Total knee replacement (total knee arthroplasty) is the operation in which the worn articular surfaces of the knee are resurfaced with metal and polyethylene components and the alignment of the limb is corrected. It is one of the most reliable procedures in orthopaedics for relieving the pain of advanced arthritis and restoring walking.
Surgery is considered when knee osteoarthritis or inflammatory arthritis has destroyed the cartilage and the patient has pain at rest or at night, pain that limits walking distance, progressive deformity into varus or valgus, stiffness and loss of function — and when analgesics, weight management, physiotherapy and injections no longer help. Radiographs typically show joint space loss, subchondral sclerosis, cysts and osteophytes. The decision rests on symptoms and function, not on the X-ray alone.
Most knees are replaced with a cemented cruciate-retaining or posterior-stabilised implant. Where the posterior cruciate ligament is deficient or deformity is severe, a more constrained design is used. Highly cross-linked polyethylene and modern metal or ceramicised alloys have improved wear performance considerably. If arthritis is confined to one compartment, a partial (unicompartmental) knee replacement may be a better option, preserving the healthy compartments and the cruciate ligaments.
Under spinal or general anaesthesia, the worn femoral and tibial surfaces are resected with precise bone cuts, the ligaments are balanced so that the knee is stable through the full range of motion, and the trial components are tested before the definitive implants are fixed. The patella is resurfaced when indicated. Robotic assistance can be used to plan and execute the bone cuts and to quantify soft-tissue balance. The procedure usually takes sixty to ninety minutes.
Patients stand and walk with a frame on the day of surgery or the following morning and normally leave hospital in two to four days. Crutches are used for two to four weeks. Achieving and holding flexion beyond ninety degrees in the first six weeks is the single most important goal of rehabilitation. Most patients drive at four to six weeks and return to sedentary work at six weeks. Swelling and warmth settle gradually, and the knee continues to improve for a full year. Walking, cycling, swimming, golf and doubles tennis are encouraged; running and impact sports are not.
There is no upper age limit. Older patients with medical comorbidities are assessed carefully before surgery, but age by itself is not a reason to withhold an operation that restores independence. Equally, in younger patients the durability of the implant is weighed against years of disability, and joint-preserving alternatives such as osteotomy are considered first.
The cost of knee replacement in Greece depends on the implant and whether robotic assistance is used, the hospital and room category, length of stay, anaesthesia and the surgical team, pre-operative investigations and post-operative physiotherapy, and on the patient’s insurance cover. A written, personalised estimate is provided after the clinical assessment — contact the practice to discuss your case.
to guide you about your condition, to choose the best possible treatment.
