MYTHS and FACTS About Pathophysiology Of Total Knee Replacement Surgery

What is the pathophysiology of total knee replacement surgery?? Here I will give you a brief idea, that makes you understand the process clearly.

So keep reading this article. It will be highly informative. People after a certain age suffer from severe arthritis, or osteoarthritis, gout, or knee joint pain. Sometimes doctors prescribe them to do joint replacement surgery as a permanent solution.90% joint replacement surgery is successful in India. Now I am going to discuss it in detail.

What is Total Knee Replacement Surgery?? Pathophysiology of Total Knee Replacement

Knee replacement is also known as total knee replacement or knee arthroplasty. The Knee replacement surgery Reconstruct a  knee damaged by arthritis or Osteoarthritis. End of the bone capped by plastic or metal material. This surgery is applicable to the patient who is suffering from a Knee injury and severe arthritis.

Different type of arthritis is there to damage your knee joint. One of them is Osteoarthritis, majorly middle-aged, or older women suffering from Osteoarthritis, which is a degenerative joint problem.

Osteoarthritis damage the joint cartilage and surrounded bone of the Knee.

The second is Rheumatoid Arthritis. That causes  Inflammation of the synovial membrane and consequently increases the synovial fluid membrane fluid, which leads to stiffness and severe pain.

Third Is Traumatic arthritis or arthritis due to injury, that damages the Knee bone cartilage.

The main perspective of Knee replacement surgery is to resurface the damaged part of the knee. And get relieved from pain, Which cannot be managed by medicine, physiotherapy, and other treatment…

Anatomy of Human Knee

The Joint is the connection of two bones. In normal human joints are mobile, which gives us the flexibility of movement. The knee joint is mainly the connection of two long leg bones. These two long bones are connected with the help of muscle,  tendon, and ligament. Each bone is protected by cartilage, that absorbs any kind of shock and protects our knee.

Basically, there are two types of muscle

  1. Quadriceps muscle- This category of muscle strengthens our legs.
  2. Hamstring muscle-located behind the thigh, bend the leg at the knee.
  3. also read,

The tendon is the collection of hard connective tissue and the tendon connects the bone and tissue. Ligaments are also a collection of elastic tissue that connects two bones. Gives stability to our knee and protects our knee joint.

They consist of different parts

Tibia- Large bone of the lower leg


Patella- Knee cap

Cartilage- Band of tissue that covers the bone of the joint.

Synovial membrane-Synovial membrane secrets synovial fluid, that gives joint mobility and flexibility.

Ligament- this is a  hard, elastic tissue, that surrounded our joint area, and gives support for the movement.

Tendon-tendon, muscle tissue, that controls the directional movement of the joint.

Meniscus-Meniscus or knee cap acts as a shock absorber.

Why do Doctors Recommend Knee Replacement Surgery??

In an emergency, when knee pain is severe, the patient is suffering from arthritis or osteoarthritis, the Knee joint part is damaged, the doctor recommends Knee replacement surgery.

Osteoarthritis is actually damaging to joint cartilage. So, That cannot give the flexibility of the movement, which causes pain. Patients with severe degenerative joint tissue cannot lead a normal life, regular activities get interrupted. They can not bend their leg, and cannot walk, and climb stairs. As movement becomes so painful.

Rheumatoid arthritis is the reason for chronic Knee pain, and severe knee joint damage. RA or Rheumatoid arthritis may lead to degenerative tissue damage.

Again, there is a lot more disease, where the doctor recommends you to do Knee replacement surgery.

Apart from surgery doctor also advise you of some medications


Weight loss, and management of weight

Take the help of a cane during walking, and avoid severe exercise.

The doctor may prescribe You Anti-inflammatory, pain killer medicine.

Pain relief Cortisone injection into your Knee joint

Lubricant injected Into your joint, to make joint movement less painful, and more flexible.

There is some risk of this  surgery procedure

Few complications of any surgical procedure are common. Some possible complications are

  • Continued pain and stiffness
  • Infection and bleeding
  • Blood Clot in leg

As we all Know surgery is a complicated process, there will be fewer risks, but don’t worry about that. An experienced surgeon can provide you with the best treatment with the best rehabilitation process.

