**11.1 Knee joint replacement surgery**

Knee joint replacement is one of the best treatments available for end-stage osteoarthritis, wherein the damaged cartilages are replaced with an implant, allowing patients to regain joint function. This life-changing procedure improves health-related quality of life and functional status by providing optimal analgesia and near-normal joint function [1, 2].

Depending upon the extent of the disease, joint replacement surgeries can be divided into the following types.


Surgical Steps involved in such surgery include,

• **Incision:** TKR can be performed by various approaches (**Figure 16**) like medial parapatellar, lateral parapatellar, Sub-vastus, Mid-vastus, and midline.6Medial parapatellar/longitudinal incision (From 5 cm proximal to

**Figure 16.** *Various approaches of knee replacement surgeries. (Source: Images is courtesy of 3D4Medical's essential anatomy).*

the superior pole of the patella to tibial tuberosity) is most commonly performed, especially for varus knees. For this reason, it is called a workhorse of the Varus knee.


The total duration of surgery is 1–2 hours. The majority of the patients begin physiotherapy within 24 hours of surgery. The patients are usually discharged within 3–5 days post-surgery.

Post-surgery complications include infection, nerve damage, increased risk of fall, bone fractures, persistent/chronic pain, deep venous thrombosis, joint stiffness, prosthesis-related complications (loosening/fracture of prosthesis components, joint instability, and dislocation, component misalignment, and breakdown.
