When Is Total Knee Replacement Indicated?
The decision to proceed with knee replacement is based on a combination of symptoms, functional limitation, radiographic findings, and the failure of non-surgical management. It is not a decision made lightly, and surgery is not offered until conservative treatments have been exhausted.
- Osteoarthritis — degeneration of articular cartilage across multiple compartments, causing bone-on-bone contact, deformity, and significant pain
- Rheumatoid arthritis and inflammatory arthropathy — where joint destruction has occurred despite optimal medical management
- Post-traumatic arthritis — arthritis developing as a consequence of previous fracture or significant injury
- Severe functional limitation — inability to walk comfortable distances, climb stairs, or manage basic daily activities
- Inadequate response to conservative care — including physiotherapy, weight management, anti-inflammatory medication, and intra-articular injections
The Procedure
During total knee replacement, the worn cartilage and bone surfaces of the femur, tibia, and patella are precisely resurfaced and replaced with metal and polyethylene components that recreate the smooth mechanics of a healthy knee. The operation is performed under general or spinal anaesthesia and typically takes one and a half to two hours.
Femoral Component
A metal alloy component resurfaces the end of the femur, replicating the rounded shape of the femoral condyles.
Tibial Component
A flat metal tray fixed to the cut tibial surface, with a highly cross-linked polyethylene liner that bears against the femoral component.
Patellar Component
A polyethylene button may be cemented to the back of the patella to resurface the kneecap and improve patellofemoral tracking.
Recovery & Outcomes
Physiotherapy begins on the day of or day after surgery, with walking aids used initially. Hospital stay is typically three to five days. A structured rehabilitation programme is essential to achieving the best outcome.
Weeks 1–6
Walking frame or crutches, exercises to restore knee flexion, wound management, and DVT prophylaxis. Driving typically avoided for six weeks.
Weeks 6–12
Walking without aids, progressive return to daily activities, swimming, and stationary cycling. Knee swelling gradually subsides.
3–12 Months
Continued strengthening, improved endurance, and return to recreational activities. Full recovery of strength and function may take up to 12 months.
Patient satisfaction following total knee replacement is high, with over 90% of patients reporting significant improvement in pain and function. Modern implants are designed to last 15–20 years or more in the majority of patients.
Discuss Knee Replacement
For a personalised assessment and treatment plan, contact Dr. Pirpiris’s rooms at Cabrini Medical Centre, Malvern.
📞 Call 03 9508 9600