Total Knee Replacement

Surgical Technique

RELEVANT LINKS:
Comprehensive Patient Guide to Knee Replacement Surgery
Total Knee Replacement Rehab
Avoiding Artificial Knee Replacement Surgery
Articular Cartilage Regeneration
Unicompartmental Knee Replacement Story – Patient Experience

The steps involved in replacing the knee begin with making an incision on the front of the knee to allow access to the knee joint. This incision has become shorter now that we use minimally-invasive surgical instruments and techniques.

Above- Shaping the Distal Femoral Bone: Once the knee joint is entered, a special cutting jig is placed on the end of the femur. This jig is used to make sure that the bone is cut in the proper alignment to the leg's original angles, even if the arthritis has made you bowlegged or knock-kneed. The jig is used to cut several pieces of bone from the distal femur so that the artificial knee can replace the worn surfaces with a metal surface.

Above- Preparing the Tibial Bone: Attention is then turned toward the lower bone, the tibia. The top of the tibia is cut using another jig that ensures the alignment is satisfactory.

Above- Preparing the Patella: The undersurface of the patella is removed.

Above- Placing the Femoral Component: The metal femoral component is then placed on the femur. The metal prosthesis is cut so that it matches the taper almost exactly. With a cemented femoral component, an epoxy cement is used to attach the metal prosthesis to the bone.

Above- Placing the Tibial Components: The metal tray that will hold the polyethylene spacer is attached to the top of the tibia. The metal tray is cemented into place. The plastic spacer is then attached to the metal tray of the tibial component. If this component wears out while the rest of the artificial knee is sound, it can be replaced.

Above- Placing the Patellar Component: A patella button is sometimes cemented into place behind the patella depending on the degree of arthritis.

The artificial knee replacement is now complete.

Closing the Incision:
Nylon stitches or absorbable stitches are used to close the skin. Nylon has withstood the test of time and is nearly as inert as stainless steel. It is strong and holds well until it is removed (somewhere between 10-14 days after surgery).

Components for Knee Replacement Surgery
Implant designs vary in important ways to meet specific patient needs. Restoration of normal knee joint function is the goal of knee replacement surgery. We select the implant based on the patient’s anatomy, degree of looseness of the knee, their range of motion and their planned sports activities.