Knee replacement surgery steps and success rate

Knee replacement surgery is one of the most successful surgical procedures in improving the quality of life for patients suffering from chronic pain or joint degeneration in the knee. If you're considering undergoing this surgery or seeking answers to questions about its success rate and the lifespan of the artificial joint, you're in the right place! In this article, we will uncover everything you need to know about knee replacement surgery, from its impressive success rate to the expected lifespan of the artificial joint. Continue reading to learn how to achieve the best outcomes from this surgery and how to care for your new knee to ensure it lasts as long as possible.

What is a Hip Replacement?

A hip replacement is a surgical procedure where a damaged or worn-out hip joint is replaced with an artificial joint (prosthesis). This surgery is typically performed to relieve pain and improve mobility, helping patients regain their ability to perform daily activities.

How Long Does the Hip Replacement Surgery Take?

The surgery typically takes between 60 to 90 minutes, depending on the type of prosthesis used and the patient's overall health. In more complicated cases, such as severe bone wear, the surgery may take longer to rebuild the affected bone areas.

What is the Lifespan of an Artificial Hip Joint?

Generally, artificial hip joints can last from 15 years or more. Studies show that about 90% of hip replacements remain in good condition after 15 years. However, the lifespan depends largely on how well the joint is cared for and avoiding excessive load or strain.

Types of Artificial Joints:

Knee Replacement Prosthesis:
The artificial knee joint is the most common and is used when the knee cartilage is severely damaged or worn out due to arthritis or significant injury.

Main Types:
- Total Knee Replacement (TKR): All parts of the joint, including the upper leg bone and lower bone, are replaced.
- Partial Knee Replacement: Only the affected part of the knee joint is replaced.
Advantages:
- Significant pain relief.
- Improves mobility and restores quality of life.
Disadvantages:
- May require extensive physical therapy post-surgery.
- Some patients may experience difficulty adjusting to the new joint.

Knee Replacement Joint Problems:

Artificial Joint Infection:
Infection is one of the most serious complications that can occur after knee replacement surgery. It can develop from weeks after the surgery or even years later.

Symptoms:
- Severe pain around the knee.
- Redness and swelling.
- High fever.
- Difficulty moving the knee.
Causes:
- Bacterial infection during or after surgery.
- Contamination that spreads to the prosthesis.
Treatment:
- Mild infections are treated with antibiotics.
- Severe infections may require surgery to remove or replace the prosthesis.
Wear and Tear of the Artificial Joint:
Over time, wear occurs due to continuous friction between the artificial parts of the joint.

Symptoms:
- Continuous knee pain.
- Difficulty in movement or walking.
- Reduced ability to perform daily activities.
Causes:
- Continuous use of the joint.
- Excess weight or intense physical activity.
Treatment:
- Physical therapy or pain medications may reduce symptoms.
- If wear continues, joint replacement may be necessary.
Implant Misalignment:
Misalignment of the prosthesis components can occur during surgery or over time, leading to movement issues in the knee.

Symptoms:
- Severe pain when walking or standing.
- Creaking or clicking sounds during knee movement.
- Difficulty in bending or straightening the knee.
Causes:
- Incorrect alignment during surgery.
- Damage to surrounding tissues affecting the stability of the joint.
Treatment:
- Surgical adjustment to realign the joint.
- In some cases, the joint may need to be replaced.
Deep Vein Thrombosis (DVT):
Blood clots are a common complication after surgery and can lead to serious health issues if not addressed promptly.

Symptoms:
- Pain or swelling in the leg.
- Redness or warmth in the affected area.
- Difficulty breathing if the clot travels to the lungs (pulmonary embolism).
Causes:
- Limited movement after surgery.
- Risk factors like obesity or previous clotting disorders.
Treatment:
- Blood-thinning medications like heparin are used to prevent clot formation.
- Early physical therapy to improve blood circulation and reduce clotting risk.
Periprosthetic Osteolysis:
This is an inflammation of the tissues surrounding the artificial joint, often caused by the body’s reaction to the materials used in the prosthesis.

