Total Knee Replacement
What is Total Knee Replacement?
Total knee replacement (TKR), also known as total knee arthroplasty, is the definitive treatment for end-stage knee arthritis that has failed non-operative management. The damaged joint surfaces are resurfaced with metal and polyethylene components, restoring a smooth, pain-free articulation. TKR is one of the most successful and satisfying operations in modern orthopaedic surgery, reliably relieving pain and restoring function in the vast majority of patients.
Robotic-Assisted Surgery and Functional Alignment
One of the most important advances in modern knee replacement is robotic-assisted surgery. Combined with the concept of functional alignment, this technology allows the procedure to be tailored to the individual patient’s anatomy rather than following a one-size-fits-all mechanical alignment philosophy.
Traditional “mechanical alignment” aims to make every knee neutral regardless of the patient’s native anatomy. However, we now understand that most healthy knees are not neutrally aligned, and forcing every replacement into neutral alignment can alter soft tissue balance, change the natural feel of the knee and contribute to the 15–20% rate of dissatisfaction historically reported after TKR.
Functional alignment, delivered through robotic-assisted surgery, takes a different approach. The implants are positioned to respect the patient’s native ligament balance and bony anatomy within defined safe boundaries, resulting in a more natural feel and improved function.
Who is suitable?
Total knee replacement is indicated for:
Dr Stoita will review your symptoms, activity goals, and any existing imaging. A detailed clinical examination is performed to confirm the diagnosis and discuss whether this procedure is the right option for you.
Initial visitX-rays, MRI or other imaging may be used to confirm the diagnosis and assess the extent of the condition. In complex cases, 3D computerised modelling may be used to assist with surgical planning.
Pre-surgeryThe procedure is performed under anaesthesia using the most appropriate surgical technique for your condition. Dr Stoita uses minimally invasive approaches where possible to reduce recovery time and optimise outcomes.
Day of procedureFocus is on pain and swelling control, gentle range of motion exercises and walking with assistance.
Progression to full weight bearing without aids, working toward achieving 0–120 degrees of knee motion.
Return to most activities of daily living and driving is generally expected during this phase.
Gradual return to low-impact activities and gentle sport as strength and confidence build.
Frequently Asked Questions (FAQ)
In a total knee replacement, the entire knee joint surface is replaced – the ends of the femur (thigh bone), tibia (shin bone), and usually the underside of the kneecap are all resurfaced with artificial components. In a partial knee replacement (PKR), also called unicompartmental knee replacement, only the damaged compartment of the knee is replaced, leaving healthy bone, cartilage, and ligaments intact.
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Although knee arthritis can affect anyone, there are several factors that can increase the risk of arthritis:
- Genetic predisposition
- Previous knee injury or surgery
- Other joint conditions such as rheumatoid arthritis or gout
- Occupations involving heavy manual work
- Age (over 40)
- Female gender
- Being overweight or obese
- Participation in high impact activities or sports (e.g. running, soccer or rugby)
Knee arthritis typically develops as a result of progressive cartilage wear within the joint. This process may occur naturally with age or be accelerated by factors such as previous injury, altered joint alignment, or increased mechanical load.
In some cases, inflammatory conditions such as rheumatoid arthritis can also contribute to joint degeneration.
