The knee is the largest joint of the body and healthy knees with perfect mobility are required to perform almost every physical activity. Different types of arthritis i.e. osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis can limit the mobility of the knee joint and cause chronic pain in the knee. In such cases, the orthopedic surgeon may recommend a Total Knee Replacement surgery.
Total Knee Replacement (TKR)
In Total Knee Replacement surgery, the diseased portions of the patient’s bone are removed in order to reshape the remaining bone for perfect accommodation of the knee implant. During this surgical procedure, the artificial knee is built inside the patient’s leg to create the most compatible artificial joint.
Steps of Total Knee Replacement Surgery
- First of all, the surgeon makes a precise incision in the front area of the knee to gain proper access to the kneecap or patella. This incision is about eight to ten inches long.
Once the patient’s knee is open, the orthopedic surgeon rotates the kneecap outside the knee area in order to view the specific knee area where the surgical procedure is to be performed. - Now the surgeon will measure the bones and make small cuts with their special surgical instruments.
- The first resurfacing is done on the femur or the thighbone. The surgeon cuts the injured cartilage and bone from the patient’s diseased femur and then the femur is expertly resurfaced to fit the femoral component which is the first part of the patient’s artificial joint.
- After proper resurfacing of the femur, the metal femoral component is attached to the end of the femur. The surgeon uses special bone cement to seal the femoral component into place.
- The next bone which is resurfaced is the shinbone or tibia. The surgeon removes the damaged cartilage and bone from the top of the patient’s tibia and reshapes the tibia so that it fits the plastic and metal tibial components.
- Now the tibial tray i.e. the bottom area of the implant is fitted to the tibia’s top and it’s properly secured into place by using the bone cement. Then the surgeon will place a polyethylene insert (medical-grade plastic) between the femoral component and the tibial tray that works like a buffer. This polyethylene provides support during the bending and flexing of the knee.
- Next, the surgeon will flatten the patient’s patella and fit an extra plastic component to ensure a perfect fitting of the implant. This plastic piece is usually cemented to the underlying bone.
- In order to ensure the optimum working of the artificial implant, the surgeon will perform bending and flexing of the knee. The surgeon may give final finishing touches to the sizing, alignment, and positioning of the implant. Then the incision is closed with staples or stitches and properly bandaged.
- The patient’s leg is then put on a CPM i.e. Continuous Passive Motion machine which gently bends and flexes the knee for a certain time while the patient is on bed rest.
Total knee replacement surgeries have proven to be highly effective in restoring the natural mobility of the knee and providing relief from chronic knee pain. Picking the right surgeon the first time can make all the difference in your outcome! Dr. LaButti is an expert in hip and knee replacement surgery and is a board certified orthopedic surgeon and fellowship trained in total joint replacement. Dr. LaButti has been voted “Best of the Best” by Oklahoma Magazine 5 years in a row . Dr. LaButti also performs MAKOplasty for partial knee replacements, navigation and computer assisted surgery.
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