Total Knee Replacement Video

To help reduce swelling, you may be asked to elevate your leg or apply ice to the knee.

Video of Knee Replacement – Amazing Surgery Footage

Ever wondered what knee replacement surgery actually looks like on video? We have you covered with some of the best views of the operating table.

Knee Replacement Video Footage

If you are considering knee replacement surgery for your osteoarthritis (OA), you are probably wondering what exactly happens once you get on the operating table. We scoured youtube for the best videos of knee replacement surgery to give you the birds-eye view of the operating table.

WARNING – The following videos contain graphic content of real surgeries, viewer discretion is advised.

As you will see from the knee replacement videos, the procedure is fairly invasive. Over the course of two hours, an orthopedic surgeon will saw away bone and attach the prosthetic knee joint to your patella, femur, and tibia.

Click on the menu at the top left of the video below to see the whole playlist.

Knee Replacement Video Playlist

Knee Replacement Surgery Steps

Initial Incision: A scalpel will be used to make an incision down the center of your knee cap to allow access to the entire joint.
Relocation of the Knee Cap: In order to access the end of your thigh bone and shin bone, the knee back will be moved gently to the side of the joint.
Preparation of the Femur: Bone is sawed away to create a smooth surface for the to-be-attached femoral implant.
Femoral Implant: The formal implant is cemented to the freshly exposed bone.
Preparation of the Tibia: Bone is sawed away from the tibia to create a surface for tibial implant.
Tibial Implant: Tibial Implant is cemented to the newly exposed smooth bone.
Preparation of the Patella: Underside of the patella is ground down and flattened.
Readjusting the Patella: Plastic prosthetic is cemented on the newly exposed bone.
Procedure Conclusion: Before closing up the joint, the surgeons move the knee around passively to ensure the prosthetic implant is functioning correctly.

Alternatives to Knee Surgery

The decision to undergo knee replacement surgery should not be taken lightly. However, depending on your situation it may be the only viable option. That being said one study estimated that over ⅓ of the knee surgeries were inappropriate 1 . Patients either did not have severe enough symptoms to warrant surgery, were too young, or didn’t have severe enough damage to their knee joint.

Knee surgery is meant to be a last resort. It is recommended that you exhaust all of your conservative treatment options. For a full view of non-surgical treatment of severe knee OA take a look at this guide.

One of the primary reasons why knee replacement surgery gets recommended to a patient is because they have bone on bone knee pain. In this situation, the friction of the bony surfaces rubbing together within the knee joint causes inflammation, bone spurs, stiffness, and pain. Knee replacement surgery helps by cutting away the damaged bone and replacing it with an artificial metal surface. This is a proven long term solution for increasing joint function and reducing knee pain, but are their less invasive options that can accomplish similar increases in function and relief from pain?

Tri-compartment offloading is an exciting new treatment for severe knee osteoarthritis. Here rather than replacing the damaged areas, they are offloaded. A new type of knee brace/exoskeleton hybrid uses spring technology to provide additional support to the joint, reducing pressure by over 40% 2 . To learn more about this innovation, click the button below.

Other Resources

References

Riddle, D. L., Jiranek, W. A., & Hayes, C. W. (2014). Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. Arthritis & rheumatology, 66(8), 2134-2143.
McGibbon, C. & Mohamed, A. Knee Load Reduction From an Energy Storing Mechanical Brace. Canadian Society for Biomechanics (2018)

Frequently Asked Questions

What happens during a knee surgery?

During a full knee replacement the surfaces of your patella, tibia and femur are shaved down with a bone saw creating a platform for the implant. Once the joint is prepared the metal components of the knee replacement are attached using a cement-like adhesive.

How long does knee replacement surgery take?

Knee replacement surgery takes 1-3 hours depending on the complexity.

How long does the pain last after knee surgery?

Knee pain can last 6-12 months and occasionally even longer. The recovery trajectory is very unique to the individual.

By Simon Watts

Simon Watts is a former strength and conditioning coach with an extensive background in orthopedics and athletic therapy. He has a wealth of experience with the rehabilitation of common knee injuries such as osteoarthritis, meniscus tears, ligament injuries, and tendonitis. Simon studied Kinesiology at Dalhousie University, and as a track and field student-athlete was a national champion in the high jump and triple jump. He continues to be actively involved in the track and field community in Nova Scotia as a coach.

Knee Replacement Surgery Procedure

Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury.

Various types of arthritis may affect the knee joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, may cause damage to the cartilage of the knee.

The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments.

Anatomy of the knee

Joints are the areas where 2 or more bones meet. Most joints are mobile, allowing the bones to move. Basically, the knee is 2 long leg bones held together by muscles, ligaments, and tendons. Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee.

There are 2 groups of muscles involved in the knee, including the quadriceps muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles (located on the back of the thighs), which bend the leg at the knee.

Tendons are tough cords of connective tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments of the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).

The knee consists of the following:

Tibia. This is the shin bone or larger bone of the lower leg.
Femur. This is the thighbone or upper leg bone.
Patella. This is the kneecap.
Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.
Synovial membrane. A tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
Ligament. A type of tough, elastic connective tissue that surrounds the joint to give support and limits the joint’s movement.
Tendon. A type of tough connective tissue that connects muscles to bones and helps to control movement of the joint.
Meniscus. A curved part of cartilage in the knees and other joints that acts as a shock absorber, increases contact area, and deepens the knee joint.

