Minimally Invasive Total Knee Replacement
What is total knee replacement?
Total knee replacement is a type of surgery to replace a damaged knee joint. A minimally
invasive surgery uses a smaller cut (incision) than a traditional total knee replacement.
This type of surgery typically requires special tools so that the surgeon can see
and do the procedure through the smaller incision.
The knee has several parts: the lower end of the thighbone (femur), the upper end
of the shinbone (tibia), and the kneecap (patella). A smooth substance called cartilage
caps the ends of these bones and keeps the bones from grinding together. When there
is damage to the knee joint, these bones may scrape together abnormally and cause
During minimally invasive total knee replacement, your surgeon makes an incision to
access your shinbone and thighbone. Next, he or she removes a portion of the bones
that make up the knee joint. Your surgeon replaces these bone parts with metal components
that recreate the joint surface. A layer of plastic is placed between the metal components
for smooth gliding.
Minimally invasive total knee replacement often takes place under general or spinal
Why might I need total knee replacement?
You might need a total knee replacement if you have significant damage to your knee
joint. Different types of medical conditions can damage this joint, such as:
Osteoarthritis (most common)
Injury or fracture of the knee joint
Bone tumor in the knee joint
This damage might be very painful and limit your normal activities. The procedure
may help decrease your pain, improve your joint mobility, and quality of life. Usually,
healthcare providers only recommend total knee replacement when you still have significant
problems after trying more conservative treatments, like pain medicines and corticosteroid
Talk with your doctor about the benefits and risks of having minimally invasive total
knee replacement instead of traditional total knee replacement. Minimally invasive
total knee replacement uses a smaller incision than a traditional knee replacement,
so it may lead to less pain and decreased recovery time. It's not yet clear whether
the procedure leads to increased risk of certain complications, though.
In some cases, you may have other surgical options, like shortening the bone or a
partial knee replacement. Talk with your doctor about the risks and benefits of all
What are the risks of total knee replacement?
Most people do very well with their minimally invasive total knee replacement. But
as with any surgery, the procedure does carry some fairly rare risks. Possible complications
of the surgery include:
There is also a very slight risk that the procedure might not relieve your pain. Your
own risk of complications may vary according to your age and your other medical conditions.
Ask your provider about the risks that most apply to you.
How do I get ready for total knee replacement?
Ask your provider how you should plan to get ready for your surgery.
Tell your provider about any medicines you are taking, including:
All prescription medicines
Over-the-counter medicines such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Ask if there are any medicines you should stop taking ahead of time, like blood thinners.
If you smoke, try to quit before your surgery.
If you are overweight, your provider may advise you to try to lose weight before your
Don’t eat or drink after midnight the night before your procedure.
You may want to make some changes to your house, to make your recovery smoother. This
includes things like adding a handrail in your shower.
In some cases, your provider might want additional tests before you have your surgery.
These might include:
X-rays, to get information about your hip
MRI, to get more detailed information about your hip
Electrocardiogram (ECG), to make sure your heart rhythm is normal
Follow any other instructions from your healthcare provider.
What happens during total knee replacement?
Your provider can help explain the details of your particular surgery. An orthopedic
surgeon will perform the surgery aided by a team of specialized healthcare professionals.
The whole procedure may take a couple of hours. In general, you can expect the following:
Most likely, you will be given spinal or general anesthesia so that you’ll sleep through
the surgery and won’t feel any pain or discomfort during the procedure. Or you may
get local anesthesia and a medicine to keep you relaxed but awake.
A healthcare professional will carefully watch your vital signs, like your heart rate
and blood pressure, during the surgery.
You may get antibiotics, during and after the procedure, to help prevent infection.
Your surgeon will make an incision over the middle of your knee, cutting through your
skin and underlying tissue.
He or she will remove the damaged portions of your thighbone and shinbone, removing
a little of the bone beneath as well.
Next, metal implants are placed into the joint space, usually cementing them into
the remaining bone.
In most cases, your surgeon will also remove part of the underside of the kneecap.
A plastic spacer is inserted into the space between the metal implants, for ease of
The layers of your skin and muscle will be surgically closed.
What happens after total knee replacement?
Talk with your healthcare provider about what you can expect after your surgery. You
may have significant pain around your incision after your procedure, but pain medicines
may help to relieve your pain. You should be able to get back to a normal diet fairly
You may get imaging, like an X-ray, to see the results of the surgery. You might be
able to go home within a day or two.
Your provider will let you know when you can put weight on your leg. You may have
specific instructions about limiting your movements. You might need to use a cane,
walker, or crutches for a few days or weeks. A physical therapist can help you maintain
your range of motion and strength. You should be able to go back to most light activities
within a few weeks. During this time, you may find it helpful to have some extra help
You might have some fluid draining at the incision site. This is normal. Let your
provider know right away if you have an increase in redness, swelling, or draining
at the incision site. You should also let your provider know if you have high fever,
chills, or severe pain that does not improve.
Make sure to keep all of your follow-up appointments with your surgeon. You may need
to have your stitches or staples removed a week or so after your surgery.
Most people note a significant decrease in their pain after a total knee replacement.
You may have some remaining stiffness in the joint, as well as more limited range
The mechanical parts of your knee may wear out or loosen over time. Because of this,
you may need a revision surgery at some point. But most people will still have functioning
knee replacements 15 years after their surgery. You may be able to extend the life
of your implant through regular low-impact exercise, while avoiding high-impact exercise
(like jogging), and taking precautions to prevent falls.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure