Outpatient Total Knee Replacement

Total knee replacement is the surgical treatment for knee arthritis where the damaged knee cartilage is removed and replaced with an artificial knee implant. Traditionally performed as an inpatient procedure, total knee replacement surgery is now being conducted on an outpatient basis allowing patients to go home the same day of the surgery. This is made possible with recent advances such as improved perioperative anesthesia, minimally invasive techniques and initiation of rehabilitation protocols soon after surgery. Outpatient total knee replacement is considered in patients who are healthy and motivated to recovery quickly and are comfortable returning home the day of surgery. While not all patients are appropriate candidates to have their knee replacement performed on an outpatient basis, potential benefits include the ability to recover completely in a comfortable, familiar environment, avoidance of risks associated with inpatient hospital stay, and a more efficient, specialized experience.

The outpatient procedure is performed using advancements in anesthetic techniques such as regional nerve blocks, multimodal pain management protocols, accelerated therapy exercises, and advanced surgical techniques that help reduce blood loss and trauma to the tissue.

You will be lying on your back on the operating table and a tourniquet may be applied to your upper thigh to reduce blood loss. The arthritic knee is approached through an straight incision made over the front of the knee. Care is taken to preserve the soft tissue and minimize the amount of trauma to muscle and tendon which may aid in faster recovery. The damaged portions of the femur (thigh bone) are trimmed at appropriate angles using specialized jigs and special guides to ensure a perfect fit of the implant. The next step involves the removal of the damaged area of the tibia (shinbone) and the back of the knee cap.

The femoral component is attached to the end of the femur with or without bone cement depending on the quality of the bone. The tibial component is then secured to the end of the bone in a similar fashion. Your surgeon places a polyethylene liner that acts as an articular surface between the thigh bone and shin implants and the back of the knee cap to ensure smooth gliding movement. With all the components in place, the knee joint is examined for range of motion.

All excess cement is removed and the entire joint is cleaned out with a sterile saline solution to prevent infection. Drains may be inserted and the incision is closed. A surgical dressing or bandage is placed. The whole process typically takes less than two hours. Several hours after surgery, the patient can be discharged from the hospital after a thorough examination to make sure they meet the requirements for discharge such as stable vital signs during exercise, ability to eat and take pain medicine by mouth.