Total knee arthroplasty replaces the damaged and arthritic joint surfaces of the knee with artificial implants.
Arthritis occurs as the protective cartilage covering the ends of the bones wears away. As this cartilage deteriorates, the contacting bones can cause pain and swelling. Total knee replacement is generally considered a last resort when reasonable conservative treatments have been exhausted and pain continues to significantly affect quality of life.
What Is Total Knee Arthroplasty?
Total knee arthroplasty replaces the damaged and arthritic joint surfaces of the knee with artificial implants.
Through a limited open incision along the front of the knee, the worn joint surfaces are replaced while the surrounding muscles, tendons, and ligaments remain.
The implants are typically secured to the ends of the bones with bone cement or with specialized surfaces that allow bone to grow into the implant.
Dr. Chudik uses technology including preoperative planning software, intraoperative patient-specific guides, computer navigation, and robotic assistance during total knee replacement.
Who Is a Candidate?
Total knee replacement may be appropriate for patients with knee arthritis whose pain continues to significantly affect quality of life after reasonable conservative treatments have been exhausted.
Initial treatment for arthritis generally includes:
- Physical therapy
- Injections
- Medications
- Activity modification
Contraindications include:
- Inability or unwillingness to complete the necessary postoperative rehabilitation program
- Current or previous knee infection, although this is not an absolute contraindication
How the Procedure Is Performed
Total knee arthroplasty is performed through a limited open incision along the front of the knee.
The damaged and arthritic joint surfaces are replaced with artificial implants. These implants are typically fixed to the ends of the bones with methylmethacrylate bone cement or with specialized surfaces that allow bone to grow into the implant.
The muscles, tendons, and ligaments surrounding the knee remain.
Dr. Chudik uses technologies including preoperative planning software, intraoperative patient-specific guides, computer navigation, and robotic assistance during the procedure.
Total knee replacement is generally performed as outpatient surgery. Most patients go home the same day. General anesthesia and adductor and IPACK regional nerve blocks may be used.
Recovery and Rehabilitation
Following total knee replacement:
- Most patients are discharged home on the day of surgery
- Weight bearing is allowed as tolerated, with crutches or a walker used for comfort
- The wound should be kept clean and dry for the first 10 to 14 days
- Light showering is allowed after two weeks, but the wound should not be submerged in water for three weeks
- Driving may resume at approximately four to six weeks when motion and strength have returned, if the right leg is involved
- Return to sedentary work may occur at about two weeks as long as the leg can be elevated
- Physical therapy to restore motion, strength, and proprioception (balance) may continue for about four months
Patients may return to walking and regular daily activities as soon as comfortable. Most activities may be resumed at approximately three to four months after surgery.
High-impact activities are not recommended.
Risks and Outcomes
Potential surgical risks and complications include:
- Infection
- Nerve injury resulting in numbness around the knee; a small area of temporary or permanent numbness around the incision is not uncommon
- Postoperative infection that may require removal of the implants
- Knee stiffness or loss of motion requiring prolonged rehabilitation or repeat surgery
- Pain from the implants
- Blood clot in the veins of the calf or thigh that may travel to the lungs
Total knee replacements have very successful outcomes regarding pain relief and achieving functional motion.
Why Dr. Chudik for Total Knee Arthroplasty
Dr. Chudik uses current technology in total knee replacement, including preoperative planning software, intraoperative patient-specific guides, computer navigation, and robotic assistance.
His goal is to replace the damaged and arthritic joint surfaces while preserving the surrounding muscles, tendons, and ligaments and restoring functional knee motion.