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Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.

Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly.

Knee replacement surgery can be performed as a partial or a total knee replacement.In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.

The operation involves substantial postoperative pain, and includes vigorous physical rehabilitation. The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient’s return to preoperative mobility

In total knee replacement surgery, the damaged bone surfaces and cartilage are removed and replaced with artificial surfaces made of metal and a plastic material. These surfaces are called “implants” or “prostheses” and restore the alignment and function of your knee.

Typically, a total knee replacement takes about two hours. For a complete overview of this procedure, please see the illustrated piece on Total Knee Replacement.

You will be admitted to the hospital on the day of your scheduled surgery. You will be asked to arrive to the hospital two hours before the start of your surgery. After admission, you will move into the pre-operative area where you will be evaluated by an anesthesiologist. The most common type of anesthesia is general, in which you are given anesthesia through an intravenous (IV) drip that keeps you asleep for the entire surgery. Your anesthesiologist also may offer you an epidural or spinal injection or a combination of the above. You will discuss this with your anesthesiologist prior to your surgery.

Computer Assisted Surgery:Our experts are trained in computer-assisted orthopedic surgery, which uses special cameras and intra-operative imaging tools that project images of the area being operated onto a television screen. On-screen prompts help guide surgeons to the ideal alignment of the implant and provide real-time vision of the surgical site. High-precision alignment may extend the long-term survival of the implanted artificial hip or knee, thus reducing the need for future corrective surgeries. UCSF Medical Center surgeons are currently involved in studying these new technologies to determine their impact on total knee replacement.

Knee Replacement Procedure:The procedure of knee replacement surgery involves removal of the damaged bone of the knee joint and replacement with prosthesis or an artificial joint made of metal alloys, high grade plastics and polymers.

During the surgery, the knee is kept in bent position so that the surface of the knee is fully exposed. An incision of 6-12 inches is made after which the muscles, kneecap and connective tissues are moved aside to expose the damaged joint surface. After smoothening the bone’s rough surface, the prosthesis is inserted.

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