Up to three bone surfaces may be replaced during a total knee replacement – the lower end of the femur, the top surface of the tibia and the back surface of the patella. The end of the femur is replaced with a metal component that curves around the end of the bone and has an interior groove so the kneecap can move up and down smoothly against the bone as the knee bends and straightens. The tibia is replaced with a flat, metal platform with a plastic cushion for the femur to articulate against, and the patella is replaced with a dome-shaped piece of plastic which replicates the shape of the patella.

During a total knee replacement, the knee is placed in a bent position so the entire surface to be replaced is exposed. Typically, an incision is made lengthwise over the front of the knee, or just to the inside of the kneecap. The quadriceps muscles and patella are then moved to the side to access the bone. The rough edges of the bones are smoothed and the femur is trimmed to fit inside the prosthesis. The tibia is then cut flat across the bone and a portion of the bone’s center is drilled out. Once the prostheses are inserted, they are tested and balanced to ensure the joint is in the right place and the patella is accurately aligned for proper joint movement.

According to the American Academy of Orthopedic Surgeons, more than 581,000 total knee replacements are performed in the United States each year. If you have the following symptoms, a total knee replacement may be an option to discuss with your doctor:

• severe knee pain limits your everyday activities such as walking
• climbing stairs or getting out of a chair
• moderate to severe knee pain while resting
• chronic knee inflammation
• swelling that does not improve with rest or medications
• knee stiffness make it impossible to bend or straighten.

This process typically begins with a referral by your doctor to an orthopedic surgeon for an evaluation.

At The Christ Hospital we have developed an advanced strategy for pain control that includes the use of a “pain cocktail” and a peripheral nerve block. We have found this approach to be very beneficial, as it markedly reduces or eliminates your need for intravenous or oral narcotics to control pain after your joint replacement. By reducing your pain and the use of narcotics after surgery, we are able to reduce your length of stay and improve the overall quality of your recovery.

To learn more about the peripheral nerve block and how your pain is controlled after a total knee replacement, click on the video type you would like to watch below.

To learn more about preparing for your total knee replacement, click on the video type you would like to watch below.