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Total Knee Replacement: TKR Explained
A total knee replacement (TKR) is a surgical procedure in which a damaged knee joint is replaced with an artificial implant. It relieves pain and restores mobility in patients with severe knee arthritis.
Add as Preferred SourceThings worth knowing about "Knee TKR"
A total knee replacement (TKR) is a surgical procedure in which a damaged knee joint is replaced with an artificial implant. It relieves pain and restores mobility in patients with severe knee arthritis.
What is a Total Knee Replacement?
A total knee replacement (TKR), also called total knee arthroplasty (TKA), is a surgical procedure in which the damaged surfaces of the knee joint are replaced with artificial components made of metal, plastic, and/or ceramic. It is one of the most commonly performed orthopedic surgeries worldwide and is primarily indicated for advanced knee osteoarthritis (gonarthrosis).
Indications (When is a Total Knee Replacement Performed?)
A TKR is recommended when conservative treatments such as physiotherapy, pain medications, or joint injections no longer provide sufficient relief. Common indications include:
- Advanced gonarthrosis (knee joint degeneration)
- Rheumatoid arthritis with severe joint destruction
- Significant knee joint damage following injury
- Persistent severe pain and considerably limited range of motion
- Significantly reduced quality of life despite conservative therapy
Components and Materials
A total knee replacement typically consists of three components:
- Femoral component: A metal cap fitted over the lower end of the thighbone (femur).
- Tibial component: A metal tray with a plastic (polyethylene) insert anchored to the shinbone (tibia).
- Patellar component (optional): A plastic button that may be attached to the back of the kneecap (patella).
Surgical Procedure
The operation is performed under general or spinal anesthesia and typically takes 1 to 2 hours. The surgeon removes damaged cartilage and bone, then secures the prosthetic components using bone cement or through cementless fixation (bone in-growth). Modern minimally invasive techniques allow for smaller incisions and faster recovery.
Rehabilitation and Aftercare
Rehabilitation is a key factor in achieving a successful outcome. Physiotherapy and walking exercises typically begin on the first or second day after surgery. The typical phases of aftercare include:
- In-hospital phase: 5 to 10 days of inpatient care
- Inpatient rehabilitation: 3 to 4 weeks at a rehabilitation facility
- Outpatient physiotherapy: Several weeks to months following discharge
Full recovery and optimal function are typically achieved within 3 to 6 months, and sometimes up to one year after surgery.
Benefits and Risks
Total knee replacement achieves excellent results in most cases: over 90% of patients report significant pain reduction and improved quality of life. Modern implants often last 15 to 20 years or longer. However, as with any surgical procedure, risks exist:
- Infection (including late-onset infection)
- Deep vein thrombosis or pulmonary embolism
- Implant loosening or failure
- Wound healing complications
- Nerve or blood vessel injury
- Persistent pain or limited range of motion (rare)
References
- Carr AJ et al. - Knee replacement. Lancet. 2012;379(9823):1331-1340. DOI: 10.1016/S0140-6736(11)60752-6.
- National Institute for Health and Care Excellence (NICE): Knee replacement - Guidance. www.nice.org.uk (accessed 2024).
- Bourne RB et al. - Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clinical Orthopaedics and Related Research. 2010;468(1):57-63.
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