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Scott Martin, Orthopedic Surgery, answeredDuring total knee replacement surgery, the surgeon first cuts away thin slices of bone with damaged cartilage from the end of the femur and the top of the tibia, making sure that the bones are cut to precisely fit the shape of the replacement pieces. The metal prosthesis is applied to the cut ends of the bone using cement, with plastic in between. The artificial joint is attached to the bones with cement or screws. A small plastic piece goes on the back of the kneecap (patella) to ride smoothly over the other parts of the artificial joint when you bend your knee.
Discovery Health answered
You and your orthopedic surgeon have prepared for this day- the day of your total knee replacement surgery. You've had a physical. You're blood has been analyzed. Your surgeon has pinpointed the location of damage in your knee thanks to X-rays. And you've chosen the type of anesthesia you wish to use-general, spinal or epidermal. Whether you are conscious or not during the procedure you will be hooked up to heart leads and monitors will register your heart rate and your oxygen level. Here is what happens now.
During the surgery the knee will be stabilized in a bent position enabling the surgeon to see the joint in as much detail as possible. The region will be scrubbed with an antiseptic and a tourniquet may be placed strategically above the knee to reduce blood loss. An incision from 6 to 12 inches (15 to 30 centimeters) in length will be made.
Once the kneecap is delicately placed to the side, the surgeon will focus on the removal of damaged bone tissue, all the while paying particular attention to leaving a sufficient amount of bone in place so that the implant may be attached. If this is the first total knee replacement, the surgeon will ensure enough bone remains intact should another surgery be required when this implant deteriorates in a decade or so.
Typically, to allow the implant to fit properly, bone is cut away at the end of the femur, in addition to the front and back sides of the bone end. Bone is slashed at the tip of the tibia, flattening the end. Damaged bone tissue on the back of the patella is also cut away. Measurements of the bones are taken and the artificial implant is put in place when everything is ready for fitting.
The implant is attached and to maximize function of the prosthesis, the surgeon may adjust the alignment of the ligaments. The surgeon will now repair tissue that was moved during the procedure and sews it back into place. Before closing the incision, a tube may be inserted to drain excess fluid from the knee. The final stitches are complete and the entire procedure took about two hours.
Simple physical therapy exercises will be next to help your leg heal.