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Outpatient Total Knee Replacement

Total knee replacement is the surgical treatment for knee arthritis, where the damaged knee 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 overnight or same-day outpatient basis. 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 when your vital signs are stable, such as heart and respiratory rate, blood pressure and temperature during your post-operative physical therapy session. Moreover, you need to be able to maintain pain control with oral medication and tolerate a regular diet before being discharged on the same day of surgery.

The outpatient procedure is performed using advancements in anesthetic techniques like a regional block and a spinal anesthetic. in addition to a multi-modal pain protocol.

You will be lying on your back on the operating table and a tourniquet is applied to your upper thigh to reduce blood loss. The arthritic knee is approached and 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 bone cement. The tibial component is then secured to the end of the bone using bone cement. 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. The incision is closed. A surgical dressing or bandage is placed. Few hours after surgery, a physical therapist will help you stand up and walk using crutches or a walker. Before leaving the hospital, you will be encouraged to walk short distances with an assistive device, climb a few stairs, dress, and perform other basic functions.