Total Knee Replacement: A Patient's Guide.

Figure 1 - X-ray of a traditional total knee replacement. This operation is done for patients who have arthritis throughout the knee. Excellent long-term results are obtained in most patients.

Figure 2 - Model of a traditional total knee replacement. The patella (knee cap) is not shown in this model.

Figure 3 - X-ray of a partial, or unicompartmental, knee replacement. This operation is done for patients whose arthritis is limited to one side of the knee. It may be done through a very small incision, and recovery from this procedure is usually much quicker than that seen with traditional total knee replacement.

Figure 4 - Model of a partial knee replacement. This smaller implant leaves undamaged cartilage in other parts of the knee intact.

Summary

Overview

This article reviews the benefits, risks, and alternatives to total knee replacement surgery (which is sometimes called total knee arthroplasty).

Knee replacement is a surgical procedure that decreases pain and improves the quality of life in many patients with severe arthritis of the knees. Typically, patients undergo this surgery after non-operative treatments (such as activity modification, anti-inflammatory medications, or knee joint injections) have failed to provide relief of arthritic symptoms. Surgeons have performed knee replacements for over three decades, generally with excellent results; most reports have ten-year success rates in excess of 90 percent.

Broadly speaking, there are two types of knee replacements: total knee replacements (see figures 1 and 2) and minimally-invasive partial knee replacements (mini knee) (see figures 3 and 4). Both have long “track records” and good clinical results in this country and in Europe.

Traditional total knee replacement involves a 7-8” incision over the knee, a hospital stay of 3-5 days, and a recovery period (during which the patient walks with a walker or cane) typically lasting from one to three months. The large majority of patients report substantial or complete relief of their arthritic symptoms once they have recovered from a total knee replacement.

Partial knee replacements have been around for decades and offer excellent clinical results, just like total knee replacements. Less invasive techniques are available to insert these smaller implants, but only a minority of knee replacement patients (about 10%) are good candidates for this procedure. Minimally-invasive partial knee replacement (mini knee) is the topic of another article on this website.

View a patient skiing deep powder at Bridger Bowl, Montana, on a total knee replacement; note that not all patients are able to ski, and we do not recommend this activity to patients with knee replacements.

Knee Arthritis

Surgery for Severe arthritis of the knee at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

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