Steps of the Total Knee Replacement Procedure begin with understanding that total knee replacement is a well-established surgical procedure performed to relieve chronic knee pain and restore mobility in individuals with advanced knee joint damage. In places like Kerala, many people consider total knee replacement when knee pain, stiffness, and reduced movement begin to interfere with daily activities such as walking, climbing stairs, working, or sleeping. Understanding the step-by-step process of total knee replacement helps patients feel informed, prepared, and confident before undergoing surgery.
Total knee replacement is not a single action but a carefully planned sequence of steps that begins with evaluation and continues through surgery, recovery, and long-term rehabilitation. Each stage is designed to improve joint function, reduce pain, and support long-lasting results.
Step 1: Identifying the Need for Total Knee Replacement
The process begins when knee pain becomes persistent and no longer responds adequately to non-surgical treatments such as medications, physiotherapy, injections, or activity modification. Symptoms often include constant pain, swelling, stiffness, deformity, and difficulty performing routine movements.
At this stage, total knee replacement is considered when knee joint damage significantly affects quality of life and daily independence.
Step 2: Detailed Clinical Evaluation
A thorough evaluation is essential before planning total knee replacement. This includes understanding the severity of pain, duration of symptoms, functional limitations, and previous treatments tried.
Patients are usually asked about walking ability, sleep disturbance due to pain, difficulty using stairs, and impact on work or household activities. This assessment helps confirm whether surgery is the most appropriate option.
Step 3: Medical History and General Health Assessment
Before proceeding, overall health is carefully reviewed. Conditions such as diabetes, high blood pressure, heart disease, or respiratory issues are assessed because they can influence surgical safety and recovery.
Current medications, allergies, and lifestyle factors such as smoking or physical activity levels are also reviewed to reduce risks and optimise outcomes.
Step 4: Imaging and Diagnostic Tests
X-rays of the knee joint are performed to evaluate the extent of cartilage loss, bone damage, joint alignment, and deformity. These images confirm the severity of arthritis and guide surgical planning.
Additional tests such as blood investigations or heart evaluations may be performed to ensure the body is fit for surgery.
Step 5: Pre-Surgical Planning
Once surgery is confirmed, detailed planning begins. This step involves deciding implant size, alignment goals, and surgical approach based on individual knee anatomy.
Careful planning ensures that the replaced knee functions smoothly, feels stable, and lasts longer.
Step 6: Pre-Operative Preparation
Patients receive instructions on preparing for surgery. This may include medication adjustments, fasting before surgery, and guidance on skin care to reduce infection risk.
Physical preparation may involve gentle exercises to strengthen muscles around the knee, which supports recovery after surgery.
Step 7: Admission on the Day of Surgery
On the day of total knee replacement, patients are admitted to the hospital and prepared for the procedure. Final checks are done to confirm the surgical site and readiness for surgery.
Anaesthesia is administered to ensure comfort throughout the operation.
Step 8: Anaesthesia Administration
Total knee replacement is usually performed under regional or general anaesthesia. This step ensures the patient does not feel pain during the procedure.
The type of anaesthesia is chosen based on health status and surgical requirements.
Step 9: Surgical Access to the Knee Joint
The procedure begins with careful exposure of the knee joint. Soft tissues are gently moved aside to allow access to damaged joint surfaces while preserving surrounding structures.
This step is performed with precision to minimise tissue trauma.
Step 10: Removal of Damaged Joint Surfaces
The damaged cartilage and a small amount of underlying bone from the thigh bone, shin bone, and kneecap are removed. These surfaces are the source of pain and stiffness.
Removing damaged tissue creates space for the artificial joint components.
Step 11: Bone Preparation and Alignment
The bones are shaped accurately to fit the artificial knee components. Proper alignment is crucial to ensure balanced movement, stability, and long-term durability of the implant.
This step directly influences how natural the knee feels after surgery.
Step 12: Placement of Artificial Knee Components
Artificial components made of metal and medical-grade plastic are placed on the prepared bone surfaces. These components replace the worn-out joint and create a smooth surface for movement.
The implant design allows bending, straightening, and weight-bearing with reduced pain.
Step 13: Balancing Ligaments and Soft Tissues
The ligaments and surrounding tissues are adjusted to ensure the knee moves smoothly and remains stable throughout its range of motion.
This step helps prevent stiffness, instability, or uneven wear of the implant.
Step 14: Trial Movement and Stability Check
Before final fixation, the knee is moved through bending and straightening to check alignment, stability, and movement quality.
Adjustments are made if needed to optimise function.
Step 15: Final Fixation of the Implant
Once alignment and balance are confirmed, the components are fixed securely to the bone. This ensures long-term stability and durability.
