Total Knee Arthroplasty (TKA) is a joint replacement surgery used to relieve pain and stiffness in people with advanced knee joint damage. It involves removing the damaged bone and cartilage and replacing it with metal and plastic implants to restore function and alignment.

Conditions Treated

• Osteoarthritis (most common)

• Rheumatoid arthritis

• Post-traumatic arthritis

• Avascular necrosis

• Failed previous knee surgeries or partial replacements

• Severe knee deformities or instability

The Procedure

1. Preparation

• General or spinal anesthesia is given

• A tourniquet may be applied to reduce bleeding

• The leg is sterilized and draped

2. Incision and Exposure

• A vertical incision is made over the front of the knee

• Muscles and soft tissues are moved aside to expose the joint

3. Bone Preparation

• The damaged surfaces of the femur, tibia, and sometimes patella are removed

• Bone ends are shaped to fit the new components

4. Implant Placement

• A metal femoral component is placed on the thighbone

• A metal and plastic tibial component is fixed to the shinbone

• A plastic patellar buttonmay be placed behind the kneecap

• All components are secured with bone cement or press-fit

5. Knee Alignment and Movement

• The surgeon tests range of motion and ligament balance

• Any adjustments are made before closure

6. Closure

• The joint capsule and soft tissues are closed in layers

• Skin is closed with sutures or staples

• A dressing and compression bandage are applied

Recovery

Hospital Stay

• 2-5 days

Pain Management

• Managed with oral pain meds, nerve blocks, or epidurals

Mobility

• Walking usually begins on the day of surgery or the next

• Physical therapy starts immediately

• Use of a walker or cane is common for 2–6 weeks

Physical Therapy

• Critical to regain motion, strength, and balance

• Focuses on knee extension (straightening) and flexion (bending)

• Lasts 6–12 weeks, often longer

Return to Activities

• Light daily activities: 3–6 weeks

• Driving (if left leg or automatic car): ~4 weeks

• Full recovery: 3–6 months

• Full strength & endurance: up to 24 months

Success Rates

• 90–95% of patients have significant pain relief and improved mobility

• Implants last 15–20+ years in most patients

• Very high satisfaction rates with proper rehab and care

Risks and Considerations

• Infection (superficial or deep)

• Blood clots (DVT or PE)

• Stiffness or limited range of motion

• Implant loosening or wear (over time)

• Nerve or vessel injury (rare)

• Persistent pain or swelling

An arthroscopic meniscectomy is a minimally invasive knee surgery used to treat a torn meniscus by removing the damaged part. The meniscus is a C-shaped piece of cartilage that cushions and stabilizes the knee joint.

Conditions Treated

• Meniscal tears (traumatic or degenerative)

• Knee pain or locking due to torn cartilage

• Mechanical symptoms (clicking, catching, or giving way)

• Tears that are not repairable (typically in the avascular “white zone”)

The Procedure

1. Preparation

• Performed under general or regional anesthesia

• Entire procedure is usually 30–60 minutes

2. Arthroscopic Access

• 2–3 small incisions (~1 cm) are made at the front of the knee

• A camera (arthroscope) is inserted to visualize the inside of the joint

• Sterile fluid is used to expand the knee and improve visibility

3. Meniscus Removal

• Specialized tools remove only the torn or unstable portion of the meniscus

• Edges are smoothed to prevent further fraying

• The entire meniscus is rarely removed, only the damaged part (called partial meniscectomy)

4. Inspection and Closure

• Other parts of the knee (cartilage, ligaments) are inspected

• Instruments are removed, and the incisions are closed with stitches or steri-strips

Recovery

Hospital Stay

• Outpatient — go home the same day

Pain and Swelling

• Mild to moderate swelling is expected for a few days

• Ice, rest, and elevation are important early on

Mobility

• Weight Bearing is allowed immediately (as tolerated)

