What are the steps of the total knee replacement procedure?
For patients undergoing total knee replacement surgery in Thrissur, understanding the step-by-step process of the procedure can help reduce anxiety and improve preparedness. Total knee replacement is a structured surgical process designed to relieve pain, restore joint alignment, and improve knee function. Each stage of the procedure follows standardized medical protocols to ensure safety, accuracy, and long-term outcomes.
1. Preoperative Preparation and Patient Positioning
Before the surgical procedure begins, the patient is taken to the operating room and positioned carefully on the operating table. The surgical team ensures proper alignment of the leg to allow precise access to the knee joint. Sterile preparation of the surgical area is performed to reduce infection risk.
Monitoring equipment is attached to track vital signs such as heart rate, blood pressure, and oxygen levels throughout the procedure. Once preparation is complete, the surgical area is covered with sterile drapes, leaving only the knee exposed for surgery.
2. Administration of Anesthesia
Anesthesia is administered to ensure comfort and pain control during the procedure. Depending on medical evaluation and patient suitability, either general anesthesia or regional anesthesia such as spinal or epidural anesthesia may be used.
The anesthesia team continuously monitors the patient’s condition throughout the surgery. Proper anesthesia management ensures that the patient remains stable and comfortable while allowing the surgeon to perform the procedure effectively.
3. Surgical Incision and Access to the Knee Joint
Once anesthesia has taken effect, a surgical incision is made at the front of the knee. This incision allows access to the joint structures, including the damaged cartilage and bone surfaces.
The surrounding soft tissues are carefully moved aside to expose the knee joint. Special care is taken to protect muscles, ligaments, and nerves during this stage. The incision size and technique are chosen based on surgical planning and joint condition.
4. Removal of Damaged Bone and Cartilage
After gaining access to the knee joint, the damaged portions of the femur (thigh bone), tibia (shin bone), and kneecap surface are carefully removed. These damaged areas typically include worn cartilage and irregular bone surfaces caused by arthritis or joint degeneration.
Precision instruments are used to shape the bone surfaces so that the artificial components can fit securely. Accurate bone preparation is essential for proper alignment, joint stability, and long-term implant performance.
5. Preparation of Bone Surfaces for Implant Placement
Once the damaged tissue is removed, the remaining bone surfaces are cleaned and shaped to receive the artificial knee components. This step ensures that the implant fits correctly and remains stable after placement.
Alignment guides and measuring tools are often used to achieve correct positioning. Proper alignment helps distribute body weight evenly across the joint and reduces stress on surrounding structures.
6. Placement of the Artificial Knee Components
The artificial knee components are then placed onto the prepared bone surfaces. These components typically include a metal femoral component, a metal tibial base plate, and a plastic spacer that allows smooth joint movement.
The surgeon checks the fit and stability of each component before securing them in place. Depending on the implant type, special bone cement or press-fit techniques may be used to fix the components securely to the bone.
7. Resurfacing of the Kneecap (If Required)
In many cases, the underside of the kneecap is also resurfaced during total knee replacement. This involves placing a smooth plastic component on the back of the kneecap to improve movement and reduce friction.
Resurfacing the kneecap helps improve joint function and can reduce postoperative discomfort related to patellar movement. The decision to resurface the kneecap is based on joint condition and surgical assessment.
9. Closure of the Surgical Site
Once the implant positioning and joint function are confirmed, the surgical site is thoroughly cleaned. The tissues and muscles are returned to their natural positions, and the incision is closed in layers.
Sutures or surgical staples are used to close the skin. A sterile dressing is then applied to protect the wound and promote healing. Proper wound closure helps reduce infection risk and supports tissue recovery.
10. Immediate Postoperative Monitoring
After surgery, the patient is moved to a recovery area where vital signs and overall condition are closely monitored. Pain management protocols are initiated to ensure comfort during the early recovery phase.
Medical staff assess circulation, sensation, and movement in the operated leg. Early monitoring helps identify and address any immediate concerns following surgery.
11. Early Mobilization and Physiotherapy Initiation
In most cases, gentle movement and physiotherapy begin within the first day after surgery. Early mobilization helps reduce stiffness, improve blood circulation, and promote faster recovery.
Physiotherapy exercises focus on improving knee movement, strengthening surrounding muscles, and restoring basic functional activities such as standing and walking with support.
