Knee Joint Arthroplasty

There are two main types of knee arthroplasty:

• Total knee arthroplasty (TKA) involves replacing all compartments of the knee joint.
• Partial knee arthroplasty (PKA) involves replacing only the damaged part of the knee joint, leaving the healthy parts intact.

Knee replacement surgery may be advised for people with:

• Severe knee pain that does not improve with rest, medication, or physiotherapy
• Knee joint stiffness or reduced range of motion, especially in the morning or after sitting for long periods.
• Persistent swelling in the knee.
• Difficulty walking, climbing stairs, or performing daily activities.
• Weakness or instability in the knee joint.
• Advanced osteoarthritis, which leads to the breakdown of cartilage and causes pain and stiffness.
• Rheumatoid arthritis or other inflammatory arthritis types with knee involvement.
• Secondary arthritis, which develops after an injury or infection of the knee.

• The patient is given anaesthesia (general or regional).
• The surgeon makes an incision over the knee to access the joint.
• Damaged bone and cartilage are removed.
• Artificial components (metal and plastic implants) are fixed in place to recreate the joint surface.
• The incision is then closed, and a dressing is applied.

The procedure typically lasts for 1–2 hours, depending on the complexity and type (total or partial replacement).

Before surgery, patients undergo:

• Medical evaluation is done to assess general health, blood tests, and heart and lung function checks.
• Anaesthesia assessment is done to ensure fitness for the procedure.
• Planning for recovery by arranging help at home, mobility aids, and physiotherapy sessions.
• Lifestyle preparation include stopping smoking, controlling weight, and adjusting medications if required.

Types of surgical approaches include:

• Conventional partial knee replacement or total knee replacement surgery
• Navigation-assisted knee surgery uses computer system for better precision
• Robotic-assisted surgery is more precise and requires fewer bone cuts (Bone preserving). It is associated with fewer complications, faster recovery, and good functional outcomes.

Like all major surgeries, knee replacement has some risks, including: 

• Blood clots
• Infection
• Injury to surrounding nerves/blood vessels
• Loosening or damage of the implant over time
• Persistent pain or stiffness
• Allergic reaction to implant materials (rare)
   

Post procedural care and recovery include:

• Hospital stay for 2-4 days is usually required for patients undergoing this procedure.
• Rehabilitation involving post-surgery physiotherapy starts soon after surgery to restore movement, strength and flexibility.
• Pain management includes pain medications and ice therapy to help reduce pain and swelling.
• Light activities may be resumed within a few weeks, but heavy lifting or strenuous sports should be avoided until cleared by the doctor.
• Long-term care such as ongoing physical therapy and lifestyle modifications are important for long-lasting results.