Total Knee Replacement Surgery (Knee Arthroplasty)
Home > Condition & Treatment Map > Knee Conditions & Treatments > Total Knee Replacement: Handbook & Pathway
If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down. If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgeries is a safe and effective procedure to relieve pain, correct leg deformity, and will help you resume normal activities.
Left: Normal Knee.
Right: Total Knee Replacement - The arthritic cartilage and underlying bone has been removed and resurfaced with metal implants on the femur and tibia, and a plastic spacer between them.
Total Knee Replacement Pre-Operative Preparation
Our surgeons routinely involve a specialist physician in the care of patients undergoing total joint replacement procedures. This will typically involve a referral to them, and in many cases a pre-operative assessment for medical optimisation. This may involve blood tests, medication reviews or further investigations as necessary to make your surgery as smooth as possible.
Our orthopaedic surgeons recommend patients stay as fit as possible pre-operatively and utilise non-impact activities for strengthening their muscles prior to surgery. This improves patients’ rehabilitation afterward and speeds up their recovery. Typical activities involve quadriceps strengthening activities, hydrotherapy, and cycling.
Diet + Nutrition
To optimise your rehabilitation, it is advisable to consume a high protein, healthy diet prior to surgery, so that your body is in good shape to recover from your surgery. It is also advisable to have Vitamin D and Calcium supplementation prior to surgery, as most patients’ dietary intakes are inadequate.
It is also advisable to stop smoking at least 2-3 weeks prior to smoking.
It is very important that if you have any injuries, rashes, abrasions, or are otherwise unwell that you contact us prior to your admission. Read More
Discover Comprehensive Total Knee Replacement Treatment Options in Melbourne
Knee injuries can occur at any age to anyone. However, here at Victorian Bone and Joint Specialists, we're here to assist you in your journey to wellness. Our specialists are trained in the latest surgical innovations and will endeavour to ensure your ease and comfort.
Knee surgery can seem like a daunting option, but we offer an end-to-end service, starting with booking an appointment with our friendly receptionist and finishing with postoperative care and rehabilitation. Our team at Victorian Bone and Joint Specialists are all fellowship-certified sub-specialists which means we are fully equipped to deliver sophisticated expertise and better outcomes for orthopaedic problems.
Choosing the Right Total Knee Replacement Surgeon
Why choose Victorian Bone and Joint Specialists for total knee replacement surgery?
If you're looking for knee replacement options in the Melbourne area, look no further. We've scored five-star reviews across the board on Google, with our clients being assured that 'I certainly feel that I am in the right hands'. Our specialists are 'knowledgeable and accommodating', meaning our services are 'fully recommended for quality patient service and excellence'.
Our focus on new and industry-leading innovation and patient care ensures that we can provide exemplary service to each and every client. Before your surgery, our knee surgeon will talk you through the process and predicted outcomes, ensuring that you are fully informed. After your surgery, we can provide all the support and advice required to make a seamless recovery.
We Offer a Range of Total Knee Replacement Surgery Options
Take back freedom of movement with Victorian Bone and Joint Specialists, regardless of the condition.
One of the most popular treatments we offer is total knee arthroplasty surgery. Total knee arthroplasty surgery, also known as Total Knee Replacement surgery (TKR), is a proven and reliably effective solution for knee pain and limited physical mobility. The highly precise and meticulously performed procedure will restore the natural movement and function of the knee - eliminating pain and discomfort along the way. Knee Arthroplasty surgery technology continues to develop, allowing surgery to become more accessible and comfortable than ever before.
In sum, you get rid of persistent knee pain with this tried-and-true procedure. By replacing the joint in question with an artificial implant, mobility is restored while alleviating pain and discomfort. Thousands of total knee replacements are carried out each year, making it a popular choice for those suffering from knee pain.
Another treatment that we are highly qualified to deliver is total knee reconstruction surgery. Knee reconstruction refers to reconstruction of the ligaments of the knee, rather than replacing the whole knee joint. Our specialists complete this treatment regularly, ensuring that our clients enjoy the shortest possible recovery times and the most competitive prices.