Reasons for the procedure

Knee replacement surgery is a treatment for pain and disability in the knee. The most common condition that results in the need for knee replacement surgery is osteoarthritis.

Osteoarthritis is characterized by the breakdown of joint cartilage. Damage to the cartilage and bones limits movement and may cause pain. People with severe degenerative joint disease may be unable to do normal activities that involve bending at the knee, such as walking or climbing stairs, because they are painful. The knee may swell or “give-way” because the joint is not stable.

Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury, may also lead to degeneration of the knee joint. In addition, fractures, torn cartilage, and/or torn ligaments may lead to irreversible damage to the knee joint.

If medical treatments are not satisfactory, knee replacement surgery may be an effective treatment. Some medical treatments for degenerative joint disease may include, but are not limited to, the following:

Anti-inflammatory medications
Glucosamine and chondroitin sulfate
Pain medications
Limiting painful activities
Assistive devices for walking (such as a cane)
Physical therapy
Cortisone injections into the knee joint
Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
Weight loss (for obese persons)

There may be other reasons for your doctor to recommend a knee replacement surgery.

Seminar Management of Knee Arthritis

Have you been diagnosed with arthritis of your knees? Watch this webinar with Dr. Vishal Hegde, hip and knee surgeon and Assistant Professor of Orthopaedic Surgery at Johns Hopkins as he discusses the diagnosis and management of knee osteoarthritis and treatment options to improve your function to get you back to the activities you enjoy.

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

Bleeding
Infection
Blood clots in the legs or lungs
Loosening or wearing out of the prosthesis
Fracture
Continued pain or stiffness

The replacement knee joint may become loose, be dislodged, or may not work the way it was intended. The joint may have to be replaced again in the future.

Nerves or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The joint pain may not be relieved by surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Before the procedure

Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
If you are pregnant or suspect that you are pregnant, you should notify your doctor.
You will be asked to fast for eight hours before the procedure, generally after midnight.
You may receive a sedative prior to the procedure to help you relax.
You may meet with a physical therapist prior to your surgery to discuss rehabilitation.
Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
Based on your medical condition, your doctor may request other specific preparation.

Pre-Operative Education

Johns Hopkins offers educational sessions to help you prepare for knee replacement surgery. During your class, we’ll review important aspects of your care and what to expect before and after surgery. You will be able to ask questions and meet many of the staff who will be caring for you in the hospital.

During the procedure

Knee replacement requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Knee replacement surgery is most often performed while you are asleep under general anesthesia. Your anesthesiologist will discuss this with you in advance.

Generally, knee replacement surgery follows this process:

You will be asked to remove clothing and will be given a gown to wear.
An intravenous (IV) line may be started in your arm or hand.
You will be positioned on the operating table.
A urinary catheter may be inserted.
If there is excessive hair at the surgical site, it may be clipped off.
The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
The skin over the surgical site will be cleansed with an antiseptic solution.
The doctor will make an incision in the knee area.
The doctor will remove the damaged surfaces of the knee joint and resurface the knee joint with the prosthesis. The knee prosthesis is made up of metal and plastic. The most common type of artificial knee prosthesis is a cemented prosthesis. Uncemented prostheses are not commonly used anymore. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis. Sometimes, a combination of the 2 types is used to replace a knee.

After the procedure

In the hospital

After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Knee replacement surgery usually requires an in-hospital stay of several days.

It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. A continuous passive motion (CPM) machine may be used to begin the physical therapy. This machine moves your new knee joint through its range of motion while you are resting in bed. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.

You will be discharged home or to a rehabilitation center. In either case, your doctor will arrange for continuation of physical therapy until you regain muscle strength and good range of motion.

At home

Once you are home, it is important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.

To help reduce swelling, you may be asked to elevate your leg or apply ice to the knee.

Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.

Notify your doctor to report any of the following:

Fever
Redness, swelling, bleeding, or other drainage from the incision site
Increased pain around the incision site

You may resume your normal diet unless your doctor advises you differently.

You should not drive until your doctor tells you to. Other activity restrictions may apply. Full recovery from the surgery may take several months.

It is important that you avoid falls after your knee replacement surgery, because a fall can result in damage to the new joint. Your therapist may recommend an assistive device (cane or walker) to help you walk until your strength and balance improve.

Making certain modifications to your home may help you during your recovery. These modifications include, but are not limited to, the following:

Proper handrails along all stairs
Safety handrails in the shower or bath
Shower bench or chair
Raised toilet seat
Long-handled sponge and shower hose
Dressing stick
Sock aid
Long-handled shoe horn
Reaching stick to grab objects
Removing loose carpets and electrical cords that may cause you to trip
Avoiding stair-climbing until recommended by your doctor

Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.

Find a Doctor

Revision Knee Surgery
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Total Joint Replacement

At Another Johns Hopkins Member Hospital:

Howard County General Hospital
Sibley Memorial Hospital
Suburban Hospital