Total Knee Replacement

What is Total Knee Replacement?

Total Knee Replacement is a procedure that involves resurfacing the bones of your knee joint with a prosthesis. When the surfaces of your knee bones become roughened and painful, they impact movement and cause a lot of pain. During this procedure, Dr. Rahme will insert implants with smooth, weight-bearing surfaces. These implants are cemented to prepared bone surfaces and aim to improve movement and reduce pain.

This procedure is considered a major operation and is only recommended when pain is seriously impacting your quality of life, and other treatments are ineffective. Alternatively, it is also a primary option when it comes to problems with function, especially when a knee is stiff and arthritic. A successful Total Knee Replacement will improve your knee function in the long run, along with your quality of life.


Total Knee Replacement Surgery

How to prepare for Total Knee Replacement
Preparing for a total knee replacement involves several tests to make sure you’re able to undergo surgery. These tests may include blood tests, x-rays, and ECGs, though Dr. Rahme will discuss these requirements with you. Your anaesthetist will also explain the anaesthetic that will be used during your surgery, as this can differ from patient to patient.

Surgery: What to expect?
You will be admitted to the hospital on the day of your operation. Dr. Rahme will visit you in the ward or anaesthetic bay to discuss your surgery and answer any questions that you may have about the procedure. He will also mark your knee with a pen.

When it’s time for your surgery, your anaesthetic will be administered. A tourniquet will be applied to your thigh and an antiseptic solution applied. Sterile sheets will also be draped across your leg, ensuring that only your knee is exposed. This minimises any chance of infection.

Dr. Rahme will perform a vertical incision on the front of your knee. This allows Dr. Rahme to access the knee joint and remove the arthritic or damaged parts of the joint. The bones in your knee joint will be smoothed to allow the prosthesis to be inserted properly, and to counter any existing deformity.

The prosthesis is made up of a femoral and tibial component, and a plastic surface is inserted between, to act as a shock absorber. Dr. Rahme may also resurface the patella (the kneecap), but this decision will be made on a case-by-case basis.

Once these components have been inserted, Dr. Rahme will ensure the knee is stable, aligned, and has the correct degree of motion. The wound will be closed with stitches and the knee will be wrapped in sterile bandages.

Immediately after your surgery, you will be monitored in the recovery ward, until you are able to return to your ward. An X-ray will also be taken to ensure the knee prosthesis is correctly placed. Your first day after your operation a physiotherapist will visit providing exercises that should be undertaken and you may be able to mobilise with assistance.

You will receive blood-thinning medication to reduce the risk of blood clots, which may form in the legs. In addition, you’ll have to wear compression stockings and an inflatable sleeve will compress your calves/feet intermittently. That prevents your blood flow from being too stagnant.

The dressings on your knee will be replaced 48 hours after your operation and once you have the right amount of mobility in your knee, and your pain is under control, you will be discharged.

Risks and Complications

Total knee replacement is major surgery, so it does come with some risks and the potential for complications. However, the likelihood of these complications occurring is very low. Dr. Rahme will discuss these risk factors with you.

Total Knee Replacement Recovery and Timeline

You’ll need to continue rehabilitation after you leave the hospital. That includes a combination of exercises at home and outpatient visits with your physiotherapist. This rehabilitation usually lasts between three and six months.

The 12 weeks following your surgery is the most important period in your recovery and it’s extremely important that you follow your rehabilitation program. You can expect to be walking unaided about one month to six weeks after your operation.