Arthritis Home > Knee Replacement Surgery

Many people who are about to have surgery for knee replacement are curious about how the procedure is done. During the surgery, a worn-out knee joint is replaced with an artificial one. In most cases, the artificial joint is made up of two metal parts with a plastic insert between them. Before the surgery is over, your healthcare provider will make sure that the knee is aligned correctly and has the proper range of motion.

What Happens During Knee Replacement Surgery?

After the anesthesia is given, a catheter (thin tube) may be inserted into your bladder. This prevents your bladder from becoming too full during or shortly after your knee replacement surgery.
 
A tourniquet or blood pressure cuff will then be wrapped around your thigh to temporarily stop the flow of blood to your knee. This allows your doctor to see the surgical area clearly.
 
To help reduce the chance of infection, your entire leg, from your hip to your toes, will be scrubbed with a special soap, and you will be covered with sterile sheets. The only area exposed will be the site where the knee replacement surgery is being performed.
 
Your healthcare provider will begin by making an incision along the front of your knee. The joint is opened, and the ends of your worn-out bones are exposed. The ends of the shinbone and thighbone and the undersurface of the kneecap are then removed using special cutting guides and saws.
 
The metal implant pieces are then selected and cemented into place at the end of the thighbone and the shinbone. A piece of plastic is cemented to the undersurface of the kneecap, and another piece of plastic is attached to the metal of the shinbone to bear weight in the new joint.
 
Your doctor will then test the movement of the new joint to make sure it is properly lined up. If you have a significant deformity present before the knee replacement surgery, this is corrected as the artificial joint is inserted.
 
In many cases, 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 surgery into a plastic container. The deep tissues are then closed with stitches that do not need to be removed. Your body will naturally absorb them.
 
Your skin is then closed with stitches or staples, a bandage is applied, and possibly a splint, and you are awakened from anesthesia. The drain will be removed in one to two days.
 
Although you will be awakened in the operating room, many people do not remember anything until they get to the recovery room. This is a normal effect if general anesthesia is used for the surgery.
 
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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