Total knee replacement

Total knee replacement (total knee arthroplasty) is a common orthopaedic procedure. It involves replacing the worn articular surfaces of the knee joint, which are the femur (thigh bone), tibia (shin bone) and sometimes the undersurface of the patella (kneecap), with prosthetic components.

Why knee replacement?

End-stage knee arthritis causes persistent pain, stiffness and functional limitation that can significantly impact quality of life. When conservative measures, including physiotherapy, weight management, bracing and injections, no longer provide adequate relief, total knee replacement can reduce pain and improve function. Results vary from person to person.

The procedure

Under general or spinal anaesthesia, the knee is opened through an incision over the front of the joint. Diseased cartilage and bone from the ends of the femur and tibia are removed and precisely shaped to accept the prosthetic components. A metal femoral component, a metal tibial baseplate with a polyethylene (plastic) insert, and optionally a patellar button are implanted and fixed with bone cement or press-fit.

Recovery

An enhanced recovery pathway begins on the day of surgery, with physiotherapy-assisted walking within hours of the operation. Hospital stay is typically 2–4 nights. Physiotherapy at home or in a rehabilitation facility continues for 6–12 weeks. Recovery typically plateaus by around 12 months, though it varies between people.