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TOTAL KNEE REPLACEMENT REHABILITATION 
 
Total knee replacement (TKR), also referred to as total knee arthroplasty (TKA), is asurgical procedure where worn, diseased, or damaged surfaces of a knee joint are removedand replaced with artificial surfaces.
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The procedure itself is a resurfacing of the damaged knee, and relies on the patient'smuscles and ligaments for support and function.
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According to the American Academy of Orthopaedic Surgeons (AAOS), over 760,000total hip and knee replacement procedures – which help patients to regain mobilityand quality of life – were performed in 2005 in United States, including:
235,000 total hip replacements
125,000 patients were women and 108,000 were men
534,000 total knee replacements
335,000 patients were women and 176,000 were men
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A replacement knee will not last forever, but your artificial knee will probably lastyou at least 10-15 years, depending on how active you are and the type of replacementyou have.
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Indications for TKR :
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Any condition affecting the knee that causes damage to the normally smooth liningcartilage of the knee may eventually end up with the same result.
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The protective cartilage lining the joint becomes worn away, producing increasingdamage to the bone surfaces inside the joint.
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Primary TKR is most commonly performed for knee joint failure caused by
Osteoarthritis (most common)
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Post-traumatic Arthritis
Osteonecrosis
Other types of Inflammatory Arthritis
Haemoplilia
Gout
Disorders that cause unusual bone growth (bone dysplasias)
Malalignment of Knee Joint (Knock Knees or Bow Legs)
Who is a Candidate for TKR?
Total knee replacements are usually performed on people
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Moderate to severe persistent pain that is not adequately relieved by an extendedcourse of nonsurgical management.
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Clinically significant functional limitation resulting in diminished quality of life.
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Radiographic evidence of severe arthritic involvement.
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Significant stiffness of knee.
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Significant instability of knee (constant giving away)
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Significant deformity of knee
 
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Failed conservative measures, including ambulatory aids, NSAIDS, and life stylemodifications.
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Most people who have artificial knees are over age 55, but the procedure is alsooffered to younger people with knee degeneration if their quality of life is severelyaffected. 
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Contraindications for TKR :
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 Absolute:
Recent of current joint infection - unless carrying out an infected revision
Sepsis or systemic infection
 Neuropathic arthropathy
Painful solid knee fusion due to Reflex Sympathetic Dystrophy (RSD)
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 Relative:
Severe osteoporosis
Debilitated poor health
 Nonfunctioning extensor mechanism of knee
Painless, well functioning arthrodesis
Significant peripheral vascular disease
Obesity (Obesity is not a contraindication to TKR; however, there may be anincreased risk of delayed wound healing and perioperative infection in obese patients.) 
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Different Types of TKR :
Depending on the knee condition, surgeons would either opt for 
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Total Knee Replacement
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Partial Knee Replacement
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Kneecap Replacement
Total Knee Replacement:
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In a total knee replacement, both sides of your knee joint are replaced.
Pros:
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Long lasting. Typically, a new knee lasts about 15 years.
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Tried and tested treatment that has stood the test of time.
Cons:
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Longer operation, bigger incision and more bone needs to be removed.
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Longer hospital stay and recovery period.
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Blood transfusion is sometimes needed.
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You may be aware or clicking or clunking in the knee.
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You're still likely to experience some difficulties in moving, especially in bendingyour knee, and kneeling may be difficult because of the scar.
 
 Partial Knee Replacement:
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If only one side of your knee is damaged, you may be able to have a partial, half-kneeor unicompartmental replacement.
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This is suitable for around one in four people with osteoarthritis.
Pros:
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Smaller operation, smaller incision and less bone removed.
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Shorter hospital stay and recovery period.
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Blood transfusion rarely needed.
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Better movement in the knee, which feels more like a natural knee. You may be ableto be more active than after a total knee replacement.
Cons:
 
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 Not quite as reliable as a total knee replacement in eliminating pain.
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Tends not to last as long as a total knee replacement, which is likely to mean further surgery at a later date.
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Less suitable for a young, active person.
 Kneecap Replacement:
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If just your kneecap is damaged, an operation called a patellofemoral replacement or  patellofemoral joint arthroplasty can be performed.
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This involves less major surgery with a faster recovery time. However, the long-term picture is still unclear.
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According to the Arthritis Research Campaign the operation is only really suitable for about one in 10 people with osteoarthritis. Depending on the degree of mechanical stability provided by the design of the artificial knee,there are four basic categories of knee replacements:
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 Non-Constrained
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Semi-Constrained
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Fully-Constrained or Hinge
 Non-Constrained Implant:
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It is termed non-constrained because the artificial components inserted into the kneeare not linked to each other and has no stability built into the system.
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It relies on the person's own ligaments and muscles for stability. This is the keyfeature of this group of artificial implants helping to maintain the stability of the knee.
 Semi-Constrained Implant:
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