Step 16: Closure of the Surgical Site
After implant placement, the surgical site is closed carefully. Muscles and tissues are returned to their natural position, and the skin is closed with sutures or staples.
Proper closure supports healing and reduces infection risk.
Step 17: Immediate Post-Surgery Monitoring
After surgery, patients are monitored closely for pain control, circulation, and overall stability. Swelling and discomfort are expected and managed with appropriate care.
Step 18: Early Movement and Physiotherapy
Early movement is encouraged to prevent stiffness and support circulation. Physiotherapy usually begins within a short time after surgery.
Simple exercises help regain knee movement and muscle strength.
Step 19: Gradual Recovery and Rehabilitation
Rehabilitation continues over weeks to months. Exercises focus on improving flexibility, strength, balance, and walking ability.
Consistency during this phase plays a major role in long-term success.
Step 20: Follow-Up and Long-Term Care
Regular follow-up visits allow monitoring of healing, knee function, and implant performance. Activity levels are gradually increased as strength improves.
Most individuals experience significant pain relief and improved mobility over time.
Understanding the Step-by-Step Nature of Total Knee Replacement
Total knee replacement follows a structured pathway designed to restore knee function safely and effectively. Each step builds on the previous one, ensuring a smooth transition from pain and limitation to improved movement and stability.
Final Thoughts on Total Knee Replacement Procedure Steps
For individuals undergoing total knee replacement in Kerala, understanding each step of the procedure helps reduce anxiety and supports informed decision-making. Total knee replacement is a carefully planned process focused on relieving pain, restoring joint function, and improving quality of life. With proper preparation, precise surgical execution, and committed rehabilitation, many people achieve long-lasting relief and return to daily activities with improved comfort, stability, and confidence.
Frequently Asked Questions
1. What is total knee replacement surgery?
Total knee replacement is a surgical procedure that replaces damaged knee joint surfaces with artificial components to reduce pain and improve movement.
2. When is total knee replacement recommended?
Total knee replacement is recommended when severe knee pain, stiffness, or deformity does not improve with non-surgical treatments.
3. How long does the total knee replacement procedure take?
The surgical procedure usually takes about one to two hours, depending on the condition of the knee and surgical complexity.
4. Is total knee replacement a permanent solution?
Total knee replacement is designed to provide long-term pain relief and improved function, though implants may need revision after many years.
5. How long is hospital stay after total knee replacement?
Hospital stay is usually a few days, depending on recovery progress, pain control, and mobility.
6. When can walking begin after total knee replacement?
Walking usually begins within a short time after surgery with support and guided physiotherapy.
7. Is physiotherapy necessary after total knee replacement?
Yes, physiotherapy is essential to restore movement, strengthen muscles, and improve long-term knee function.
8. How long does recovery take after total knee replacement?
Initial recovery takes a few weeks, while full recovery and strength improvement may take several months.
9. Can normal daily activities be resumed after surgery?
Most patients return to routine daily activities gradually as strength and confidence improve.
10. How long does a knee replacement implant last?
Modern knee replacement implants can last many years with proper care, activity balance, and regular follow-up.
Total knee replacement surgery is a procedure in which damaged knee joint surfaces are replaced with artificial components to relieve pain and improve movement. Total Knee Replacement
Total knee replacement is suitable for individuals with severe knee pain, stiffness, and joint damage that no longer improves with medications, injections, or physiotherapy. Candidates
The cost of total knee replacement varies based on implant type, surgical technique, hospital stay, and rehabilitation requirements, so an individualized evaluation is essential. Cost
During a consultation, the orthopedic surgeon evaluates symptoms, knee function, X-ray/MRI reports, medical fitness, lifestyle needs, and treatment history to decide whether surgery is necessary — Consultation.
Patients should ask about the necessity of surgery, procedure details, implant type, benefits, risks, hospital stay, recovery time, rehabilitation, and long-term expectations — Questions to Ask.
Total knee replacement is generally safe and highly successful, though complications like infection, bleeding, blood clots, stiffness, or implant wear may rarely occur, which can be minimized with expert care — Risks and Safety.
Preparation includes medical evaluation, medication review, pre-surgery exercises, home planning, and understanding the procedure and recovery process. Preparation
Recovery typically includes pain control, early mobilization, physiotherapy, gradual strength improvement, and regular follow-up visits. Recovery
Most patients experience significant pain relief, improved knee function, better mobility, and enhanced quality of daily activities. Results
Before-and-after results often show reduced pain, improved joint alignment, increased walking ability, and better overall knee movement. Before-and-after
Choosing the right surgeon involves assessing experience, specialization in joint replacement, patient outcomes, and clear communication. Choosing the right surgeon