Finally, our expertise extends to less invasive interventions tailored to individual conditions, such as knee arthroscopic surgery. This advanced procedure enables our skilled specialists to precisely examine and address knee issues, providing a minimally invasive alternative to extensive knee reconstruction. Opting for knee arthroscopic surgery presents the advantage of shorter recovery times and more cost-effective options, all while maintaining the highest standard of care.
For more information, visit our full list of Conditions and Treatments.
If you have any questions or would like to discover more about our knee treatment services, please email us at admin@vbjs.com.au or phone (03) 5752 5020. We look forward to hearing from you.
Read LessWhat to Expect During Your Total Knee Replacement Surgery
Day of Surgery
You will be advised of the time of your admission by the hospital and VBJS staff prior to your procedure. It is important that you arrive punctually to ensure that your total knee replacement (TKR) or total knee arthroplasty surgical procedures is not delayed. You should have filled out your admission information online prior to attending the clinic or hospital.
You will be admitted to the clinic or hospital and placed into a gown, and a surgical pre-wash of your leg is conducted with antiseptic solution.
You will be taken to an anaesthetic holding bay by an orderly, where you will meet your surgeon, anaesthetist, surgical assistant, and anaesthetic nurse, who will check you into theatre. A drip/cannula will be placed into your arm at this stage. From there you will normally proceed into theatre after a short wait.
Typically, once in theatre you will be given an anaesthetic, normally a combination of a spinal anaesthetic and general anaesthetic is used. The spinal anaesthetic makes you numb from the waist down and it avoids the use of strong pain killers which can lead to nausea and vomiting after the procedure. It is similar to an epidural that is used during childbirth, and it lasts several hours. If this is used sedation is used so that you are not aware of what is occurring during the surgery, and you will not have any memory of the procedure. This will be discussed with your anaesthetist prior to the procedure.
Immediate Post Operative Period
You will normally remember ‘waking up’ in the recovery area, here you are monitored by an anaesthetic nurse after your procedure to ensure that your pain is well managed, that your vital signs are stable, and that you are safe to return to the ward. Often you may have no recollection of this due to medications which are given.
You will have a dressing on your hip, and you will have a drip in your arm. You will also likely have an oxygen mask on your face which assists with your breathing, you will be attached to various monitors to measure things like your heart rate, temperature, and blood pressure.
Total Knee Replacement Post Operative Care Procedure
Pain Relief
If you had a spinal anaesthetic, your leg may be numb for 3-6 hours, and you may not have any feeling in your legs and be unable to move your feet. Although you may not be having much pain, start taking your pain medication 6 hours after surgery.
Icing
Bowel and Bladder Function
It is important that regular medications are given to soften bowel contents and typically coloxyl and senna is given or Movicol daily for the first two weeks, as the pain medications can reduce bowel function post operatively. It is also important to eat a high fibre, high protein diet to assist with bowel function.
Blood Tests and X-Rays
You will undergo x-rays after the procedure on Day 1 to check the alignment of your hip. You may also undergo blood tests depending upon your physician and surgeon.
Robotic Assisted Knee Replacement
Our surgeons routinely use robotics for knee replacement surgery, using either a NAVIO™ or MAKO™ system, paired with tried and tested high performance implants on the Australian National Joint Registry. Using robotic assistance, a 3D model is generated of the knee, then simulations are performed to optimise the component position and sizes, then the robot is used to precisely place and verify the components to ensure that the plan exactly matches what is performed. If any fine tuning is required, this can be performed with robotic assistance to ensure accuracy.
Total Revision Knee Replacement Surgery Recovery
After your total knee replacement operation you will spend time in the recovery room, where you will be closely monitored before being transferred back to your room. You will have a large amount of local anaesthetic injected at the time of operation around your knee joint, as well as a local anaesthetic catheter so most patients are very comfortable post operatively.
You will be able to get up from Day 1 with the use of crutches for balance and start walking on your new knee with the guidance of our physiotherapy team. Some discomfort is to be expected during the first week or two, and this will settle gradually over time. We will review you at two weeks to check your wounds and monitor your rehabilitation. In most cases by week 4-6 patients are comfortable walking unassisted with the use of crutches. Normally by 12 weeks patients are significantly improved and well on the way to full recovery. An exercise bike is recommended from 2 weeks post operatively and hydrotherapy from 4 weeks post operatively. Patients continue to improve with strength, walking and balance up to 1-year post surgery.
