Knee replacement surgery, also known as knee arthroplasty, is a common procedure performed to address severe knee osteoarthritis (Kuijer & Burdorf, 2020). This surgery is typically considered when other conservative treatments have not provided sufficient relief for the patient’s symptoms (Kuijer & Burdorf, 2020). The duration of knee replacement surgery can vary depending on several factors, including the specific technique used, the complexity of the case, and the surgeon’s experience (Kuijer & Burdorf, 2020). While there is no fixed time frame for how long knee replacement surgery takes, it is generally considered to be a procedure that can be completed within a few hours (Raveendran & Wong, 2014).
Research indicates that most of the blood loss in total knee replacements occurs during the first few hours after surgery (Raveendran & Wong, 2014). This suggests that the initial stages of the procedure, which involve preparing the joint, removing damaged tissue, and implanting the prosthetic components, are critical in terms of managing blood loss and ensuring a successful outcome (Raveendran & Wong, 2014). Techniques such as the use of tranexamic acid have been shown to be effective in reducing blood loss during joint replacement surgeries, including knee arthroplasty (Raveendran & Wong, 2014).
Advancements in surgical techniques and perioperative care have led to the development of fast-track and outpatient surgical pathways for total knee arthroplasty (Hirschmann et al., 2017). These approaches aim to streamline the surgical process, minimize hospital stays, and expedite the recovery process for patients undergoing knee replacement surgery (Hirschmann et al., 2017). Outpatient surgical pathways even aim for same-day admission and discharge of patients undergoing partial or total knee arthroplasty, highlighting the efficiency and effectiveness of modern surgical practices (Hirschmann et al., 2017).
Total knee replacement surgery has evolved significantly over the years, with improvements in surgical techniques, implant materials, and postoperative care contributing to better outcomes for patients (Moran, 2000). Despite these advancements, it is important to note that the longevity of total knee replacements can vary, with some studies reporting survival rates of around 85% at 13 years post-surgery (Moran, 2000). Factors such as patient age, activity level, and implant selection can influence the long-term success of knee replacement surgery (Moran, 2000).
In the context of knee surgery, including procedures such as ACL reconstruction and meniscal transplant surgery, the importance of patient-reported outcomes and long-term survivorship has been emphasized (Noyes, 2020). Studies have shown that while these surgeries can provide significant benefits in terms of restoring knee function and reducing pain, there is a subset of patients who may require additional procedures, such as graft removal or total knee replacement, due to various factors such as graft failure or disease progression (Noyes, 2020).
The decision between total or partial knee replacement in cases of medial femorotibial osteoarthritis of the knee is crucial for achieving optimal outcomes (Argenson et al., 2020). Surgeons must consider various factors, including the extent of joint damage, patient age, activity level, and overall health, when determining the most appropriate surgical approach for each individual case (Argenson et al., 2020). The goal is to provide patients with the best possible results while minimizing the risk of complications and the need for revision surgery in the future (Argenson et al., 2020).
In recent years, there has been a shift towards more targeted and evidence-based approaches in knee surgery, including arthroscopic procedures (LaPrade et al., 2020). Research has shown that the outcomes of arthroscopic surgeries, such as partial meniscectomy, can vary depending on patient characteristics and the specific indications for surgery (LaPrade et al., 2020). By adopting a more selective approach to knee arthroscopy, surgeons can optimize patient outcomes and reduce the likelihood of unnecessary procedures that may not provide long-term benefits (LaPrade et al., 2020).
Overall, the duration of knee replacement surgery can vary based on individual patient factors, surgical techniques, and the complexity of the case. While advancements in surgical practices and perioperative care have led to more efficient procedures and faster recovery times, the ultimate goal of knee replacement surgery remains to improve patient function and quality of life in the long term. By considering the latest evidence-based practices and tailoring treatment approaches to each patient’s specific needs, orthopedic surgeons can continue to enhance the outcomes of knee replacement surgeries.
References #
- Argenson, J., Jacquet, C., & Ollivier, M. (2020). Medial femorotibial osteoarthritis of the knee: total or partial knee replacement?. Annals of Translational Medicine, 8(11), 721-721. https://doi.org/10.21037/atm.2020.01.131
- Hirschmann, M., Kort, N., Kopf, S., & Becker, R. (2017). Fast track and outpatient surgery in total knee arthroplasty: beneficial for patients, doctors and hospitals. Knee Surgery Sports Traumatology Arthroscopy, 25(9), 2657-2658. https://doi.org/10.1007/s00167-017-4660-1
- Kuijer, P. and Burdorf, A. (2020). Prevention at work needed to curb the worldwide strong increase in knee replacement surgery for working-age osteoarthritis patients. Scandinavian Journal of Work Environment & Health, 46(5), 457-460. https://doi.org/10.5271/sjweh.3915
- LaPrade, R., Spalding, T., Murray, I., Chahla, J., Safran, M., Larson, C., … & Engebretsen, L. (2020). Knee arthroscopy: evidence for a targeted approach. British Journal of Sports Medicine, 55(13), 707-708. https://doi.org/10.1136/bjsports-2020-103742
- Moran, C. (2000). Total knee replacement: the joint of the decade. BMJ, 320(7238), 820-820. https://doi.org/10.1136/bmj.320.7238.820
- Noyes, F. (2020). Editorial commentary: long-term survivorship of knee meniscal transplant surgery—the importance of patient-reported outcomes with magnetic resonance imaging demonstration of retained meniscal transplant function. Arthroscopy the Journal of Arthroscopic and Related Surgery, 36(8), 2275-2278. https://doi.org/10.1016/j.arthro.2020.05.005
- Raveendran, R. and Wong, J. (2014). Tranexamic acid: more evidence for its use in joint replacement surgery. Transfusion, 54(1), 2-3. https://doi.org/10.1111/trf.12494