Knee replacement surgery — also known as knee arthroplasty (ARTH-ro-plas-tee) — can help relieve pain and restore function in severely diseased knee joints. During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers.

Total Joint Replacement

The ends of two or more bones form a joint and are covered with a smooth tough layer called cartilage that allows movement without friction. When injury or conditions like arthritis or old age damage the cartilage, the joints become stiff and painful. Joints are enclosed in a capsule lined a layer called the synovium that produces fluid that reduces friction and wear.

What is total joint replacement and why is it necessary?

Joint replacement is the procedure in which the joint is removed and replaced with an artificial joint or prosthesis. Damaged or diseased joints produce pain that may be severe and debilitating. Movement becomes gradually restricted. Total joint replacement is considered if other treatment options do not relieve pain and disability.

How is a total joint replacement performed?

The procedure is performed under anaesthesia. The damaged ends of the bones and cartilage are removed and replaced with metal and plastic surfaces that are shaped to restore movement and function of the joint. Hip and knee joint replacements are the most common. The prosthesis is composed of two parts: a metal piece that fits closely into a matching plastic piece. The metals used are stainless steel, alloys of cobalt and chrome, and titanium. The plastic material is durable and tough (polyethylene).

What happens after joint replacement?

The doctor will encourage use of the "new" joint in a few days after the operation. Initially, walking is permitted with the help of a walker, crutches or a cane. There may be some pain in the replaced joint initially because the surrounding muscles are weak. This gradually improves in a few weeks. Exercise helps in the recovery process. Activities such as walking and climbing stairs are permitted, but strenuous sports such as running or tennis are discouraged.

What can be the possible complications?

The success rate following the surgery is more than 90%. The possible complications include:

  • Infection- may occur early after surgery or may even occur years later. Minor infections are treated with antibiotics. Major or deep infections may even require removal of the prosthesis.
  • Blood Clots- should be suspected if pain and swelling develop in the calf or thigh. This may require treatment with blood thinning medicines (anticoagulants) and elastic stockings.
  • Prosthesis malfunction- The prosthesis may become loose within the bone or may be dislodged from the socket. Sometimes the prosthesis develops excessive wear or may break. All these require a revision operation to place a new artificial joint.

Is total joint replacement permanent?

Most total joint replacements last a decade or more. Therefore, the younger joint replacement patients may need a second total joint replacement. The advantage is that this operation gives years of pain-free living resulting in an improved quality of life.