Total knee replacement surgery FAQs
Dr Edward Graham
MBBS FRACS (Orth)
02 9679 7088
Lakeview Private Hospital Orthopaedics
Lakeview Private Hospital
Suite 1, 17-19 Solent Circuit.
Bella Vista NSW 2153
1. Do I need the surgery?
Knee replacement is an elective procedure. I am not in the habit of convincing patients to have surgery; every surgery has risk. The time to have the procedure is when you are convinced it’s necessary.
2. Will I be awake?
I like to leave this decision up to the anaesthetist. The real question being asked is “Will I be aware and will I be in pain?” Patients will be monitored constantly. The anaesthetist will be present and providing specialist care during the entire procedure. Patients will come to a pre-operative clinic and see the anaesthetist, physiotherapist and rehabilitation team. They will have pre-operative investigations such as bloodwork, chest x-ray, ECG and urine tests. General and regional anesthetic options are available; usually spinal, general and PCA (patient controlled anesthesia). We will always do our best to keep patients comfortable and cared for at all times.
3. Do I keep my own patella?
Patients often think we remove the patella however this is not the case. A resurface procedure takes place 61 per cent of the time. The patella is everted and the superficial 7-8 mm of bone and cartilage are removed. I am selective in choosing which patellas should be resurfaced. Some patellas should be resurfaced such as patients with rheumatoid arthritis. Some should be left such as a thin patella with a high risk of fracture.
4. What is the prosthesis made of?
- Metal femoral component
- Plastic insert
- Metal tibia component
- Plastic patella button
- The femoral component is an alloy of chromium, cobalt, molybdenum and nickel.
- The tibial component is an alloy of titanium, aluminum and vanadium.
- The common metal sensitisers are chromium, nickel and cobalt. For these patients we can use titanium.
- Please note metal allergies are very rare.
5. How long will the prosthesis last?
In previous years, knee replacements were estimated to have a 10 year survivorship. This statistic has recently been revised to a 15 year survivorship. It is preferred to delay knee replacement surgery in a younger patient (such as a 55 year old patient) for the reason mentioned above. The average age for patients undergoing knee replacement is 65 to 75 years.