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Knee Replacement

Clip Number: 5 of 7
Presentation: Knee Arthritis
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Reviewed By: Arthur Schoenstadt, MD
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After anesthesia is given, a tourniquet or blood pressure cuff will be wrapped around the thigh to temporarily stop the flow of blood to the knee.
To help reduce the chance of infection, the entire leg, from the hip to the toes will be scrubbed with a special soap, and will be covered with sterile sheets.
The doctor will begin by making an incision along the front of the knee. The joint is opened and the ends of the worn out bones are exposed. The ends of the shin bone and thigh bone and the undersurface of the kneecap are then removed using special cutting guides and saws.
For this procedure, a special implant, or artificial joint, is used to replace the knee. The thigh and shinbone parts of the implant will look something like this. The implants are made of metal, normally an alloy, which is a combination of several metals.
Most implant designs use a small, specialized plastic insert between the two metal parts, that acts as a weight-bearing surface for the joint. This helps it move smoothly, much like natural cartilage. It will look something like this.
Depending on the type of implant used, bone cement may be used to fix the implant components securely into place.
The doctor will then test the movement of the new joint to make sure it is properly lined up. Any deformity present before the procedure, is corrected as the artificial joint is inserted.
Often plastic drains will be placed from inside the joint to the outside of the skin. Their function is to drain the fluid that collects inside the joint for the first few days after the operation into a plastic container. The deep tissues are then closed with stitches that do not need to be removed. The body will naturally absorb them. The drain will be removed in 1-2 days.
The skin is then closed with stitches or staples, a bandage is applied and possibly a splint, and you are awakened from anesthesia.

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