Watching a Total Knee Replacement

    This first time I watched a surgery, I was surprised and bored in the beginning, but this time I was interested throughout. The surgery I watched this time was a total knee revision. Orthopedic surgeons perform this procedure when the replacement for a patient's knee developed some problem. In my case, the knee replacement was too loose. So in this procedure the surgeon replaced the prosthetic knee with another prosthetic knee. This surgery was much shorter than the surgery I watched the last time. This one lasted around one and a half hour while the radical prostatectomy lasted almost six hours. This surgery was not performed by a robot was the type of surgery you would expect to see in the movies. There were three main surgeons, two senior mentors, and a surgical nurse. In this blog, I will describe the procedure to the best of my ability. The major stages of this procedure are preparation, incision, resection of the previous prosthetic, drilling holes, preparing a cement, adding a testing prosthetic, removing the testing prosthetic and adding the actual prosthetic, alignment and testing of the new prosthetic, sterilizing the surgical area, and then closing.

The patient is prepared for surgery, which may include administering anesthesia, either general or regional (spinal or epidural). The surgeon makes an vertical incision incision over the knee, exposing the damaged joint. Then the surgeon removes any fat and cuts layers into the tissues. The damaged or diseased parts of the knee joint, including the ends of the femur and tibia and the backside of the patella, are removed. Also, the old damaged prosthetic is also removed. Then the surgeon has to drill some holes into the tibia, fibula, and the femur, so that the new prosthetic can be added. The surgeon replaces the removed joint surfaces with artificial components made of metal, plastic, or ceramic. The components may include a metal femoral component, a metal tibial component, and a plastic spacer. In my case the surgeon used a metal knee and a plastic spacer. To ensure that the new prosthetic stays where it should be and it doesn't move around, the surgeon created a cement-like paste that rapidly solidifies and fills the holes made by the surgeon. The surgeon ensures proper alignment of the prosthetic components and tests the range of motion and stability of the new knee joint. After testing the components of the new knee, the surgeon floods the surgical site with a betadine solution to kill any bacteria. It is paramount that the surgeon performs this step because infections from this procedure can lead to bone infections, which are the worst type of infection to happen. Once the surgical site has been flooded with betadine solution for approximately five minutes, the surgeon uses a suction tube and gets rid of all of it and begins to close the incision. Once the components are securely in place and the joint functions properly, the surgeon closes the incision with sutures or staples. In my case the, surgeon used sutures to stitch all the tissues together. The patient undergoes a postoperative recovery period, typically in the hospital initially and then at home. Physical therapy and rehabilitation are crucial to regain strength, flexibility, and mobility in the knee. The patient spends two to three days at the hospital and uses either crutches or a walker to help them walk to places. 

This surgical experience was very different was extremely informational because I learned about the more traditional type of surgery that involved a large incision unlike last time in which small incisions were made and a robot performed the procedure.

If anyone has seen a procedure like this please share your experience in the comment below. Also if you have any questions please feel free to ask.