Total Knee Replacement: All You Need to Know

What is knee osteoarthritis?

Osteoarthritis, also known as “wear and tear” arthritis, is a common problem for many people after they reach middle age.

A healthy knee bends and straightens because of smooth, slippery tissue called articular cartilage. The cartilage covers, protects and cushions the ends of leg bones that form your knee.

Osteoarthritis causes the cartilage to wear away. It causes pain and stiffness, resulting in difficulty in carrying out daily activities such as walking and climbing stairs. If non-surgical treatments like pain killers, steroid injections or rehabilitation are no longer useful, your specialist might advise you to consider a total knee replacement surgery. Knee replacement is a

safe and effective procedure that helps ease pain and correct leg alignment.

Rapid Physiocare will explain to you the different kinds of treatment options for knee pain and understand more about Total Knee replacement surgery.

What causes knee osteoarthritis?

Your risk for developing knee osteoarthritis can be caused by many factors.

Age – The ability of cartilage to heal itself decreases with age. Osteoarthritis typically affects people middle-aged and older.

Heredity – Inherited traits such as being knock-kneed, bowlegged or double jointed, can also put you at higher risk for developing osteoarthritis.

Weight – The more your weight is, the more stress you put on your knees.

Injury – Previous traumatic injury such as sports injury can lead to osteoarthritis later in life.

Overuse – Work that involves repeated kneeling or squatting, or heavy lifting and walking, can cause repetitive stress injuries in the knee. This makes you more prone to develop osteoarthritis.

Inactivity – Particularly for individuals who only participate in high impact or vigorous sports after a prolonged period of rest. This group of people are more prone to injuries from the sudden burst of intense activity.

Other illnesses – If you have other medical conditions with your knee, such as gout, knee infection, diabetes or Lyme disease, your risk for osteoarthritis is greater.

According to a study published in Annals by Academy of Medicine, 96% of knee replacements performed in Singapore are to repair knee osteoarthritis. These statistics echo a global reality – knee osteoarthritis is one of the growing causes of disability, and is a prevalent condition suffered by elder population.

How do you know if you have Knee Osteoarthritis? 

Numerous symptoms such as joint inflammation, swelling, stiffness, clicking sound or popping sensation, and a diminished range of motion (especially difficulty in straightening your knees) are common in osteoarthritis.

Pain – Usually sharp pain on movement especially when performing weight bearing activity such as walking and climbing stairs. Pain usually gets better with rest but may present lying in bed if one knee rests on the other.

Stiffness – Your knee might feel restricted when bending and straightening your knee. This may seem worse after periods of rest, generally first thing in the morning and when standing up from prolonged sitting.

Swelling – Soft or hard swelling may occur around the knee joint. A fluid-filled lump (known as a Bakers cyst) may sometimes develop at the back of the knee joint.

Crepitus – Crepitus is described as a grinding sound or sensation may occur on movement of the knee caused by friction between bone and cartilage.

Deformity – In the later stages of the condition, the knee joint shape can alter, often appearing enlarged, especially on the inner aspect. The leg alignment may alter to either a bow-legged or knock-kneed.

Giving Way / Locking – Sometimes the affected knee might give way when putting weight onto it, in part due to weakness and wasting of your thigh muscle. This can make the knee feel momentarily unstable. Knees can sometimes lock as a result of joint changes. This can be an isolated incident or happen intermittently. A fully locked knee requires orthopaedic review.

Total Knee Replacement Surgery for Knee Osteoarthritis

Typically for patients with knee osteoarthritis whose symptoms are manageable and less severe, lifestyle adjustments and physiotherapy treatment with stretching, strengthening and balance exercises can help to relieve their symptoms. In more severe cases of osteoarthritis, your doctor may consider surgery if your pain worsens and causes disability.

Knee arthroplasty or total knee replacement, is a surgical procedure to resurface an arthritic knee. The procedure is as follows:

An incision is first made along the front of the knee. Next, damaged portions of the joints are removed, and the ends of the bones are trimmed to accommodate the knee prosthesis, a component manufactured from high-grade plastic and metal parts. Surgical cement is then used to attach the knee prosthesis to the femur, tibia, and patella. A plastic spacer is then placed between the joints to act as cartilage. At the end of the procedure, the kneecap or patella is repositioned along the front of the knee. The incision is then surgically closed, and the site dressed to prevent infection.

It is important to know that total knee replacement surgery is not compulsory as it is dependent on the severity of the knee damage. In less severe cases, a partial knee replacement might be more appropriate. In this instance, only the damaged portions of the knee are removed, resurfaced, and replaced. Partial knee replacement surgeries are typically less invasive and have shorter recovery times.

Optimise Your Recovery with Rapid Physiocare

Physiotherapy plays an important role in both non-surgical and surgical Knee Osteoarthritis treatments, with the physiotherapist formulating a personalised routine following your lifestyle and habits. These involve osteoarthritis knee exercises to strengthen your muscles supporting the joint. When done properly, they will help reduce joint stress.

At Rapid Physiocare, we help you get the best out of your recovery. With dedicated knee physiotherapy, you will be guided on ways you can rebuild your strength, mobility, and range of motion so that you can resume your daily activities after treatment. Our Allied Health Professionals Council registered physiotherapists are here to walk with you on this journey to recovery, as they assist you in your post-operative care.

Apart from patients recovering from their total knee replacement surgery, we also have experience assisting those who seek knee pain physiotherapy here in Singapore.

Learn more about our post-surgery physiotherapy care programme and what it can do for you. Should you have any questions, feel free to contact us by phone or email.