Total Knee Replacement (TKR) is a common orthopedic procedure performed to treat severe arthritis, most often osteoarthritis, which causes chronic pain and limits mobility. This surgery involves resurfacing the damaged portions of the knee joint with artificial implants. Patients often wonder if TKR is considered a “major” surgical procedure, given its complexity and significant recovery period. Understanding the medical criteria and the demands of the operation helps answer this question.
Defining Major Surgery: Criteria for Classification
Medical professionals classify surgical procedures based on several factors. Major surgeries typically necessitate general or regional anesthesia, which carries a higher risk profile than local anesthesia used for minor procedures. Surgeries involving significant manipulation of deep structures or extensive tissue dissection are also classified as major.
The potential for substantial blood loss, fluid shifts, or the involvement of a major body cavity often designates a procedure as major. The expected duration and complexity of the techniques required also contribute to the classification. TKR meets these criteria because it is a complex, deep tissue procedure performed under general or regional anesthesia involving significant bone modification, placing it firmly within the category of major surgery.
The Surgical Procedure and Invasiveness
The physical steps taken during a Total Knee Replacement illustrate the procedure’s invasiveness. The operation begins with a substantial incision, typically 8 to 10 inches long, made over the front of the knee to expose the joint. While newer, minimally invasive techniques may use a shorter incision (4 to 6 inches), the fundamental steps involving deep tissue manipulation remain.
Once the joint is exposed, the surgeon removes the damaged cartilage and a small amount of underlying bone from the ends of the femur (thigh bone) and the tibia (shin bone). Specialized instruments are used for this bone-cutting process to ensure precise alignment and fit for the new prosthetic components. The metal components are then precisely positioned and secured, sometimes with bone cement, recreating the joint surface. The undersurface of the kneecap (patella) may also be resurfaced with a plastic component before the deep tissues and skin are closed.
Immediate Post-Operative Care and Rehabilitation
The intensive nature of the recovery process follows Total Knee Replacement. Patients typically spend one to three days in the hospital for close monitoring of immediate complications like infection or blood clots and for initial pain management. Effective pain control is managed using a multimodal approach, often combining opioids, nonsteroidal anti-inflammatory drugs, and nerve pain medications.
Rehabilitation begins almost immediately, with the patient encouraged to stand and walk with assistance on the first day after surgery. This early, rigorous physical therapy is important for regaining mobility and preventing joint stiffness. Within the first four to six weeks, most patients can transition to walking with a cane or no assistance and may return to desk work or resume driving. While significant improvement is often seen within 12 weeks, full recovery, including the restoration of strength and stamina, can take up to 6 to 12 months.