So, ask your doctor about your doubt. Cure procedure. And the doctor will explain to you the whole procedure. That opens up your mind and gives you mental clarity.

This Knee replacement surgery may be complicated, but it will give the patient a permanent solution, with a new life.

So go for a routine check-up, and stay stress-free, If doctors recommend you for surgery.

Pathophysiology of Knee replacement surgery
Source: Pixabay free image

Knee Replacement Surgery, Recovery Time, Risks & Exercises

In this article, I’m going to give you a clear understanding of knee replacement surgery. After reading this article you will gain an overall knowledge on what to do and what not in time of your knee surgery. As per the research report published in the year 2019, a total of 82% of people who attempted knee surgery are still functioning properly even after 25 years.

The maximum number of people who successfully replaced the knee generally leads to a higher quality of life, better mobility, and lesser pain. A successful total knee replacement can improve your symptoms of arthritis. Nowadays, knee replacement surgery has become very common in almost every hospital. Annually, surgeons perform more than 600000 total knee replacements in the US. So let us start with a brief overview about it-

Overview of Knee Replacement Surgery:

Knee replacement surgery is also known as Total Knee Arthroplasty. Generally, the surgery involves replacing the knee joint with a prosthetic device. The device carries out the same functions as an original knee of a person. Additionally, it helps you to restore all the normal functions in sternly injured or diseased joints.

Surgical Procedure of Knee Replacement:

The overall procedure of Knee Replacement involves separating the damaged part of bone and cartilage from your shinbone, thighbone, and kneecap and replacing it with a prosthesis or artificial joint made of high-grade plastics, metal alloys, and polymers. An orthopaedic surgeon always assesses the motion of range, strength, and stability of your knee before determining whether a knee replacement is right for you or not. Additionally, your doctor can use X-rays to find out the extent of the damage.

Also, your doctor can choose from different knee surgical techniques, replacement prostheses considering your activity level, weight, age, knee shape and size, and overall health. The truth about knee replacement surgery is it is relatively safe and well if you don’t have any other health complications.

Types of Knee Replacement Surgery:

Mainly, there are two different kinds of knee surgery. The first one is total knee replacement surgery and the second one is partial or half knee replacement surgery. Firstly, total knee replacement surgery means replacing both sides of your knee. Secondly, partial or half knee replacement surgery means only a single side of your knee joint is replaced. Partial or half knee replacement surgery is very much like a smaller operation, including less time of hospital stay and period of recovery.

However, there are other surgery options too,such as arthroscopic washout and debridement, osteotomy, mosaicplasty and so more. These surgeries are not as good as the upper mentioned surgeries and not good for the long run. You should only follow these surgeries when your doctor prescribes them to you.

Firstly, in the case of arthroscopic washout and debridement, a small telescope is inserted into the knee. Then, it uses saline to clear any bits of cartilage or bone. In addition, in Osteotomy, the surgeon separates the shinbone and realigns it. With that, your damaged knee doesn’t have to carry your weight. Lastly, in the case of mosaicplasty, a plug of hard cartilage is transferred, including some underlying bone from another part of your knee in order to repair your damaged surface.


Reason for Knee Replacement Surgery:

You may need knee replacement surgery when the joint in your knee is worn or damaged. This surgery is suggested by doctors when you are in immense knee pain and on verge of losing your mobility. The most common reasons for adopting this knee replacement surgery are osteoarthritis. However, there are other health conditions too, where you may need the surgery such as-

  • Haemophilia
  • Rheumatoid arthritis
  • Gout
  • Bone death in the joint of the knee following problems related to the blood supply
  • Disorders that may cause unnatural growth of bone
  • Injury in knee
  • Deformity of the knee, including loss of cartilage and immense pain

These are the most common reasons for having knee replacement surgery. Now the question is, “Who may offer the knee replacement surgery?” and the answer is it depends on your test results and your health condition.