• Most patients use crutches for 1–3 days

Physical Therapy

• Often starts within a few days

• Focuses on restoring range of motion, strength, and function

• Total rehab time: 4–8 weeks in most cases

Return to Activity

• Desk work: 1–3 days

• Light exercise: 2–3 weeks

• Full sports: 4–6 weeks, depending on fitness and goals

Success Rates

• 80–90% of patients have significant pain relief and return to normal function

• Best outcomes in younger patients with acute tears

• May not prevent arthritis in the long term, especially with large or degenerative tears

Risks and Considerations

• Swelling or stiffness

• Persistent pain if other knee structures are damaged

• Infection (very rare)

• Blood clot (DVT) (very rare in low-risk patients)

• Progressive arthritis in cases of large meniscus removal

• Meniscus re-tear (if any tissue remains and is vulnerable)

ACL reconstruction is a surgical procedure to replace a torn anterior cruciate ligament (ACL) in the knee. The ACL is one of the key ligaments that helps stabilize your knee during pivoting, jumping, and cutting movements.

Conditions Treated

• Complete ACL tear (most common)

• Partial ACL tear with instability

• ACL injury with high physical demands (athletes, active individuals)

• ACL tear with additional meniscus/lateral ligament damage

Not usually recommended for:

• Sedentary individuals with low activity needs

• Isolated partial tears without instability

The Procedure

1. Preparation

• Performed under general or regional anesthesia

• Minimally invasive, using arthroscopy

• Lasts about 1–2 hours

2. Graft Harvesting

There are several graft options used to replace the torn ACL:

• Autograft (from the patient):

  • Patellar tendon (strongest, used in athletes)

• Allograft (from a donor):

  • Used in older, less active patients or revisions

3. Arthroscopic ACL Removal and Tunnel Drilling

• Torn ACL is removed arthroscopically

• Tunnels are drilled in the femur and tibia to anchor the new ligament

4. Graft Placement and Fixation

• Graft is threaded through the bone tunnels

• Fixed with screws, buttons, or other fixation devices

5. Closure

• Incisions are closed with sutures or steri-strips

• Bandage and brace are applied

Recovery

Hospital Stay

• Same day or overnight

Weight Bearing

• Immediate with crutches (as tolerated) in most cases

• Some protocols delay weight bearing for a few days

Physical Therapy

• Starts within days of surgery

• Key goals:

  • Week 1–2: Reduce swelling, regain extension

  • Week 3–6: Improve strength and ROM

  • Months 3–6: Functional training, running

  • Months 6–9+: Return to cutting, pivoting sports

Return to Activities

• Light activities: 2–3 months

• Jogging: 3–4 months

• Cutting/pivoting sports: 6–9 months

• Full return to competition: 9–12 months, with clearance

Success Rates

• 85–95% of patients return to pre-injury levels of activity

• Best outcomes in patients who follow rehab closely

• Athletes can return to sport at high levels, though reinjury risk exists

Risks and Considerations

• Graft failure or re-tear (5–15%)

• Stiffness or loss of motion

• Knee instability (if graft loosens)

• Infection (rare)

• Pain at graft site (especially with patellar tendon graft)

• Blood clots (DVT)

• Long-term arthritis risk (especially if meniscus was also damaged)

Patellofemoral replacement is a partial knee replacement procedure used to treat arthritis that is isolated to the patellofemoral compartment — the joint between the kneecap (patella) and the thigh bone (femur).

It’s designed to preserve the rest of the knee joint, offering a quicker recovery and more natural motion compared to a total knee replacement.

Conditions Treated

• Isolated patellofemoral arthritis

• Chondromalacia patella (advanced cartilage wear behind kneecap)

• Failed previous kneecap surgeries (e.g. realignment, cartilage repair)

• Congenital or acquired patellar tracking disorders with cartilage damage

Best for:

• Younger, active patients with localized arthritis

• Intact medial and lateral compartments of the knee

• Proper patellar tracking and alignment

Not suitable if:

• Arthritis is spread to other parts of the knee

• There's knee instability, ligament damage, or inflammatory arthritis (like rheumatoid)

