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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.

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Things 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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