Orthopedics & Joint Replacement

Total Knee Replacement Surgery

A new joint for a knee worn out by arthritis, so you can walk, climb stairs and sleep through the night without pain.

Total Knee Replacement Surgery at Prakash Hospital, Orthopedics & Joint Replacement
Surgery duration
1 to 2 hours
Anaesthesia
Spinal, often with a nerve block
Hospital stay
3 to 5 days
Recovery
6 to 12 weeks for daily activities

Overview

Severe knee arthritis changes the small things first. You take the lift instead of the stairs, plan outings around where you can sit down, and need two attempts to get up from a chair. Eventually the pain follows you to bed.

In a total knee replacement (total knee arthroplasty), your surgeon removes the worn cartilage and a thin layer of bone from the end of your thigh bone (femur) and the top of your shin bone (tibia). Both ends are capped with metal components, and a medical-grade plastic spacer sits between them so the joint glides smoothly again. If the back of your kneecap is badly worn, it can be resurfaced with a plastic button too.

For most people it brings lasting relief. The new knee won't feel exactly like the one you were born with, but most people stop planning their day around the pain.

At Prakash Hospital, your orthopaedic surgeon and our physiotherapy team plan the operation and the rehab together. We usually get you on your feet within 24 hours of surgery, because early movement makes a real difference to how well the knee bends later. If only one part of your knee is damaged, a partial knee replacement may be enough, and we'll tell you if that's the case.

Why it's done

The most common reason is osteoarthritis, where the cartilage that cushions the joint wears away until bone grinds on bone. X-rays show a narrowed joint space and bony spurs, and in advanced cases the knee starts to bow inward or outward. Surgery is considered once the damage is advanced and other treatment has stopped working.

  • Knee pain that wakes you at night or stays even when you rest
  • Pain that limits walking to a few hundred metres or makes stairs a struggle
  • Stiffness that stops you from fully bending or straightening the knee
  • Bow legs or knock knees that are getting worse
  • Rheumatoid arthritis, or arthritis that set in after an old fracture or ligament injury
  • No lasting relief after several months of medicines, physiotherapy, weight loss and injections

Is it right for you?

Usually a good fit

  • X-rays show advanced arthritis and the pain affects your daily life
  • You're fit for anaesthesia, with diabetes and blood pressure under control
  • You can commit to daily physiotherapy exercises for about three months

May not be suitable

  • An active infection in the knee or anywhere else in the body, until it's treated
  • Pain that mainly comes from the hip or spine rather than the knee
  • Arthritis limited to one side of the knee, where a partial replacement may suit you better
  • Very high blood sugar, or a recent heart attack or stroke, until these are stabilised

Types and techniques

Cemented or uncemented implants

Most knees are fixed with bone cement, which holds the parts firmly from day one. In younger patients with strong bone, your surgeon may choose press-fit components that the bone grows into over a few months.

Keeping or replacing the back ligament

The ligament at the back of the knee (the posterior cruciate) can be kept, or its job can be taken over by a post built into the implant. It depends on how healthy that ligament is and how deformed the knee has become.

One knee or both

If both knees are badly affected, they can be replaced on the same day or a few months apart. Doing both together means one anaesthetic and one rehab period, but it is a bigger strain on the body and suits fitter patients.

Preparing for surgery

  • Blood tests, HbA1c, ECG, chest X-ray and knee X-rays, most of them done in our pathology lab
  • Get diabetes under control. High blood sugar raises the risk of wound infection
  • Tell us about blood thinners such as aspirin or clopidogrel. Some are stopped 5 to 7 days before surgery, only on your doctor's advice
  • Treat any dental abscess, urine infection or leg ulcer first, because bacteria can travel to the new joint
  • Stop smoking at least four weeks before, if you can. It slows healing
  • Start the thigh-strengthening exercises your physiotherapist shows you
  • Set up your home: a firm chair with armrests, a Western-style toilet or commode chair, no loose rugs, and a ground-floor bed if stairs are hard
  • Arrange for someone to stay with you for the first week or two, or ask about our home care plan
  • Check your policy's cover and waiting period early. See the insurance and TPA panels we work with

The procedure, step by step

  1. 01

    Anaesthesia

    Most knee replacements are done under spinal anaesthesia, which numbs you from the waist down, with light sedation so you doze through it. A nerve block in the thigh keeps pain down for the first day.

  2. 02

    Opening the knee

    The surgeon makes a cut of about 15 to 20 cm down the front of the knee and moves the kneecap aside to reach the joint.

  3. 03

    Shaping the bone ends

    Using cutting guides, the surgeon removes the damaged cartilage and a few millimetres of bone from the femur and tibia. The cuts are angled to correct any bowing, so your leg ends up straighter.

  4. 04

    Balancing the ligaments

    The ligaments on either side are adjusted until the knee is equally stable bent and straight. This balance has a lot to do with how natural the new knee feels.

  5. 05

    Trial fit and final implants

    Trial parts go in first, and the knee is moved through its full range to check the fit. Then the final metal components are fixed in place with the plastic insert locked between them.

  6. 06

    Closing the wound

    The wound is closed with stitches or staples and a padded dressing goes on. The whole operation typically takes 1 to 2 hours.