• Patellar maltracking is severe or uncorrectable

The Procedure

1. Preparation

• Performed under general or spinal anesthesia

• Usually takes 60–90 minutes

2. Incision and Exposure

• An incision is made over the front of the knee

• The underside of the kneecap and trochlea (groove of the femur) are exposed

3. Bone Preparation

• Damaged cartilage and bone are removed from:

  • Underside of the patella

  • Trochlear groove of the femur

4. Implant Placement

• A metal trochlear component is placed in the femur groove

• A plastic button is attached to the back of the patella

• These components replicate the sliding motion of the kneecap

5. Closure

• The joint is tested for smooth tracking

• Soft tissues are repaired, and the incision is closed

• A dressing and sometimes a brace are applied

Recovery

Hospital Stay

• Typically overnight stay or possibly same day

Weight Bearing

• Immediate weightbearing as tolerated with crutches or walker

Physical Therapy

• Starts within a few days

• Goals:

  • Regain full extension and flexion

  • Strengthen quads

  • Normalize gait and kneecap tracking

• Lasts 6–12 weeks depending on progress

Return to Activity

• Desk work: 1–2 weeks

• Low-impact activity: 4–6 weeks

• Full activity: 3 months

• Impact sports are not recommended (e.g., running, jumping)

Success Rates

• 85–90% of patients experience significant pain relief and improved function

• Success is highest when arthritis is truly isolated to the patellofemoral joint

• Preserves more natural motion than total knee replacement

Risks and Considerations

• Progression of arthritis in the other knee compartments (may require revision to total knee later)

• Kneecap maltracking or instability

• Persistent pain (especially if arthritis is underestimated)

• Infection

• Implant loosening or wear

• Stiffness or reduced motion

• Conversion to total knee replacement (in 10–20% over 10–15 years)

Unicompartmental knee replacement is a partial knee replacement surgery where only one of the three compartments of the knee is replaced — most commonly the medial compartment (the inner side of the knee). This preserves more of your natural knee compared to a total knee replacement.

Conditions Treated

• Unicompartmental osteoarthritis (arthritis in just one part of the knee)

• Cartilage damage isolated to one compartment

• Patients with pain, stiffness, and functional limitation from localized knee arthritis

Best for:

• Older but active adults

• Intact ligaments, especially the ACL

• Stable knee with full range of motion

• No significant inflammatory arthritis or deformity

Not suitable if:

• Arthritis is in more than one compartment

• There is ligament damage or knee instability

• Significant knee deformity, stiffness, or inflammatory arthritis (e.g., RA)

The Procedure

1. Preparation

• Surgery is performed under general or spinal anesthesia

• Lasts about 1–1.5 hours

2. Incision and Exposure

• An incision is made over the front of the knee

• The surgeon exposes the damaged compartment (usually medial)

3. Bone Preparation

• Worn-out cartilage and a small portion of bone are removed from the femur and tibia in the affected area

4. Implant Placement

• A metal femoral component is fixed to the thigh bone

• A metal tibial component is fixed to the shinbone with a plastic insert between them

• These implants replicate smooth joint movement

5. Closure

• Surrounding soft tissue is repaired

• The incision is closed with sutures or staples

• A dressing and sometimes a compression bandage or brace is applied

Recovery

Hospital Stay

• Overnight or possibly same day.

Weight Bearing

• Full weight bearing is usually allowed immediately with crutches or a walker for support

Pain and Swelling

• Managed with oral meds, ice, and elevation

• Swelling may persist for a few weeks

Physical Therapy

• Starts within days of surgery

• Focuses on:

  • Range of motion

  • Strength (especially quads)

  • Gait and balance

Return to Activities

• Desk work: 1–2 weeks

• Light exercise: 3–4 weeks

• Full activities: 6–12 weeks

• High-impact sports (running/jumping): not recommended

Success Rates

• 90–95% patient satisfaction in properly selected cases

• Implant survival rates:

  • 90–95% at 10 years

  • 80–90% at 15 years

Risks and Considerations

• Progression of arthritis in other compartments

• Implant loosening or failure

• Infection

• Stiffness or persistent pain

• Blood clots (DVT)

• May require conversion to total knee replacement later