Symptoms:
- Persistent pain around the joint.
- Weakening of the bones surrounding the joint.
- Difficulty in movement.
Causes:
- Friction between the prosthetic parts releases small particles that can trigger an immune response.
Treatment:
- Surgery may be needed to remove contaminated parts or replace the joint.
- In some cases, bone-strengthening treatments may be necessary.

6. Ligament or Tendon Tears Around the Prosthetic Joint

After knee replacement surgery, the ligaments or tendons supporting the artificial joint may be affected, leading to tears or injuries.

Symptoms:

Severe pain in the knee.
Difficulty in bearing weight or moving normally.
A feeling of abnormal stability in the knee.

Causes:

Improper healing of the ligaments post-surgery.
Weak muscles around the joint.

Treatment:

Surgery may be required to repair the damaged ligaments or tendons.

7. Early Failure of the Prosthetic Joint

In some cases, the prosthetic joint may fail shortly after surgery, requiring replacement or repair.

Symptoms:

Persistent knee pain.
Difficulty walking or performing daily activities.
Knee swelling or a feeling of instability.

Causes:

Poor quality of the materials used in the prosthetic joint.
Problems with alignment or fixation during surgery.

Treatment:

Early failure may require full joint replacement.

How is the Prosthetic Joint Fixed in the Knee?

Bone Preparation:
- Removing damaged tissue: Cartilage and diseased tissue are removed from the knee joint.
- Shaping the bones: Special tools are used to shape the bones so they fit the prosthetic parts.
Choosing the Right Prosthesis:
The artificial joint consists of three main parts: the femoral cap, the tibial component, and the support.
Fixing the Prosthetic Parts:
- Cemented fixation: The joint is fixed with special surgical cement.
- Uncemented fixation: The prosthesis is fixed using techniques that allow bone growth into the joint.
Checking Alignment:
After fixing the parts, the alignment is checked to ensure smooth movement.
Closing the Incision and Post-Surgery Exercise:
The incision is closed, and the patient begins exercises and physical therapy to improve knee movement.

Complications of Knee Replacement Surgery:

Infection:
Description: Infection is one of the most serious complications after knee replacement surgery. It can affect the incision or the prosthetic joint.

Symptoms:
- Swelling, redness, and severe pain around the knee.
- Fever or purulent discharge from the incision.
Risks:
- Infection can destroy the prosthetic joint or necessitate its removal and replacement.
Treatment:
- Mild infections are treated with antibiotics.
- Severe infections may require surgical intervention to remove the prosthetic joint.
Deep Vein Thrombosis (DVT):
Description: Blood clots in the deep veins of the leg are a common complication after surgery due to reduced movement.

Symptoms:
- Pain or swelling in the leg.
- Redness or warmth in the affected area.
Risks:
- If the clot travels to the lungs, it can cause a life-threatening condition known as pulmonary embolism.
Treatment:
- Anticoagulant medications such as heparin to prevent clot formation.
- Early physical therapy to stimulate circulation and reduce clotting risk.
Dislocation or Loosening of the Prosthesis:
Description: Over time, the prosthetic joint may become misaligned or lose stability, causing pain and difficulty moving.

Symptoms:
- Sudden pain and difficulty moving the knee.
- Misalignment or dislocation of the joint.
Risks:
- Surgery may be required to re-align the joint or even replace it.
Treatment:
- If the prosthesis is unstable, surgery may be needed to adjust its alignment or replace it entirely.
Chronic Swelling:
Description: Normal swelling can occur after surgery, but in some cases, it may persist for a long period.

Symptoms:
- Persistent swelling in the knee or leg with difficulty in moving the knee.
Risks:
- Chronic swelling may indicate infection or failure to stabilize the prosthesis.
Treatment:
- Ice, rest, and anti-inflammatory medications.
- In severe cases, a doctor’s visit is required.
Bone Fractures:
Description: Bone fractures around the prosthetic joint may occur due to excessive pressure or improper movement.

Symptoms:
- Severe knee pain.
- Difficulty in moving the knee.
Risks:
- Additional surgery may be required to repair the fracture and re-stabilize the joint.
Treatment:
- Fractured bones are typically fixed using supports or surgery to place stabilizing systems.
Ligament or Tendon Rupture:
Description: Ligaments or tendons around the knee may become stressed or torn due to improper movements post-surgery.