Total knee replacement treatment in over 90% of cases gives a dramatic reduction in pain and significant improvement in the ability to perform tasks of daily life. Realistic activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports. With appropriate activity modification, knee replacements can last for many years.
Driving
You may not drive at least until your post-op visit when your surgeon can make a decision regarding this, this is based upon your pain, medications, leg strength and also which leg has been operated on. Typically it takes 4-6 weeks after a right total knee replacement and 2 weeks following a left total knee replacement surgery.
Physiotherapy
You will be seen on the wards twice daily by the physiotherapy team. They will help you with:
Getting in and out of bed
Using crutches
Helping you with walking and gait retraining
You can arrange to be seen by PT within the first week of discharge from surgery. You will continue therapy, with specific therapist instructions, at the first post-operative visit. You may wish to set up an appointment with physiotherapy in advance (2-3 sessions/week).
Rehabilitation
Most patients do not need to go to an inpatient rehabilitation facility following a knee replacement. Inpatient rehabilitation is reserved for patients who live alone, or those who have complex medical conditions which require monitoring. Rehabilitation physiotherapy services can be arranged at home for you, where a physiotherapist visits your home on a daily basis.
Home Modifications/Assistive Devices
Shower: a plastic shower stool/chair may be useful
Toilet: an over toilet frame may be useful, especially if you have a low toilet
Mats: consider removing rugs/loose floor coverings to prevent tripping hazards
Bed: low mattresses are best avoided as these can be difficult to get off
Kitchen: everyday items should be in easy reach to prevent stretching and reaching overhead
Room: consider moving furniture so that easy access in and out of rooms can be achieved
Grasper: this can be very useful for getting things off the floor
Nutrition for Recovery
Nutrition management is a critical part of your surgical recovery. Protein and essential amino acids are vital to healing your tissues and muscles and expediting your recovery. Protein is mainly found in meat, chicken, fish, eggs, dairy, legumes, and other vegetarian and vegan alternatives. Protein spread throughout the day is best for your surgical recovery, and you should aim to consume this 2-3 times per day during your recovery.
Calcium and vitamin D are also recommended to promote bone health and growth following your procedure. Most adults in Australia are vitamin D deficient, and therefore it is recommended to start calcium and vitamin D several weeks prior to your procedure, as this has been shown to be beneficial to your health and recovery. Vitamin D is naturally generated from sunlight exposure, and it is also present in oily fish, fortified foods, mushrooms, and egg yolks.
What to Report Immediately
Signs and symptoms to report:
- persistent fever
- wound redness, drainage, or increased skin temperature around the incision
- increasing numbness
- sudden increase in pain or swelling
- deep calf pain and/or swelling
- shortness of breath
If you have any problems please call Victorian Bone and Joint Specialists on 57525020 or 1300 266 366.
You should have a post-op appointment scheduled in 14 days. If you do not, please call 5752 5020 to schedule an appointment.
Expectations from Total Knee Replacement Surgery
Improvement of knee motion and pain relief is the goal of total knee replacement. The rehabilitation and full recovery after a knee replacement can take many months, with most patients showing continued improvement to 12 months post op. Most patients can expect to be able to fully straighten the replaced knee and to bend the knee sufficiently to climb stairs and get in and out of a car. Kneeling is sometimes uncomfortable, but it is not harmful.
Most people also feel or hear some clicking of the metal and plastic with knee bending or walking. This is normal. These differences often diminish with time and most patients find them to be tolerable when compared with the pain and limited function they experienced prior to surgery.
Some patients who have undergone a knee replacement will have ongoing swelling on their knee, this is not uncommon, and this does not mean anything bad is occurring. This should be discussed with your surgeon if you are worried.
Risks and Complications on Your Knee Joint
Total or partial Knee replacement surgery overall is highly effective and rarely has complications. Our surgeons take extensive precautions to prevent complications at every step of your journey, however, complications can still occur with any surgery. Your surgeon will get you to see a specialist physician prior to your knee replacement surgery in Melbourne to optimize your overall medical condition and prevent medical complications.
Risks related to knee replacement surgery include:
Wear of the Knee Replacement: over time and with use the plastic part of the knee replacement can wear out, similarly to the tyres on a car and may need to be changed. With modern plastics this is a rare occurrence.
