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Total Knee Replacement

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Total Knee Replacement, also known as Knee Arthroplasty, is a surgical procedure designed to relieve pain and restore function in patients suffering from severe knee arthritis or injury. This surgery involves removing damaged bone and cartilage from the knee joint and replacing them with artificial components made from metal, plastic, or ceramic materials. Total Knee Replacement is most commonly performed in patients with osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, where the cartilage in the knee has worn away, causing pain, stiffness, and reduced mobility.

The Knee Joint is made up of three components: the femur (thighbone), the tibia (shinbone), and the patella (kneecap). In a healthy knee, cartilage covers the ends of the bones, allowing smooth movement and cushioning during activities. However, when the cartilage wears down due to arthritis or injury, the bones begin to rub against each other, leading to pain, swelling, and difficulty in walking. Total Knee Replacement surgery addresses this issue by replacing the damaged surfaces of the knee with artificial parts, called prostheses, which mimic the natural movement of a healthy knee joint.

Indications for Total Knee Replacement

Osteoarthritis: The most prevalent form of arthritis, leading to cartilage
breakdown and joint pain.
Rheumatoid Arthritis: An autoimmune condition causing inflammation and
damage to the knee joint.
Post-Traumatic Arthritis: Arthritis that develops after an injury to the knee.
Severe Knee Pain: When pain interferes with daily activities and quality of life,
despite non-surgical treatments.

Diagnosis

Medical History: The physician will discuss symptoms, their duration, and
previous treatments.
Physical Examination: Assessment of knee range of motion, swelling, and
alignment.
Imaging Studies:
– X-rays: To evaluate the extent of joint damage and alignment.
– MRI (Magnetic Resonance Imaging): Occasionally used to assess soft
tissue structures around the knee.

The Total Knee Replacement Procedure

Anesthesia: The surgery is usually performed under general anesthesia or
spinal anesthesia.
Surgical Technique:
– Incision: A surgical incision is made over the knee.
– Knee Joint Exposure: The knee is carefully exposed, and damaged cartilage
and bone are removed from the femur (thigh bone), tibia (shin bone), and
sometimes the patella (kneecap).
– Preparation of the Bone: The surfaces of the femur and tibia are shaped to
fit the artificial components.
– Insertion of Components: The artificial joint components are secured in
place. These typically consist of:
– Femoral Component: A metal cap that replaces the end of the femur.
– Tibial Component: A metal base with a plastic spacer that replaces the
upper surface of the tibia.
– Patellar Component: A plastic piece that may replace the kneecap.
– Closure: The incision is closed with sutures or staples, and a dressing is
applied.

Recovery

Initial Recovery: Patients usually stay in the hospital for 1 to 3 days. Pain
management and mobility assistance will be provided.
Physical Therapy: Rehabilitation begins soon after surgery. Physical
therapists will guide patients through exercises to regain strength, flexibility,
and range of motion.
Activity Restrictions: Patients are encouraged to gradually increase their
activity levels, but high-impact activities should be avoided during the initial
recovery period.
Follow-Up Visits: Regular follow-ups with the orthopedic surgeon are
essential to monitor healing and adjust rehabilitation plans.

Risks and Considerations

Infection: As with any surgery, there is a risk of infection at the incision site.
Blood Clots: Patients may be at risk for blood clots in the legs, which can be
mitigated with preventive measures.
Implant Failure: Although rare, the artificial components may loosen or wear
out over time.
Stiffness or Limited Range of Motion: Some patients may experience
stiffness post-surgery, which can typically be managed with physical therapy.

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