Total knee replacement surgery is commonly indicated for severe osteoarthritis of the knee. The general goal of total knee replacement surgery is to relieve pain and restore the alignment and function of your knee.

Your doctor may advise total knee replacement if you have:

• Severe knee pain which limits your daily activities (such as walking, getting up from a chair or climbing stairs), occurs at rest, or disturbs sleep.
• Failure to obtain pain relief from medications, injections, physical therapy, or other conservative treatments.
• A severe knee deformity which prevents acceptable function.

The surgery is performed under spinal or general anaesthesia. Your surgeon will make an incision at the front of the affected knee to expose the knee joint. The damaged portions of the femur and tibia are cut at appropriate angles using specialized jigs. The femoral and tibial components are attached to the bones with or without bone cement. Your surgeon will place a plastic piece between the metal implants to provide a smooth gliding surface for movement. A plastic patellar component is an optional part of the procedure. With all the new components in place, the knee joint is tested through its range of motion. The joint is then irrigated and cleaned with a sterile solution. The incision is carefully closed, and a local anaesthetic and painkillers are injected directly into all tissues that have been released and repaired. In this way pain control after knee arthroplasty has become very effective, and the need for intravenous opiates or long admissions in hospital is much reduced.

Rehabilitation begins immediately following the surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement. You will be able to walk with crutches or a walker. Your physical therapist will provide you with a home exercise program and make regular appointments to guide you through the process.

As with any major surgery, there are potential risks associated with total knee replacement surgery and these include:

• Infection 1-2%
• Blood clots (deep vein thrombosis)
• Nerve and blood vessel damage
• Ligament injuries
• Instability
• Knee stiffness
• Wear and loosening of the implant, requiring revision procedures. This risk is higher with knee arthroplasty at younger ages.

If you lose sleep or find difficulty in performing simple activities such as walking or climbing stairs because of your severe arthritic knee pain, then total knee replacement may be an option for you. It has become a safe and effective procedure to relieve pain and help you resume your normal activities of daily living.