A knee replacement is a very serious and major surgery that is only recommended to the patient only when other options like steroids, physiotherapy are failing to improve the pain and mobility. Your doctor may offer you the option of surgery when –

  • You have swelling, severe pain, and stiffness in your knee joint and you start to reduce your mobility
  • You have difficulty doing regular households and other daily stuff such as getting out of the bath or shopping and things are getting difficult to impossible
  • You started to lose your social life

Apart from this, you also need to be well and fit to deal with both major surgery and post-surgery rehabilitation.

Signs and Symptoms of Total Knee Replacement:

In below, I mention about 5 most important symptoms and signs of needing a knee replacement-

When you have crucial and severe arthritis:

Most of the patients who are offered knee replacement surgery are either suffering from rheumatoid arthritis, osteoarthritis, an autoimmune condition causing joint pain, wear and tear type of arthritis, or post-injury arthritis.

Ineffectiveness of non-surgical treatments:

If you have knee arthritis, then your doctor will probably start your treatment with more conservative measures like steroid injections, medications, physical therapy, and others. However, at some point when these measures don’t work on your body then the doctor may suggest knee replacement surgery to you.

You suffer from immense knee pain doing regular households, normal day-to-day activities, or caring for yourself:

When you can’t get relief from other treatments, then your knee pain can start to feel worse. Even, when you are resting your knee can pain badly. This thing can get only worse if you don’t take any action. In this situation, a knee replacement surgery can be the best for you and your knee.

Your knee is swollen always:

If your knee is consistently swollen in spite of having all the physical therapies, anti-inflammatory medications, steroid injections then it is time for you to have a knee replacement.

Your knee has become malformed:

In the last and critical stage of knee arthritis, your knee can get malformed which can badly affect your walking. This can also lead to other health-related problems. In this situation, you are also suggested to go through a total knee replacement surgery.

Apart from all these symptoms, people can also go for knee replacement surgery when they are old and can’t walk properly or when they are suffering from severe knee damage due to any kind of accident.

Recovery Time:

It will take 4 to 8 weeks to get fully recovered after having a total knee replacement surgery. You need to spend your time in rehab in order to strengthen your knee and muscles which help you to regain your movement.

Side Effects of Knee Replacement:

Most of the time, a knee replacement surgery is safe but it has some side effects such as bone fracture, stiffness, pain, dislocation of bone, wound infection, and pulmonary embolism. In addition, you may also notice blood clots in your body in the deep veins of the leg. This situation is called Deep Vein Thrombosis or DVT. Additionally, you can also notice swollenness in your knee area. You should take proper care of yourself post-surgery to avoid any kind of risk.

Things needed for fast recovery after Knee Surgery:

After knee replacement surgery, your doctor may provide you knee brace. Try to wear it as much as possible. However, there are some additional significant things you have to follow for fast recovery after knee surgery. This may sound comfortable or not but you should keep your knee straight after surgery and don’t walk too much on the first few days.

Additionally, you should follow regular appropriate exercises for removing the complexity and improving your overall physical health. Also, you can do swimming, thigh, squeezing, straight leg raises, lying kicks, sitting kicks, chair pushups, cycling, walking, bending and stretching, and other moderate exercises. However, you should follow your exercise routine as prescribed by your doctor.

In addition, you can also follow some physical therapies under the supervision of a certified physical therapist. You need to follow all of this for better and faster recovery. Additionally, physical therapy is the best way to get relief from knee pain after Knee Replacement Surgery. Total knee replacement recovery time can extend from 6 weeks to months. Y

You can start your physical therapies after 24 hours of surgery. However, it takes 1 year or more to disappear the swelling of your knee. Lastly, you need to follow total knee replacement post-operation care very strictly for the sake of your health.

Total Knee Replacement Surgery Time:

Generally, total knee replacement surgery takes 60 to 90 minutes. However, the patient should expect to be in the operation theatre for an extra 2 hours.  On the other hand, partial knee replacement surgery recovery takes lesser time than total knee replacement surgery. In addition, patients recover fast in case of partial knee replacement surgery.

Knee Replacement Lifespan:

In 90% of cases, knee joints last about 20 years after total knee replacement. Also, some reports have mentioned that in some cases, knee replacement can last up to 30 years.

