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Preparing for Total Knee Replacement Surgery

An integrated team approach to caring for patients at the comprehensive Joint Replacement Center leads to improved outcomes, faster recovery, and high patient satisfaction.

Types of Procedures - A patient's particular type of arthritis and the location of the arthritis in the knee joint can determine the type of knee replacement surgery performed. With a number of different approaches to knee replacement surgery available, the surgeon and patient determine the most appropriate approach for the patient's condition. Knee replacement procedures performed by surgeons at Maine Medical Center's Joint Replacement Center include:

Total knee replacement: During total knee replacement surgery, also called total knee arthroplasty, arthritic bone is removed from the lower end of the thigh bone-the femur-resurfaced and replaced with a metal implant. Arthritic bone is also removed from the upper end of the shin bone, or tibia, and the area is resurfaced before a metal and plastic or total plastic implant is added. Arthritic areas of the knee cap are also resurfaced in most cases. The procedure is typically performed in the operating room in approximately two hours. Partial knee replacement: Patients with osteoarthritis of the knee on the inside or the outside of the leg who do not need a total knee replacement may undergo a partial knee replacement, also known as unicompartmental knee replacement. This procedure provides patients that are appropriate candidates with a less invasive operation than a total knee replacementwith a more normal-feeling knee. Patellofemoral knee replacement: Patients who have damage to their patellofemoral joint-the kneecap- that causes ongoing pain and loss of function may undergo a patellofemoral knee replacement to improve their ambulation and discomfort. This is also a type of partial knee replacement.

Medical Advancements - Ongoing advances in knee replacement surgical techniques and components are providing patients at the Joint Replacement Center with the latest options when choosing to undergo knee replacement surgery.

Gender-Specific Knee Rplacement: For patients with certain boney anatomy, a gender-specific knee replacement may be the most appropriate choice. Women, in particular, may benefit from this type of femoral component, as the surgeon prefers. Implanting a gender-specific knee replacement in some cases may deliver an improved fit over a traditional replacement joint. Choosing to use a gender-specific joint depends on the anatomy of the patient's bone, the angle of the quadriceps in relation to the femoral component, and the surgeon's preference.

Small-Incision Knee Replacement Approaches: Surgeons at the Joint Replacement Center use a variety of small-incision knee replacement approaches, including:

- mini-incision quadriceps approach: a less invasive quadriceps approach
- midvastus approach: avoids cutting tendon and reduces bleeding
- subvastus/quadriceps-sparing approach: the knee cap is shifted to the side, allowing the surgeon to cut arthritic bone in a step-wise fashion and implant a new joint without cutting the quadriceps tendon
- cruciate-retaining approach: the posterior cruciate ligament is left in place during joint implantation

These less invasive surgical approaches to knee replacement surgery allow the surgeon to minimize irritation of the quadriceps muscle and tendons. Patients who undergo a less invasive procedure may have a shorter hospital stay, experience a faster recovery and return of strength following the operation, and return to daily activities sooner. Many of these patients are able to walk without a walker or cane within several weeks of their procedure.

To assist you in your surgery planning here is a patient pre-operative readiness checklist, and has information about preparing to return home after your joint replacement surgery.

Transitioning to Home
Patients undergoing knee replacement surgery at the Joint Replacement Center are typically in the hospital for two to three days. The surgeon determines the length of stay based on the needs of the patient. Most patients go directly home to recover and are not admitted to a rehabilitation facility.

Returning to Normal Activities - During the recovery and rehabilitation process, joint pain and stiffness improve, allowing patients to gradually return to normal activities, with some restrictions on high-impact activities. Most knee replacement patients are able to walk with a cane within four to six weeks of surgery and may return to driving about the same time, with their surgeon's approval.

Patient Education - Educating our patients prior to surgery is a shared priority of our interdisciplinary team. Below, please find a downloadable patient education document related to total knee replacement surgery.

Frequently Asked Questions - Total Knee Replacement

Click here for an online interactive education program for total knee replacement surgery