12. Hospital Stay and Ongoing Care
The length of hospital stay varies depending on individual recovery progress and overall health. During this period, pain management, wound care, and rehabilitation exercises continue under supervision.
Patients receive guidance on walking techniques, stair use, and safe movement patterns. Education on home care and activity restrictions is also provided before discharge.
13. Rehabilitation and Recovery Phase
After discharge, rehabilitation continues at home or through outpatient physiotherapy sessions. This phase focuses on improving strength, flexibility, balance, and endurance.
Consistent participation in rehabilitation exercises is essential for achieving optimal outcomes. Gradual improvement in mobility and daily activity performance is expected over several weeks to months.
14. Follow-Up Evaluations and Long-Term Monitoring
Follow-up appointments are scheduled to assess healing progress, joint function, and implant performance. Imaging studies and physical assessments may be performed to monitor recovery.
Long-term monitoring ensures early detection of any concerns and helps maintain joint health. Regular follow-up also provides opportunities to adjust rehabilitation programs as needed.
15. Expected Functional Outcomes After the Procedure
After completing the recovery process, most patients experience significant pain relief, improved knee stability, and better mobility. Daily activities such as walking, climbing stairs, and standing for longer periods become easier.
While recovery timelines vary, continued improvement is commonly seen over several months. Maintaining a healthy lifestyle and following rehabilitation recommendations contribute to long-term joint performance.
For individuals planning total knee replacement surgery in Thrissur, understanding the step-by-step procedure helps build confidence and realistic expectations. Being informed about each phase of the surgical process supports better preparation, smoother recovery, and improved long-term results following total knee replacement surgery.
Table Of Content
Introduction
The Introduction gives a brief overview of total knee replacement and why it is done.
Candidates
The Candidates section explains who may need total knee replacement and when it is recommended.
Consultation
The Consultation section describes what happens during a knee replacement consultation and evaluation.
Questions to Ask
The Questions to Ask section covers important doubts patients should clarify before surgery.
Risks and Safety
The Risks and Safety section explains possible complications and how the procedure is kept safe.
Cost
The cost of total knee replacement surgery varies based on implant type, hospital facilities, surgical approach, and postoperative care needs.
Preparation
Preparation includes medical evaluation, medication review, prehabilitation exercises, home planning, and understanding the recovery plan.
Recovery
Recovery includes pain management, early mobilization, structured physiotherapy, gradual strength gains, and scheduled follow-up visits.
Results
Most patients experience significant pain relief, improved knee stability, better mobility, and enhanced daily function. Results
Before-and-after
Before-and-after results commonly show reduced pain, improved alignment, increased walking ability, and better overall knee movement.
Choosing the right surgeon
Choosing the right surgeon involves assessing experience in joint replacement, patient outcomes, communication clarity, and access to comprehensive rehabilitation.
Frequently Asked Questions
1. What is the first step in the total knee replacement procedure?
The first step involves preoperative preparation, patient positioning, and sterilization of the surgical area before the operation begins.
2. What type of anesthesia is used during total knee replacement surgery?
General or regional anesthesia may be used depending on the patient’s medical condition and surgical assessment.
3. How is the damaged knee joint prepared during surgery?
The surgeon removes worn cartilage and damaged bone surfaces and reshapes the area to fit the artificial joint components.
4. What materials are used in total knee replacement implants?
Most implants are made of metal components and a durable plastic spacer that allows smooth knee movement.
5. Is the kneecap always resurfaced during total knee replacement surgery?
Kneecap resurfacing is performed in many cases but depends on the condition of the joint and surgical evaluation.
6. How does the surgeon check implant placement during the procedure?
The knee is bent and straightened to assess movement, stability, and alignment before final closure.
7. What happens immediately after the surgery is completed?
Patients are moved to a recovery area for monitoring, pain management, and early assessment of leg movement and circulation.
8. When does physiotherapy usually begin after total knee replacement surgery?
Physiotherapy typically starts within the first day after surgery to support early movement and recovery.
9. How long does the hospital stay usually last after surgery?
Hospital stay duration varies depending on recovery progress and individual health factors.
10. What is the purpose of follow-up visits after total knee replacement surgery?
Follow-up visits help monitor healing, evaluate joint function, and ensure long-term implant performance.