Total Knee Replacement
Total knee replacement surgery (total knee arthroplasty) is a common option for the treatment of osteoarthritis (knee arthritis). Unlike a partial knee replacement, which involves replacing only the damaged sections of bone and cartilage in the knee, total knee replacement surgery involves replacing the entire knee joint.
“The areas of damaged cartilage are removed from the end of the bone and replaced with metal and a high-density polyethylene (plastic). The plastic is placed between the pieces of metal to mimic your old joint and cartilage,” says Dr Rhys Clark.
Am I a candidate?
Your knee is made up of three sections– the medial (inside), the lateral (outside), and the patellofemoral (kneecap). When two or more of these areas are damaged by osteoarthritis, a total knee replacement may be required. When osteoarthritis is at its worst, it can completely wear away your cartilage resulting in your bones rubbing against each other. This can mean a smaller range of movement and stiffness in your knee and can also cause issues such as bow-leg or knock-knee deformities. X-ray and CT/MRI imaging will be used to determine the extent of the damage in your knee.
“Once the cartilage in your knee becomes damaged it can cause you a considerable amount of pain. When that pain can’t be treated with medication, physical therapy, and/or injections, a total knee replacement may be an option for you.”
Robotic assistance and a virtual pre-op
Rhys uses robotic assistance in total knee replacement surgeries. While Rhys is still in control of the procedure, the robot assists in the bone preparation and placement of the implant. You will be required to have an additional CT scan to help with the planning of your surgery. These images help Rhys to create an image of your knee that allows him to choose the correct size and location of your knee replacement.
“Before any surgery takes place, I use the images from your CT scan to complete a virtual pre-operation on a computer. When it comes to performing your surgery, the robotic arm helps guide me in making the boney cuts and implant placement. This additional planning and robotic assistance helps me perform the best possible knee replacement I can.”
What to expect from surgery
You can usually return home three to five days after your operation. Rehabilitation exercises and further appointments will follow, but most patients are able to bear weight within six hours after surgery. You may be required to use crutches or a walking stick for the first four to six weeks depending on your stability. It is important for your post-op recovery that you continue to move your knee while also allowing your wound to heal. Keeping up your movement post-op will increase your range of motion and prevent blood clots and other complications.
The surgery is generally very successful both in patient satisfaction, reducing pain, and improving quality of life. In the rare case something with your knee replacement goes wrong, knee revision surgery may be necessary. The chances of you needing another knee surgery later in life is lower than those that have partial knee replacements.
“Total knee replacement surgery is one of the most rewarding operations I do. Seeing my patients returning to life without being limited by their pain means they get to experience the joy of movement again.”