A surgical treatment in which the damaged cartilage and bone surfaces of the knee joint are replaced with metal and specialized plastic components. The aim is to reduce pain and to make daily movements easier.
Indication
- Persistent pain and limitation of movement due to advanced knee osteoarthritis
- Severe joint damage in inflammatory joint diseases such as rheumatoid arthritis or psoriatic arthritis
- Inadequate response to conservative treatment (medication, physical therapy, intra-articular injection, weight control)
- Significant knee deformity (varus or valgus alignment) and loss of function
- Post-traumatic osteoarthritis after injury
- Joint surface collapse due to avascular necrosis (impaired blood supply to the knee bone)
- Chronic knee pain with night pain that significantly affects daily living
Preparation
- Detailed clinical examination, knee X-rays, and MRI or CT when needed
- Blood tests, ECG, chest X-ray, and anesthesia consultation
- Pre-operative control of chronic conditions such as cardiac disease, diabetes, and hypertension
- Anticoagulant medications are adjusted with physician approval; smoking is ideally stopped at least 4 weeks before surgery
- Treatment of any active dental infection identified at a prior dental check-up
How it's performed
- General or regional (spinal/epidural) anesthesia is administered
- A longitudinal incision is made on the front of the knee
- Damaged cartilage and bone surfaces are shaped and removed using specialized cutting guides
- Femoral, tibial, and (when needed) patellar components are placed, with a polyethylene insert in between
- Joint stability, alignment, and range of motion are checked
- The wound is closed in layers; drainage and a compressive dressing are applied
Post-procedure
- Hospital stay is generally 2-4 days
- Standing and walking with a walker or crutches together with the physiotherapy team begins on the day of surgery or the day after
- Deep vein thrombosis (DVT) prophylaxis: anticoagulant medication, mechanical compression stockings, and early mobilization, generally for 2-6 weeks
- A structured physical therapy program lasts 6-12 weeks and targets joint range of motion and muscle strength
- Cautious activity for the first 6 weeks; modifications to the home environment to prevent falls and appropriate footwear are recommended
- Annual follow-up X-rays monitor the condition of the prosthetic components
Risks
- Infection (superficial or deep prosthetic infection, around 1-2%)
- Deep vein thrombosis (DVT) and pulmonary embolism — risk is reduced with appropriate prophylaxis
- Joint stiffness or limited range of motion that may require manipulation
- Periprosthetic fracture (fracture of bone around the prosthesis)
- Vascular or nerve injury (rare)
- Wear of the polyethylene insert and loosening of components over time; revision surgery may be required
- Anesthesia and general surgical risks (cardiac and pulmonary complications)
FAQ
How long does a knee prosthesis last?
With modern knee prostheses, functional service of 15-20 years and beyond is frequently reported. Expected longevity depends on patient age, weight, activity level, bone quality, and surgical technique.
What is the risk of clot formation after knee surgery and how is it prevented?
After total knee replacement, deep vein thrombosis (DVT) and pulmonary embolism are important risks. The risk is largely reduced through anticoagulant medication, mechanical compression (stockings/devices), early mobilization, and adequate hydration. Prophylaxis is generally continued for 2-6 weeks and is individualized by the physician.
How long does physical therapy take and is it important?
Physical therapy is decisive for the success of total knee replacement. An intensive program is followed for the first 6-12 weeks targeting joint range of motion, muscle strength, balance, and gait quality. Full functional recovery may take 4-6 months and sometimes up to a year.
Can I kneel for prayer or sit cross-legged after the surgery?
Kneeling, sitting on the knees, and cross-legged sitting place high loads on the prosthetic components, and these positions are generally not recommended. Walking, swimming, cycling, and low-impact activities without running are considered safe. Patient-specific restrictions are determined by the surgeon.
Related Information
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PARTIAL KNEE REPLACEMENT
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Partial knee replacement — partial resurfacing surgery in which only the damaged compartment of the knee joint is renewed.
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Anterior cruciate ligament (ACL) reconstruction — arthroscopic reconstruction of the torn ACL using a graft.
Intra-articular injection
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Intra-articular injection — pain management for osteoarthritis using hyaluronic acid and other medications.
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PRP injection — application of platelet-rich plasma in selected tendon and joint conditions.
PARTIAL HIP REPLACEMENT
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Exercise bike therapy — knee range of motion and lower-extremity conditioning.