Knee replacement
The surgery involves the replacement of the tibial and femoral articular surfaces with artificial implants.
Important information
- Knee replacement surgery can treat knee pain and stiffness in those suffering from arthritis or severe osteoarthritis who do not respond to non-surgical treatment.
- At the time of your surgery, Dr. Benoit will replace the two articular surfaces at the end of your knee with artificial components.
- Physiotherapy and your dedication to your rehabilitation are crucial in order to regain your mobility and to resume your activities with less pain.
What is a knee replacement?
The surgery involves the replacement of the articular surfaces of the femur and tibia with artificial implants. The goal of the procedure is to allow you to resume your daily activities and exercise more comfortably.
Who can benefit from a knee prosthesis?
Dr Benoit may recommend knee replacement surgery if you feel pain, have inflammation or severe damage to your knee joint because of conditions such as:
- Osteoarthritis (most common)
- Arthritis
- Osteonecrosis (avascular necrosis)
How to know if you need a hip replacement?
When your quality of life is compromised because of knee pain, it may be time to replace the knee. Signs of a decrease in quality of life include:
- Difficulty in performing simple daily tasks such as walking, getting dressed, putting on shoes, going up and down stairs, simply standing up, etc.
- Inability to fully take part in the activities you enjoy.
At first, Dr. Benoit may recommend other treatment options such as medication to relieve pain or inflammation, walking aids, intraarticular injections and physical therapy. If these do not alleviate the pain and stiffness, knee arthroplasty may be necessary to restore function and improve your quality of life.
The surgery
During a total knee arthroplasty, the main gliding surfaces of the knee are replaced.
Components of a knee prosthesis
- A metal implant that covers the femur.
- A metal implant that covers the tibia.
- A polyethylene insert between the two for optimal gliding.
Implant fixation to the bone
Biological fixation involves a non-cemented implant which adheres to the bone thanks to its porous coating, allowing the bone to naturally bond with the implant. For a cemented implant, fixation is achieved with bone cement which acts as glue. The cemented and non-cemented techniques are both good ways to secure the implant.
Replacing both knees at the same time
The left and right knee can both be replaced during a single surgery. This is called a bilateral knee arthroplasty. If you have issues with both your knees Dr. Benoit may recommend this procedure if you are in good health and can tolerate the surgery and the rehabilitation afterwards.
What goes on during knee replacement surgery?
Knee arthroplasties are performed in a surgical center. Although they are occasionally performed as same day surgery, it is sometimes required to stay one or two nights.
A typical total knee arthroplasty without any complications involves the following steps:
- Once in the operating room, you will undergo general anesthesia (entire body) or anesthesia below the waist (epidural or spinal), based on the recommendation of your anesthesiologist and/or Benoit.
- Then, Dr. Benoit will position you adequately for the surgery. The surgical site will then be scrubbed with soap and sterilized with an antiseptic solution.
- Incision and surgical approach to the knee
- Articular surface preparation and alignment of the femur and tibia
- Different trial implants will be used for sizing and to determine the best choice of implant
- Definitive implants are then installed
- The knee is reassessed to ensure that it functions correctly
- The layers of tissue are closed with sutures
- The outermost skin tissue is closed with surgical glue. No sutures or surgical staples will need to be removed after your surgery.
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You will be transported to the recovery room
After the surgery, Dr. Benoit will tell you when you can return home safely, which may be the same day, depending on your condition.
How long does a knee replacement surgery take?
On average, knee replacement surgeries take less than one hour. A dual knee replacement may take longer. Complications during surgery may also extend the length of surgery. Some imaging techniques, such as x-rays, may also need to be used immediately after the surgery or during your rehabilitation to confirm that the procedure was successful and that your knee is healing well.
Recovery after a knee replacement
Recovery after a knee replacement starts immediately. You will be encouraged to get up and move as soon as possible after the surgery. Patients without any other health issues can return home as soon as they are able to walk, climb stairs and get in and out of a car.
Some patients may need to go to an inpatient rehabilitation center before they are autonomous and able to return home. Whether you are returning home or going to a rehabilitation center post-surgery, you will need physiotherapy to help you regain muscle strength and good range of motion.
The physiotherapist can guide you on when you are ready to walk with or without assistance and on ways to manage your pain. Your motivation and cooperation to complete the physical therapy sessions are essential for an efficient recovery process and the overall success of the surgery.
During your recovery be sure to:
- Keep the surgical area clean and dry. You will receive instructions before returning home.
- Take all your medication as indicated.
- Follow the recommendations of your physiotherapist and complete all the prescribed home exercises.
- Resume your normal eating habits unless otherwise indicated.
- Elevate your leg and use ice to control swelling.
- Do not drive until Dr. Benoit has authorized it.
- Clear liquid or blood may leak from the site of your incision. This is normal in the first days after surgery. Immediately inform Dr. Benoit’s office if there is redness, swelling, or increased drainage from the incision, high fever, chills or intense pain.
What are the risks of a knee arthroplasty?
Knee replacement surgery is successful for most patients. Like any surgical procedure, there are some risks during and after a knee arthroplasty:
- Bleeding
- Infection
- Blood clots in the legs or lungs
- Injury to the neighboring nerves
- Fracture
- Continued pain or stiffness
- Noises
- Prosthetic loosening or wear
- Joint pain that is not relieved (this may be temporary or permanent)
There may be other risks depending on your health condition.
After the surgery, inform your physician if you notice any of the following:
- Fever
- Redness, swelling, bleeding or other drainage at the site of the incision that does not stop after a few days
- Increased pain in the area around the incision
- Pain in the lower leg that is not linked to the incision
- New or increased swelling of the lower part of the leg
Call 911 or go to
the emergency if you feel:
- Chest pains
- Shortness of breath