Total Knee Replacement
Complete knee joint replacement for end-stage arthritis.
Total knee replacement resurfaces all three compartments of the knee joint with an artificial implant, and is the most established treatment for end-stage knee arthritis that has not responded to non-surgical care. It is one of the most extensively studied and long-practised orthopaedic procedures, with a strong track record for relieving pain and restoring function in patients with severe arthritis.
Types
Cruciate-Retaining Implant
Preserves one of the knee's natural ligaments, used when that ligament is still healthy and functional.
Posterior-Stabilised Implant
Used when the relevant ligament is removed or damaged, with the implant itself providing joint stability.
Cemented Fixation
The implant is secured to the bone using surgical bone cement, the most common fixation method.
Cementless (Press-Fit) Fixation
The implant is designed to allow bone to grow directly into its surface over time, an alternative fixation approach in select cases.
Common Causes
Total knee replacement is considered once arthritis has progressed to affect the entire joint surface, rather than being limited to one section of the knee.
- Advanced osteoarthritis - widespread cartilage loss across the whole knee joint.
- Rheumatoid arthritis affecting the full joint surface.
- Severe post-traumatic arthritis following a significant prior knee injury.
- Significant deformity - knees that have become notably bowed or knock-kneed due to uneven joint wear.
- Failure of a previous partial knee replacement, now needing conversion to a full replacement.
Signs and Symptoms
- Constant or near-constant knee pain, including at rest
- Significant loss of knee movement, affecting daily activities
- Visible deformity of the knee, such as bowing inward or outward
- Dependence on walking aids due to pain or instability
- Pain that has not responded to injections, physiotherapy, or medication over an extended period
Diagnosis
X-rays showing complete or near-complete loss of joint space across the knee, taken alongside a full assessment of the joint's range of movement, stability, and alignment, confirm suitability for total knee replacement.
Treatment Approach
The procedure involves removing the damaged joint surfaces from the thigh bone, shin bone, and sometimes the kneecap, and replacing them with metal and plastic implant components that recreate a smooth, functioning joint. Recovery involves an early period of physiotherapy focused on regaining movement and strength. Dr. K. G. Gopalakrishna discusses the procedure, implant options, and expected recovery in detail as part of surgical planning.
Please note: This page is for general information only and does not replace a proper medical evaluation. Every case is different, and the underlying cause of your symptoms may not match what is described here. Please do not use this page to self-diagnose - consult Dr. K. G. Gopalakrishna or another qualified orthopaedic specialist for an accurate diagnosis specific to you.
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Last reviewed: August 2026