Benefits and risks

Benefits

  • Lasting relief from arthritis pain for most patients, usually clear by 6 to 8 weeks
  • Walking further and managing stairs with less effort
  • A straighter leg if the knee was bowed or knock-kneed
  • Less need for daily painkillers, which can harm the stomach and kidneys over time
  • Implants that typically last 15 to 20 years or more

Possible risks

  • Blood clots in the leg veins (DVT), reduced with blood thinners, compression stockings and early walking
  • Infection in the wound or joint. It's uncommon, at roughly 1 in 100, but serious and may need more surgery
  • Stiffness, where the knee doesn't bend as far as hoped. Extra physiotherapy usually helps
  • A numb patch of skin on the outer side of the scar, which often stays
  • Wear or loosening of the implant after many years, which may need a revision knee replacement
  • Rare problems such as nerve or blood vessel injury, or a fracture around the implant

Recovery timeline

Recovery is a steady climb, though not a straight line. Some days the knee will feel stiff and swollen for no obvious reason. Doing your exercises every day matters as much to the final result as the surgery does.

  1. 01

    Day 0 to 1

    A physiotherapist gets you standing, usually within 24 hours, and you take your first steps with a walker. In bed you do ankle pumps and thigh-tightening exercises.

  2. 02

    Days 2 to 5, in hospital

    You walk further each day, practise getting on and off the bed and toilet, and try a few stairs with help. Before you go home, the aim is to bend the knee to about 90 degrees.

  3. 03

    Weeks 2 to 6

    Stitches come out at around two weeks and you move from a walker to a stick. Some warmth and swelling is normal. Exercises focus on bending (aim for about 110 degrees by six weeks) and getting the knee fully straight.

  4. 04

    Weeks 6 to 12

    Most people walk without support, return to desk work and can drive again once they can brake firmly. A stationary cycle is good for building strength.

  5. 05

    3 months to 1 year

    Swelling keeps settling and strength keeps improving for up to a year. You'll have follow-up visits with X-rays so we can check the implant is sitting well.

When to call your doctor

  • Fever above 100.4°F (38°C) or shivering
  • Redness, heat or discharge from the wound, or a wound that opens
  • Pain, swelling or tenderness in either calf
  • Sudden breathlessness or chest pain. Call an ambulance straight away
  • A sudden increase in knee pain, or a fall onto the operated knee

Call us on +91-8826000033 or come straight to our 24/7 emergency department.

Alternatives to surgery

Weight loss, exercise and injections

Every kilo you lose takes several kilos of load off the knee with each step, and a strengthening routine eases pain for many people with mild to moderate arthritis. Check where you stand with our BMI calculator. A steroid injection can calm a flare-up for a few weeks to months.

Arthroscopy

Knee arthroscopy fixes mechanical problems such as a torn meniscus or a loose fragment of cartilage. It doesn't help established arthritis.

Talk to our Orthopedics & Joint Replacement team

Ask about your options, the cost and your insurance before you decide. See the insurance and TPA panels we work with.

This page explains Total Knee Replacement Surgery in general terms. Your own plan depends on your health, your test results and your doctor's advice. Please read our medical disclaimer.

Your care team

Total Knee Replacement Surgery is led by our Orthopedics & Joint Replacement team, with other departments stepping in at each stage of your care.

Orthopedics and Traumatology Department
Leads your treatment

Orthopedics and Traumatology Department

At Prakash Hospital, our Orthopedics and Traumatology Department offers expert diagnosis, surgical and non-surgical treatments, and rehabilitation for bone, joint, and musculoskeletal injuries.

What the department treats

Total Knee Replacement

Total Hip Replacement

Arthroscopic Surgery

Spine Surgery

Trauma and Fracture Care

Sports Medicine

Visit the Orthopedics & Joint Replacement department

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Frequently Asked Questions

Answers to common questions about Total Knee Replacement Surgery at Prakash Hospital, Noida.

How long will my new knee last?

Around 9 in 10 knee replacements are still working well 15 to 20 years after surgery. Keeping your weight down and avoiding high-impact sports such as running helps the plastic insert wear more slowly.

Is the surgery very painful?

You won't feel anything during the operation. Afterwards the knee is sore, especially during exercises in the first two weeks, but a nerve block, regular painkillers and ice keep most people comfortable enough to walk the next day.

Will I be able to sit cross-legged or squat afterwards?

Most replaced knees bend to about 110 to 120 degrees, which is enough for walking, stairs and sitting on a chair. Squatting, kneeling and sitting cross-legged on the floor need deeper bending and strain the implant, so most surgeons advise against them. Plan on a Western-style toilet or a raised seat at home.

When can I drive again?

Usually 4 to 6 weeks after surgery, once you're off strong painkillers and can press the brake hard and fast. If your left knee was replaced and you drive an automatic, it may be sooner. Check with your surgeon first.

Am I too old, or too young, for a knee replacement?

There's no fixed age limit. What matters is how much the arthritis limits you and whether you're fit for surgery. Younger patients are more likely to need a second operation later in life, so we usually try other treatments first.

Will my knee set off metal detectors?

It might at airports. Carry your discharge summary or a note from your surgeon, and tell the security staff before you go through the scanner.

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