Total knee replacement involves replacing damaged cartilage and bone in the knee joint with prosthetic components to relieve pain, improve mobility, and reduce stiffness caused by arthritis. Arthritis causes symptoms like pain, swelling, warmth, and stiffness in the knee. X-rays and medical exams are used to evaluate the type of arthritis and treatment options, which may include total knee replacement for those with moderate to severe osteoarthritis who have not benefited from conservative treatments. The procedure replaces the knee joint and is usually very effective at reducing pain and allowing patients to return to normal activities within a few months of surgery and physical therapy.

1. Total Knee Replacement: A Patient’s Guide
Total knee replacement involves replacing the damaged cartilage and bone of the knee joint
with prosthetic components. The majority of patients who have severe osteoarthritis benefit
from a total knee replacement, which relieves chronic pain, improves range of motion, and
stops stiffness.
Arthritis and the Knee
Pain is the most common symptom of knee arthritis. The kinds of arthritis that affect the
knee include:
 Osteoarthritis – The most common type of arthritis is osteoarthritis (OA), and it
affects around 25 million Americans. OA causes chronic knee pain that is often not
relieved with rest. With OA, the knee may experience morning stiffness, which
causes decreased range of knee flexibility and mobility. Other symptoms of OA
include swelling and warmth of the knee.
 Inflammatory arthritis – Rheumatoid arthritis, lupus, and gout are just three types of
inflammatory arthritis. These conditions cause severe inflammation of the knee joint,
which leads to warmth, swelling, pain, and stiffness.
 Post-traumatic arthritis – After a knee injury, damage occurs to the cartilage and
bone. This can lead to arthritis symptoms, such as pain and swelling.
Evaluating the Arthritic Knee
To determine what type of arthritis or injury you have, the doctor will take some x-rays of
your knee and conduct blood tests. After a thorough examination and medical history, the
orthopedic specialist will inform you of what type of problem exists, as well as your
treatment options. If you have tried conservative measures without results, the doctor may
suggest a total knee replacement.
Candidates for Total Knee Replacement
The majority of total knee replacement patients (90%) have complete pain relief after the
procedure. This procedure is so beneficial, that the surgeon can ensure your return to usual
activities. Additionally, total knee replacement has been proven helpful for elderly clients, as
well as young active people. The decision to have a total knee replacement depends on your
choice, the surgeon’s recommendations, your health status, and your willingness to
participate in rehabilitation.
A total knee replacement procedure is reserved for patients who have moderate to severe
knee arthritis, considerable cartilage and bone loss on x-ray evaluation, and persons who
have failed on conservative therapies. This includes failure with physical therapy, anti-
inflammatory agents, and corticosteroid injections.
Preparation
Before surgery, you must notify the doctor of all medications you are taking. Certain blood-
thinning drugs are to be held for several days. The surgeon will review the procedure with
you and have you sign a consent form. Arrange to have transportation home from the
hospital and for someone to stay with you for a few days. You need to have a raised toilet
seat, a shower chair, a walker/cane, and pre-made meals available.

2. The Procedure
The total knee replacement procedure involves making an incision on the front (anterior)
portion of the knee, displacing the patella, and replacing damaged bone ends and cartilage
with prosthetic components. After all changes are made, the incisions are closed using
staples/sutures, and a dry, sterile bandage is applied. The patient is placed in a continuous
passive motion (CPM) machine to gently move the knee through regular range of motion.
Recovery
After your surgery, you are monitored in the recovery room for a few hours. Once you are
awake, urinating, and talking, you are moved to a hospital room. Some orthopedic surgeons
are using the rapid recovery protocol, which could mean you go home 8-24 hours after your
procedure.
Effectiveness
Most studies support that the total knee replacement procedure is 95% effective, and the
new knee lasts for 10-20 years. Most patients can soon walk without an assistive device,
climb stairs normally, and return safely to usual activities. The mainstay of recovery and
effective knee function is physical therapy. You will work with a physical therapist in the
hospital and when you go home. The professional helps you learn exercises to strengthen
leg muscles, improve function, and restore range of motion.
Activities
You will gradually return to usual activities. In addition, certain physical activities are
recommended, whereas others are not allowed. These include:
 Recommended: Swimming, cross-country skiing, golf, dancing, and cycling.
 Permitted: Hiking, gentle doubles tennis, and light labor (no heavy lifting).
 Not allowed: Jogging, jumping, twisting/pivoting (basketball and racquetball), and
heavy labor.