Top 10 Knee Replacement Surgeons in India:

Here is the list of best knee replacement surgeons in India-

Dr. Ashoke Rajgopal

Education: FRCS, FIMSA, M.Ch.Orth, MBBS

Hospital: Medanta Hospital Gurgaon

Experience: 33 years


Dr. IPS Oberoi

Education: Me(Orth), Mch Orh

Hospital: Artemis Hospital Gurgaon

Experience: 26 Years


Dr. S K S Marya

Education:  M.B.B.S, M.S. (Orthopaedics), DNB (Orthopaedics), M.Ch. (Orthopaedics)

Hospital: Medanta Hospital Gurgaon

Experience: 35 Years


Dr. Rakesh Mahajan

Education:  M.B.B.S, D. Ortho, MS

Hospital: BLK Hospital Delhi

Experience: 28 Years


Dr. Pradeep Sharma

Education:  M.B.B.S, MS, MCh, Fellowship

Hospital: Indian Spine Institute Center Delhi

Experience: 40 Years


Dr. Vikram I Shah

Education:  M.B.B.S, MS, FAOAA from Switzerland and FASIF from Germany

Hospital: Shalby Hospital, Ahmedabad

Experience: 24 Years


Dr. Prakash M Doshi

Education:  M.B.B.S, MS- Orthopaedics, Diploma in Orthopaedics

Hospital: Nanavati Hospital, Mumbai

Experience: 41 Years


Dr. (Prof) Pradeep Bhosale

Education:  M.B.B.S, MS- Orthopaedics

Hospital: Nanavati Hospital, Mumbai

Experience: 35 Years


Dr. Krishnamoorty K

Education:  M.B.B.S, Diploma in Orthopaedics, DNB- Orthopaedics/ Orthopaedic Surgery

Hospital: Apollo Hospital Chennai

Experience: 22 Years


Dr. Santosh Kumar Hakkalamani

Education:  M.B.B.S, MS- Orthopaedics, MRCS (UK), FRCS- Trauma & Orthopedic Surgery

Hospital: BGS Gleneagles Global Hospital, Bangalore

Experience: 18 Years


Best hospital for Knee Replacement Surgery in India:

Top hospitals for knee replacement surgery in India are mentioned below-

Fortis Hospital, Mumbai

Location: Fortis Hospital, Mulund Goregaon Link Road, Mulund-West, Mumbai 400078

Nanavati Hospital, Mumbai

Location: Swami Vivekanand Road, LIC Colony, Suresh Colony, Mumbai 400056

BLK Super Speciality Hospital, Delhi

Location: BLK Super Speciality Hospital, Pusa Road, Rajinder Nagar, New Delhi, Delhi 110005

Indraprastha Apollo Hospital, Delhi

Location: Indraprastha Apollo Hospitals, Delhi Mathura Road, Near Jasola Apollo Metro Station, Sarita Vihar

Medanta The Medicity, Delhi

Location: E-18, Defense Colony, New Delhi, Delhi, 110024, India

MANIPAL Hospital, Bangalore

Now you know about all the best doctors and hospitals for knee replacement surgery. So, let us move forward.

Questions to ask before Knee Replacement Surgery-minQuestions to ask before Knee Replacement Surgery:

You should be more careful before going for knee replacement surgery. You should ask questions to your doctor for safety and security purposes such as what are the risks of total knee replacement surgery, what are the complications. You also need to know about what kind of implant will be used on you and what is exactly happening during a knee replacement surgery. In addition, you also ask your doctor about the level f pain you have to endure and how much time it will take for recovery.

Reviews on knee replacement surgery are pretty good. Most of the patients claim that they have had successful surgery and live a happy life. On the other hand, 1 % of people claim that they developed a post-surgery infection. Additionally, less than 2 % of people develop blood clots. Apart from all this, knee replacement surgery is safe and best for your arthritis.

So, here I close my article. I hope I’ve delivered all of the important things related to knee replacement surgery. In conclusion, I just want to say that if you have any suggestions, then please share them with me. I’ll try to come with more information in the future. Till then, take care of your health and stay healthy.

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