Total Knee Replacement: A Patient's Guide.
Edited By: Seth S. Leopold, M.D.
Last updated Tuesday, April 15, 2008
About the procedureTechnical details Total knee replacement surgery begins by performing a sterile
preparation of the skin over the knee to prevent infection, followed by
inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incision--typically 6”-7” in length,
though this varies with the patient’s size and the complexity of the
knee problem--is made down the front of the knee, and the knee joint is
inspected.
Next, specialized alignment rods and cutting jigs are used to remove
enough bone from the end of the femur (thigh bone), the top of the
tibia (shin bone), and the underside of the patella (kneecap) to allow
placement of the joint replacement implants. Proper sizing and
alignment of the implants, as well as balancing of the knee ligaments,
all are critical for normal post-operative function and good pain
relief. Again, these steps are complex, and considerable experience in
total knee replacement is required in order to make sure they are done
reliably, case after case. Provisional (trial) implant components are
placed, without bone cement, to make sure they fit well against the
bones and are well aligned; at this time, good function--including full
flexion (bend), extension (straightening), and ligament balance--is
verified.
Finally, the bone is cleaned using saline solution and the joint
replacement components are cemented into place using
polymethylmethacrylate bone cement. The surgical incision is closed
using stitches and staples. Anesthetic Total knee replacement may be performed under epidural, spinal, or
general anesthesia. We usually prefer epidural anesthesia, since a good
epidural can provide up to 48 hours of post-operative pain relief, and
allow faster, more comfortable progress in physical therapy.Length of total knee replacement surgery No two knee replacements are alike, and there is some variability in
operative times, but a typical total knee replacement takes about 80
minutes to perform.Surgery for Severe arthritis of the knee at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-3354 or Eastside Specialty Clinic at 425-646-7777 to make an appointment.
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