Total knee replacement (TKR) is a surgical procedure in which the damaged surfaces of the knee joint are removed and replaced with precision-engineered artificial components. It is one of the most commonly performed and well-studied orthopaedic procedures, offering reliable and durable relief from pain and functional limitation caused by advanced knee arthritis.
When is total knee replacement needed?
TKR is considered when knee arthritis or joint damage has progressed to the point where pain, stiffness, and loss of function significantly affects daily life, and non-surgical treatments — physiotherapy and weight management — have not provided adequate relief. Indications typically include persistent pain while walking or at rest, inability to climb stairs comfortably, sleep disturbance, difficulty standing from sitting position, and progressive deformity.
The decision is based on the full clinical picture — not on X-ray alone. Many patients with severe radiological changes may have manageable symptoms; others with moderate imaging findings have severe functional limitation. Both the patient and the surgeon weigh the totality of the presentation before recommending surgery.
What does the procedure involve?
In a total knee replacement, the surgeon removes the damaged bone and cartilage from the ends of the femur (thigh bone), tibia (shin bone), and in some cases the underside of the patella (kneecap). These surfaces are then resurfaced with metal and high-grade polyethylene components designed to replicate the smooth movement of a healthy knee joint.
The surgery is performed under regional or general anaesthesia and typically takes 60 to 90 minutes. Modern techniques like robotic assisted surgeries focus on soft tissue preservation, accurate alignment, and component sizing — all of which influence the long-term function and durability of the replacement.
Recovery and rehabilitation
Most patients begin standing and walking with minimal assistance on the day of surgery. Physiotherapy starts in the hospital and continues after discharge, progressing from early range-of-motion exercises to strengthening, balance, and functional walking. Return to routine activity typically occurs within weeks. The pace and extent of recovery depend on age, pre-operative fitness, and commitment to rehabilitation.
How long does a knee replacement last?
Modern knee replacement implants are designed to last 20 to 25 years or longer with technology assistance. Longevity is influenced by body weight, activity demands, implant positioning, bone quality, and follow-up care. Regular post-operative review with the surgeon allows early identification of any changes.
Written by Dr Shrishti Patil, MS Ortho, Consultant Orthopaedic and Robotic Joint Replacement Surgeon, SPARSH Hospital, Hennur Road, Bengaluru.
To book a consultation with Dr Shrishti Patil at SPARSH Hospital, Hennur Road, Bengaluru, visit linqmd.com/doctors/dr-shrishti-patil-joint-replacement-surgeon-hennur-bengaluru