Loosening: over time the knee replacement may come loose and need to be exchanged, the rate of this with modern prostheses is very low, and we would expect at least 15-20yrs before this occurs.
Infection: Infection may occur in the wound or deep around the prosthesis, this even occur years later. Minor infections in the wound area are generally treated with antibiotics. Major or deep infections may require more surgery. Any infection in your body can spread to your joint replacement. Our surgeons give all patients antibiotics before and during the operation to prevent infections occurring.
Blood clots (DVT): Blood clots in the leg veins can be life-threatening if they break free and travel to your lungs. Dr Slattery utilizes a range of preventative measures to stop these occurring which include medications, compression stockings, pneumatic compression devices, and early mobilization.
Stiffness: scarring occurs around any place that you undergo surgery, in the knee this scarring causes stiffness and prevents it bending properly. It is essential to move your knee early and take sufficient painkillers to allow you to perform your range of exercises daily. If stiffness is an ongoing problem sometimes further surgery is required to remove the scar tissue.
Continued Pain: A small number of patients continue to have pain after a knee replacement. This complication is rare, however, and the vast majority of patients experience excellent pain relief following knee replacement.
Nerve/Blood Vessel Damage: While extremely rare, injury to the nerves or blood vessels around the knee can occur during surgery.
Swelling: some patients can get recurrent swelling in the knee, this can be due to a variety of causes, but normally settles over time.
FAQs
Am I too young for knee replacement surgery?
Knee replacements have been shown to wear out at a faster in younger patients, this is due to the higher physical demands younger people place on their knees. Typically, candidates for total knee replacement surgery are aged over 50yrs.
When can I walk after a knee replacement?
Full weight-bearing and walking is allowed immediately after total knee replacement. Initially, this will be aided by crutches. We get all patients mobilising Day 1 after their operation on crutches.
When can I drive after knee replacement?
You should not drive for at least 48 hours after an anaesthetic. After 48 hours, your ability to drive will depend on the side you had your operation, left or right, the type of vehicle you drive, manual or automatic and what type of pain relief you are taking. It is generally reasonable to drive when you are confident with walking and can fully weight-bear on your affected side. The usual recommendation is 6 weeks.
When can I work after knee replacement?
Your return to work will vary depending on the type of work you are engaged in. Most people can return to office work within 4-6 weeks. More strenuous manual work may require 3-6 months before returning to duties.
When can I play sports after knee replacement?
Low impact activities, such as cycling (exercise bike) and hydrotherapy, can be commenced from week 2. Walking for exercise can be commenced from week 6. More strenuous activities such as tennis takes 3-4 months. Note, this is highly variable and intended as a rough guide only.
How long will I take to heal after knee replacement?
The wounds take 7-10 days to heal. Most patients improve dramatically in the first 6-12 weeks. Occasionally, there are periods where the knee may become sore and then settle again. The knee may be swollen for some time post-surgery. This is part of the normal healing process. Continued improvements may be gained up to 1-year post-surgery.
How much pain will I experience after knee replacement?
Some discomfort is to be expected after major knee surgery. A local anaesthetic is injected around the wound during the procedure and a local anaesthetic catheter is placed in the wound after the procedure to minimise any pain you may experience. Knee replacements can be quite uncomfortable initially, and it is important to stay on top of your pain with medications to allow you to do your exercises and physiotherapy.
Will I beep going through metal detectors at airports?
Maybe. It depends upon the settings of the metal detector in use, some countries have higher sensitivities than others, so whilst you may not set them off in Australia you may do so overseas. Normally it is not an issue if you tell them in advance you have had a knee replacement.
My knee clunks and clicks – is that normal?
Knee clicking/clunking is normal after total knee replacement. As the implant is made of metal and plastic it is not as tight a fit as your native knee, and there is a small amount of movement between the components which gives rise to the clunking, this is completely normal, and patients usually ignore it over time.
How long will my knee replacement last?
Based upon current data, the duration your knee replacement will last is predominantly due to your age when it is inserted, due to wearing out of the plastic liner over time. The rate of having your knee replacement revised (exchanged/re operated) on at 20 years is approximately 11%.
