Body > Common Knee Surgeries > Total Knee Replacement

Total Knee Replacement

*Total Knee Replacements can be performed using different surgical techniques, and can require different precautions. This information should be used as a guide only and you should follow the advice given to you directly by your Surgeon or Physiotherapist.

A knee replacement is usually performed using the combination of a spinal anaesthetic and a nerve block. You will be required to stay in hospital for 2-5 days following your procedure and your rehabilitation and exercises will start as soon as you wake up.

A knee replacement is performed to remove cartilage and bone that has become rough, torn or overgrown, often due to Osteoarthritis. This surgery is also performed on people after a significant knee injury, like a fracture, where the knee joint no longer functions properly. It is a surgery used predominantly for the relief of pain.

A large incision is made down the front of the knee. Through this incision the surgeon can cut out the damaged ends of the thigh bone (femur) and shin bone (tibia) that make up the knee joint. The back surface of the knee cap (patella) may also be smoothed-off and replaced. The new joint surfaces are then fixed onto the ends of both bones and can be held in place with cement or else the bone grows onto them (uncemented). The anterior cruciate ligament is usually removed or already torn from previous injury. The knee cap and joints are then put back in place and the skin incision is stitched up.

In some cases, only one part of the knee joint may need replacing, this is called a partial knee replacement.

Exercises

It is very useful to have seen a physiotherapist prior to surgery, and to get in the best shape possible before the operation. Typically closed chain exercises such as static cycling can aid in muscle bulk and build up, and ensure you "hit the ground running" after surgery.
After your knee replacement it is very important to perform exercises and walking to regain your mobility, and later strength
Do not sit with a pillow under your knee all the time. Whilst elevating the leg is important and can be done by placing a pillow under the ankle, if you put a pillow under your knee all the time, the knee will become very difficult to straighten.
If you do not get your knee moving early, the joint can become stiff and difficult to move.
Only perform exercises taught to you by your physiotherapist or surgeon.
Exercises should be performed 3-5 times a day. It may be helpful to take pain medication 30-40 minutes prior to exercise (as prescribed by your doctor).
A physiotherapist will see you the day of/after your surgery on the ward.
Ensure your exercises are not too painful or causing more swelling. If you have any concerns, contact your physiotherapist.

Swelling

You may have considerable swelling around your knee after surgery.
If this swelling persists it may impede healing and knee movement.
This can be treated by elevation, and by applying ice for 20 minutes following exercises.
Ice (crushed, cubes, frozen peas, gel pack etc.) should be wrapped in a towel and placed directly on the knee.

Walking and Crutches

You will be asked stand and walk the day of/after your surgery, with the assistance of your nurse and physiotherapist.
You will be asked to bring your own crutches or frame prior to admission by your surgeon.
Make sure you stay active, attempting to walk on the leg as much as tolerated after the operation, ensuring the knee does not swell afterwards.

Sleeping

Sleeping can be uncomfortable for some time after your knee operation.
You may sleep on your side, and might be more comfortable placing a pillow between your knees.