Total knee replacement is considered a major surgery and would require a lengthy evaluation process. It is uncommon for total knee replacement to be considered as the first course of treatment without exploring more conservative treatments or minor surgeries to improve one’s condition.
Symptoms that may require total knee replacement surgery as treatment include:
Additionally, factors deciding the suitability of total knee surgeries include:
The removed cartilage and bones are then replaced with metal implants fitted into the area or by cementation. These implants may be inserted at the thigh bone, shinbone, and kneecap, depending on your condition. If necessary, your kneecap will be cut and resurfaced with a plastic button. Additionally, if your ligaments are dysfunctional and are incapable of holding joints together, connective implants would be used to ensure they replace the functionality of ligaments.
A plastic spacer is then inserted between the metal to provide a smooth gliding surface. Finally, the site of surgery is cleaned with antiseptic solutions to prevent infections. The incisions are then closed with sutures.
It takes approximately 6 months to recover from the surgery and 12 months to resume activity. Whilst pain and stiffness would subside, your range of movement can be as limited as it was prior to surgery. However, it is best assured, you will be more functional in your day-to-day routine as satisfaction rates have been reported between 80-100% post-operation.
Results will vary from person to person, depending on the severity of the issue and your overall health. Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances.
Despite 15-20 years being seemingly long for many, this is not the case for someone who’s in their childhood, teens, or young adulthood. Thus, the apprehension for orthopaedists to conduct total knee surgeries in a younger demographic. However, if deemed completely necessary, this surgery would be performed nevertheless with future plans debriefed during consultation.
Continuously gaining weight or excess stress on knee joints through demanding activities will reduce the lifespan of your implant. Habits such as smoking will also impede the recovery rate. To attain complete recovery, one will need to attend physiotherapy sessions and appropriately manage medications such as painkillers, antibiotics and blood thinners. The frequency of physiotherapy sessions will vary according to your condition and the ability of your knee joint.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
