What is knee replacement surgery?
Knee replacement surgery, also known as knee arthroplasty or knee joint replacement, is a procedure where damaged parts of the knee joint are removed and replaced with artificial components made of metal alloy, polymer (plastic), and ceramic, usually in combination. The typical lifespan of an artificial knee joint may be 20 years or more.
Penn Medicine’s Joint Replacement program consists of a team of experienced surgeons and providers that work together to ensure a comprehensive, seamless continuum of care for people undergoing knee replacement. We offer traditional, minimally invasive, and robotic knee replacement surgery, performed by expert surgeons who help shape joint replacement standards used around the world. With locations across the southeastern Pennsylvania and New Jersey regions, you can receive exceptional care close to home.
Types of knee replacement surgery
The knee has three compartments: the medial (inside), lateral (outside), and patellofemoral (front) areas. The type of knee replacement surgery recommended depends on the extent of damage to one or more of these areas.
Your surgery may be performed using conventional methods, minimally invasive techniques, or robotic technology. Your doctor will recommend the best surgical approach for you based on your health history and knee replacement requirements.
- Total knee replacement surgery: This procedure removes the entire knee joint and replaces it with an artificial joint. It’s typically recommended if your joint damage involves two or three compartments of the knee. Full knee replacement is the most commonly performed knee replacement procedure.
- Partial knee replacement surgery: This approach may be advised if damage to your knee is limited to one compartment only, allowing healthy areas to be preserved. This surgery works best for nondegenerative arthritis injuries (not primarily caused by wear and tear on the joints) and is typically reserved for younger, active people.
- Revision knee replacement surgery: A revision surgery removes some or all parts of a previous knee replacement implant and replaces them with new components. A revision may be needed if the implant loosens or fails over time or there is an infection in the existing artificial joint. It may also be recommended if there are fractures or trauma to the area, or if pain or poor function persists after the initial knee replacement.
Who is a candidate for knee replacement?
Knee replacement surgery is most commonly performed in individuals between 50 and 70 years old. Younger patients may put additional stress on the artificial knee, potentially leading to early wear and shorter lifespan of the implant, and therefore may be advised to consider delaying the procedure. However, there is no specific age that is universally right or wrong for knee replacement surgery.
If you’re struggling with significant knee pain that affects your daily activities and isn’t resolved with nonsurgical treatment options, you may be a candidate for surgery regardless of your age. We will meet with you to examine your knee and medical history, receive diagnostic imaging, and understand your current limitations. The goal of knee replacement surgery is to relieve pain and improve function. It’s commonly used to address one or more conditions:
- Arthritis or other degenerative joint disease
- Osteoarthritis
- Post-traumatic arthritis
- Rheumatoid arthritis
- Severe knee painor disability
- Bone tissue death caused by poor blood supply (avascular necrosis or osteonecrosis)
- Failed previous knee surgeries
- Fracture or injury
- Gout
- Congenital deformity
- Infection
What to expect from knee replacement surgery
During your knee replacement surgery, you should not feel pain because you will receive either general anesthesia, which puts you to sleep, or regional anesthesia, which numbs the lower half of your body. Pain levels during and after the surgery can vary based on the surgical approach, your individual pain tolerance, and your overall health. Your Penn Medicine care team will create a comprehensive pain management plan tailored to you.
It’s natural to feel a bit nervous about undergoing knee replacement surgery. Being proactive may make the process smoother and help you feel more confident, so take time to understand what’s involved in preparing for knee replacement surgery and knee replacement recovery.
Total knee replacement usually takes about one to two hours. During this procedure:
- Your surgeon will make an incision over the front of your knee before moving your kneecap (patella) out of the way to expose your knee joint.
- Damaged cartilage and bone are removed from the ends of your thigh bone (femur) and shin bone (tibia), and prosthetic components are attached to your bone surfaces.
- If necessary, your surgeon will reshape the undersurface of your patella before inserting a spacer between components to mimic the cushioning effect of natural cartilage.
- Your surgical team will check the range of motion and stability of the replacement joint and close the incision using stitches, staples, glue, or mesh.
Partial knee replacement usually takes about one to two hours. During this procedure:
- Your surgeon will make a smaller incision than with total knee replacement over the affected side of your knee so that only the damaged portion is exposed.
- Any damaged cartilage and bone will be removed from the affected areas of your femur and tibia, and prosthetic components will be attached to the prepared bone surfaces. A spacer may be placed between them to allow smooth movement.
- The stability and range of motion of the new partial joint will be checked before the incision is closed with stitches, staples, glue, or mesh.
Revision knee replacement surgery typically takes longer than the initial knee replacement surgery. You can expect revision surgery to last two to four hours. It may require specialized tools and implants that are larger than standard implants or specially designed for additional stability. During this procedure:
- Your surgeon will make an incision to access the knee joint.
- Your bone structure will be assessed and prepared for the new implant, removing any damaged bone or tissue and possibly reinforcing weak areas with bone grafts.
- The new prosthetic components will then be attached. Your surgeon may place a spacer between the new components to ensure smooth movement and proper alignment.
- The stability and range of motion of the repaired joint will be tested before closing the incision with stitches, staples, glue, or mesh.
Advanced knee replacement with a patient-centered approach
Although a common procedure, the decision to have a knee replacement is a very personal one and requires the right team of orthopaedic knee surgeons to get you back to your daily life. If you’re facing the possibility of knee replacement surgery, there are many reasons to choose Penn Orthopaedics for your care:
- Top surgeons with access to the latest research and technology who perform a large volume of joint replacements each year, using minimally invasive techniques whenever appropriate
- Education and support from highly skilled nurses and advanced practice providers, including the nurse navigator, who will serve as your go-to guides for everything from coordinating appointments and care to answering your questions throughout the process
- Convenient access to care, with multiple specialists often available within the same location
- Effective pain management that minimizes the risk of opioid overuse and addiction
- Same-day discharge option for motivated patients in good health with strong support at home
- Comprehensive rehabilitation after surgery to improve your physical function and quality of life
When creating your individual treatment plan, we encourage open communication and shared decision-making. We always explore conservative options first, but if nonsurgical treatments don’t bring needed relief, we’ll align a surgery and recovery plan to your lifestyle and goals. Our approach emphasizes safety and effectiveness, with a focus on the whole person to get you relief from pain.
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