Early phase
- Pain and swelling control
- Early mobilisation
- Knee movement
- Walking with appropriate support
Total Knee Replacement
When a damaged knee is affecting everyday life
Total knee replacement, also called total knee arthroplasty (TKA), is a procedure in which damaged joint surfaces of the knee are removed and replaced with artificial components.
The objective is primarily to reduce pain and restore useful knee function when advanced knee disease has not responded adequately to non-operative treatment.
When is total knee replacement considered?
Knee replacement may be considered when you have:
- Persistent knee pain
- Advanced arthritis
- Significant stiffness
- Difficulty walking
- Difficulty climbing stairs
- Increasing dependence on pain medication
- Sleep disturbance due to knee pain
- Major restriction of everyday activities
- Inadequate improvement despite appropriate non-operative treatment
An X-ray showing advanced arthritis does not automatically mean that surgery is necessary. The decision should be based on the relationship between the structural disease and the patient’s symptoms and functional limitations.
What happens during a total knee replacement?
The damaged surfaces of the femur and tibia are prepared and replaced with prosthetic components.
The undersurface of the patella may also be treated depending on the surgical plan.
A plastic bearing component is positioned between the femoral and tibial components to allow controlled movement.
What is the goal of surgery?
The goals are to:
- Reduce arthritic pain
- Correct appropriate deformity
- Restore a stable knee
- Improve walking ability
- Improve functional capacity
- Allow rehabilitation and return to appropriate activities
A knee replacement is not intended to make every patient perform like a normal, unoperated young knee. Expectations should be realistic and discussed before surgery.
What happens before surgery?
Preoperative planning may include:
- Clinical examination
- Standing radiographs
- Assessment of limb alignment
- Medical evaluation
- Medication review
- Infection-risk assessment
- Diabetes and metabolic optimisation where relevant
- Planning of implant size and positioning
- Discussion of rehabilitation and postoperative expectations
What happens after surgery?
Recovery generally progresses through stages.
Rehabilitation phase
- Progressive strengthening
- Improving knee flexion and extension
- Gait training
- Functional exercises
Later phase
- Increasing walking distance
- Stair training
- Progressive return to everyday activities
Recovery varies considerably between individuals.
How long does a knee replacement last?
Modern knee replacements can provide long-term pain relief and function, but no artificial joint lasts forever.
Longevity depends on multiple factors including:
- Age
- Activity
- Implant design
- Alignment and fixation
- Body weight
- Bone quality
- Patient-specific factors
Younger and highly active patients may place greater demands on the implant over their lifetime.
What activities are possible after knee replacement?
Most patients can return to many everyday activities.
Higher-impact activities should be discussed individually.
What are the possible risks?
As with any major operation, complications can occur.
Potential complications include:
- Infection
- Blood clots
- Stiffness
- Persistent pain
- Instability
- Wound problems
- Fracture
- Nerve or vascular injury
- Implant loosening or wear
- Need for revision surgery
Risk varies according to the individual patient and medical condition.
Frequently Asked Questions
Is knee replacement only for elderly patients?
Age alone does not determine suitability. Symptoms, disease severity, activity limitation and overall health are important.
Do I need to wait until I cannot walk before having knee replacement?
No. The decision should be based on the severity of symptoms and their effect on function and quality of life.
Can I bend my knee fully after replacement?
Many patients achieve useful flexion, but the final range varies according to preoperative movement, anatomy, surgical factors and rehabilitation.
Will I be able to squat after knee replacement?
Deep squatting is not essential for a successful replacement and may not be comfortable or advisable for every patient.
How soon can I walk after surgery?
Many patients begin mobilisation early after surgery, with the exact progression determined by the procedure and individual circumstances.
Consultation
A knee replacement should be considered when the combination of symptoms, functional limitation and joint damage indicates that replacement is an appropriate treatment option.
Book an Appointment
Dr. Anup A. Panda
Orthopaedic Knee, Foot & Ankle Surgeon
Diabetic Foot Specialist
Assistant Professor, Department of Orthopaedics, KIMS Bhubaneswar
