What Is Total Knee Replacement?
Total knee replacement (TKR), or total knee arthroplasty, resurfaces the worn joint surfaces of the knee with metal and high-quality polyethylene components. It reliably relieves pain and restores function in patients with advanced knee arthritis who have not responded to conservative treatment.
Who Needs It?
TKR is recommended for patients with severe knee osteoarthritis (most commonly), rheumatoid arthritis, or post-traumatic arthritis causing significant pain and functional limitation. Candidates have typically tried physiotherapy, weight management, medications, and injections without adequate relief, and have bone-on-bone arthritis on X-ray.
The Procedure
The operation takes 1–1.5 hours under general or spinal anaesthetic. The worn surfaces of the femur, tibia, and kneecap are prepared and replaced with metal and polyethylene components that replicate the natural anatomy of the knee. The components are precisely sized and aligned using modern computer or robotic-assisted tools where available.
Recovery
A physiotherapist assists patients with walking from day one or two. Most patients go home after 3–5 days, though length of stay varies. A walking frame or crutches are used initially, transitioning to a walking stick and then independent walking. Outpatient or inpatient physiotherapy continues for 6–12 weeks. Most patients return to driving at 6–8 weeks and recreational activities at 3–6 months.
Risks
Important risks include infection (1%), blood clots (prevented with anticoagulants and compression stockings), stiffness (requiring physiotherapy), continued pain (5–10% of patients), and rare risks including nerve or vessel injury. We discuss all risks in detail during your consultation.