significant improvement in the first few weeks. Most individuals can resume light activities within a few weeks, but the complete recovery process may take several months. Full recovery, including regaining optimal strength and range of motion, typically extends over the course of 12 months or longer. The speed of recovery depends on factors such as adherence to rehabilitation exercises, overall health, and following the guidance of healthcare professionals.
