Total Knee Replacement

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Total Knee Replacement: aka Knee surgery, partial knee replacement




What is it?


Total knee replacement is an operation that replaces damaged or injured parts of a knee joint with parts that are artificial.  This is often a surgery that is done on people who have arthritis in their knee or damage from age.  Often times a doctor will do one knee at a time, but sometimes people have both knees replaced at once.


The Operation


During the procedure, ligaments and muscles around the knee are separated in order to expose the patient’s knee capsule.  This is the tough and gristle-like tissue that surrounds the knee joint.  The capsule is then opened, which exposes the inner part of the joint.  The ends of the tibia, which is the shin bone and the femur, which is the thigh bone, are removed, and more often than not the under part of the kneecap, which is the patella, is also removed.  The artificial parts of the knee are then cemented into place.  The new knee will have a metal shell on the end of your femur, a trough on your tibia which is made of both metal and plastic, and, sometimes, a plastic button that is fitted in your kneecap.




Alternatives to Surgery

As total knee replacement is usually the last thing that a doctor suggests, there are different ways that you can treat the pain from your knee.  Exercise is one thing that can help with range of motion. Some good types of exercise for someone with problem knees are water therapy, stretching exercises and bicycling.  Anti inflammatory medications and injections into the affected knee are also good to help with the pain and stiffness that a patient feels.


Before the Operation

Before the surgery, the patient will meet with the surgeon and have some tests done such as blood work, EKG, and other kinds of tests to make sure that he or she is in good health.



After the Surgery - In the Hospital

There will be a dressing applied to affected knee to help keep the area clean and to absorb any type of fluid that may drain from the wound.  The dressing will be changed between 2 to four days after the surgery.


There will be something that leads to the area of the surgery called a hemovac suction container.   This allows the nurses to take measurements and record the drainage that is being lost from the patient’s wound after the surgery.  This is typically removed by the doctor anywhere from two to three days after the surgery.

Patients should expect to have pain.  Some patients experience nausea when they come out of surgery, especially if they are not used to anaesthesia.  Barring any complications, patients should expect to be in the hospital at least four to five days. 
Before the patient is sent home, they will be taught how to walk with a walker and they will start physical therapy.   They will be advised of any lifestyle changes that they will need to make, such as what type of shoes or clothing that they should wear.   They will have to wear stockings that either go to their thigh or their knee to prevent blood clots, and they will have to take blood thinners.

Some patients are sent to a nursing facility after they are released from the hospital, but this is on a case by case basis.  Patients who have had both knees replaced are more likely to be sent to a nursing facility than those who only had one knee replaced.


After the Surgery - At Home


When the patient goes home, he or she may have a visiting healthcare professional to come and help them with their therapy, or they may have to go to therapy as an outpatient.  The doctor may suggest that they continue to wear the stockings and take the blood thinner for a period of time after the surgery, but this will vary depending on the patient.


The patient will be advised about what things they can or cannot do, and when they can resume normal activities.  The patient may be encouraged to do physical activities that are low-impact as well as the exercises that are prescribed by the doctor.  These activities may include walking, pedaling a stationary bicycle or swimming, which are great ways to help the patient on the road to recovery.


No two knee replacements are alike, so the length of recovery time will vary from patient to patient.  Age, general health, and other factors will contribute to the length of time that it will take the patient to recover from the surgery.  Patients who have both knees replaced will have a longer recovery than those who only had one knee replaced.




Possible Complications


Some of the possible complications from surgery can include:
Blood clots
Dislocation or loosening of the replacement knee

Heterotopic bone, which is extra bone that can develop on the lower part of the femur following a knee replacement.   


Patients who have had an infection in their knee joint are more likely to develop it.  This condition can cause pain and stiffness, and more than likely will require a revision surgery.




General Advice


Patients should remember that everyone reacts differently to this surgery and that no two patients are the same.  The patient should not get discouraged if their recovery takes longer than expected.  It’s important to have people who are willing to help the patient through their recovery and who are supportive.




Estimated Costs for Total Knee Replacement Surgery


Country Estimated Cost
USA $35,000
India $6,500
Malaysia $7000
Singapore $7000-9000
Thailand $6000-9000

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