Symptoms:
- Sudden knee pain.
- Difficulty bearing weight or moving the knee normally.
Risks:
- Ligament rupture can lead to knee instability and loss of function.
Treatment:
- Surgery may be required to repair the damaged ligaments or tendons.
Wear and Tear of the Prosthetic Joint:
Description: Prosthetic joints may experience wear over time due to continuous friction between metal and plastic components.

Symptoms:
- Knee pain.
- Difficulty moving the knee.
Risks:
- The prosthesis may need to be replaced after some time.
Treatment:
- If wear continues, prosthetic joint replacement may be necessary or adjustments to worn parts.
Nerve Damage:
Description: Nerves around the knee may be irritated or damaged during surgery, leading to sensory or motor issues.

Symptoms:
- Numbness or muscle weakness.
- Difficulty moving the knee.
Risks:
- Nerve damage may lead to long-term complications with movement or sensation.
Treatment:
- In some cases, symptoms may improve over time.
- If the damage persists, physical therapy or surgery to repair nerves may be required.
Wound Healing Issues or Abnormal Scarring:
Description: The incision may not heal properly, or abnormal, raised scars may form.

Symptoms:
- Persistent redness at the incision site.
- Formation of abnormal scars.
Risks:
- Delayed recovery or complications like infection.
Treatment:
- Close medical monitoring and proper wound care.
- Scar-reducing creams may be used.
Functional Impairment of the Prosthetic Joint:
Description: The artificial joint may not function as expected due to alignment issues or improper fixation.

Symptoms:

Difficulty moving the knee.
Discomfort or weakness in supporting the body.

Risks:

Reevaluation or corrective surgery may be required to adjust the joint.

Treatment:

Regular follow-up care, and in some cases, corrective surgery.

Post-Knee Replacement Tips:

Rest and Physical Rest:
- Rest during the early days after surgery to reduce swelling. Elevating the leg can help with circulation.
- Avoid overexertion in the early days, and do not put full weight on the new knee.
Physical Therapy and Rehabilitation:
- Early exercises will help improve movement and strength in the knee.
- Perform regular exercises to stabilize and strengthen muscles around the joint.
Pain and Swelling Control:
- Pain relief medications may be prescribed by your doctor.
- Use ice to reduce swelling, but avoid direct skin contact by using a cloth barrier.
Infection Prevention:
- Keep the wound clean and follow your doctor’s instructions for wound care.
- Be alert for signs of infection such as redness or fever.
Proper Diet:
- Eat foods rich in protein, vitamins, and minerals like vitamin D and calcium to support bone health.
Avoid Stressful Movements:
- Avoid excessive knee bending or activities that put pressure on the joint during the early recovery period.
Monitor Swelling or Pain:
- Persistent or increasing swelling and pain should be evaluated by your doctor.
Regular Follow-up Appointments:
- Ensure you attend follow-up appointments to monitor healing progress and check the alignment of the joint.
Weight Management:
- Maintain a healthy weight to reduce pressure on the prosthetic joint.
Gradual Return to Daily Activities:

Gradually return to normal activities based on your doctor’s advice, with focus on light physical activity and proper rehabilitation.

Rehabilitation Stages After Knee Prosthesis Surgery:

Day of Surgery:
- Rest with leg elevation, ice packs, and simple foot movements to stimulate circulation.
First Day After Surgery:
- Removal of the bandage and the beginning of gentle rehabilitation exercises.
Days 2–5:
- Focus on movement exercises and muscle strengthening.
- Begin walking with partial weight-bearing.
Sixth Day After Surgery:
- Safe walking with crutches or a walker.
- Ongoing physical therapy.
Day 6–13:
- Home rehabilitation with regular follow-ups to ensure proper execution of exercises.
Day 14 (First Medical Checkup):
- First follow-up visit with the doctor for wound examination and joint function assessment.
Weeks 4–6:
- Full weight-bearing on the prosthesis.
- Gradual abandonment of crutches.
Weeks 6–12:
- Intensive strengthening and flexibility exercises.
- Most patients can achieve 130–135° knee flexion.
Return to Normal Activities:
- Patients begin returning to their normal routines, such as walking, climbing stairs, and performing daily tasks.