TKR refers to the surgical procedure in which the damaged knee joint is replaced with implant. It is typically performed when the knee joint is severely damaged either by degenerative conditions such as Osteoarthritis, inflammatory joint conditions like Rheumatoid Arthritis, or by severe injuries leading to Post-Traumatic Arthritis.
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There are two scenarios in which you would require a knee replacement surgery. The first one is if you have sustained a severe knee injury. The second one is when the knee joint has been worn away by a degenerative condition such as osteoarthritis. For the second scenario, surgery is the last resort after all other treatment options (medications, physiotherapy, lifestyle changes) have already been exhausted. In such cases, patients typically go for surgery if they are experiencing the following symptoms:
Nevertheless, surgery is a big procedure and should be thoroughly discussed with your orthopaedic doctor before deciding on it. Your doctor will run a series of tests to assess the extent of your knee condition and explain the risks to you.
The ultimate goal of performing knee replacement surgery is to relieve pain and restore function.
If you have decided to have a knee replacement surgery, the doctor will discuss anaesthesia options with you (either general or spinal) and also run other tests to determine whether you have any other medical conditions that need to be optimized. Other things to expect are:
The patient is first given anesthesia (either general or spinal). After the anesthesia has taken effect, the skin around the knee is thoroughly scrubbed with an antiseptic fluid. The knee is bent about 90 degrees and the lower portion of the leg, including the foot, is placed in a special device to securely hold it in place during the surgery. Usually, a tourniquet is then applied to the upper portion of the leg to help slow the flow of blood during the surgery. An incision of appropriate size will then be made and the following steps will take place:
You can also refer to the video above for a more detailed overview of the surgery.
After surgery, you will be required to rest for several hours while the surgeon continues to periodically monitor your condition. The day after or the same afternoon if your surgery is done in the morning, you may be encouraged to engage in mild physical activity (e.g. standing and walking) with a physiotherapist. You will probably be discharged from the hospital in 2-3 days.
As for the recovery process, it will vary from person to person. In general, you can expect around 2 weeks for the surgical wound to heal. You may require the help of walking aids to get around for about 4 to 6 weeks.
During that time, attending physiotherapy sessions and doing knee exercises are highly recommended so that you can restore strength and mobility to your knees.
While the success rate for knee replacement surgery is high, you should still follow up with an orthopaedic clinic regularly so that your progress can be monitored and any complications can be dealt with swiftly.
Total knee replacement is generally a safe procedure. The risk of major complication after total knee replacement is <1%. After surgery, it is common to experience some pain, swelling, and stiffness – which can be easily treated with painkillers. Other potential complications include getting an infection after surgery or blood clots forming in the legs or lungs. Nevertheless, you can remain assured that your surgeon will take all the necessary precautions to reduce the risk of complications.
Dr Tan Sok Chuen is an orthopaedic surgery specialist with subspecialty training in hip and knee surgery – making her the first female hip and knee replacement surgeon in Singapore. She has trained and educated junior doctors through various teaching programmes and courses. Dr Tan has also made many contributions to the scientific literature on hip and knee arthroplasty and her publications on trunnionosis in hip replacements are frequently quoted in indexed journals.
Dr Adrian Lau is a specialist orthopaedic surgeon trained in primary and complex hip and knee arthroplasty. His clinical practice comprises mainly of total knee replacements, total hip replacements, complex hip and knee replacements, revision surgeries, prosthetic joint infections, and periprosthetic fractures. Dr Lau also plays an active role in the education and training of junior doctors and is a recipient of numerous awards, one of them being the Ministry of Health Training Award in 2014.
Certain Orthopaedic procedures done at our Clinic is claimable under Medisave and Integrated Shield Plans.
Our doctors are trained and highly experienced in diagnosing and treating orthopaedic conditions of the knee. We aim to provide you with quality care by thoroughly assessing your condition and personalising your treatments to your needs and goals.