Total Knee Replacement

When the arthritis in your knee makes it difficult to do everyday activities, it may be time to consider total knee replacement. 

The Indiana Joint Replacement Institute is led by Dr. R. Michael Meneghini, a nationally renowned total joint surgeon who has over 17 years of surgical experience and participates in orthopaedic research to improve surgical techniques and improve outcomes for patients. The board certified hip and knee replacement surgeons at the Indiana Joint Replacement Institute have done extensive research on advancements that help knee implants better replicate normal motion, and were early adopters of cementless knee replacements, which may last longer and form a more permanent bond with a patient’s bones. 

We use computer assisted navigation for all knee replacements to achieve optimal alignment. We are also developing the capacity to work with new, augmented reality (AR) technology which will allow us to use smart glasses to pinpoint overlaid surgical targets without having to look away from a patient.

Our dedicated hip and knee replacement team follows each patient through their entire experience ─ from evaluation, to surgery, through recovery. We treat everyone the way we would treat our own family, taking the time to explain the benefits of each surgical approach, computer assisted technologies and outpatient surgery options. 

If you would like to schedule a consultation with a member of the Indiana Joint Replacement Institute team, please call 317-620-0232 or book an appointment online.  

Anatomy of the Knee  

• The knee is made up of three bones: the lower end of the thighbone, the upper end of the shinbone, and the kneecap. 
• Ligaments hold the joint together to provide stability. 
• Cartilage covers the bones to provide a smooth surface and allow the joint to move easily. 
• C-shaped wedges of cartilage called menisci are located in the center of the joint, between the thighbone and shinbone, to absorb shock.

Arthritis and injury can damage cartilage or cause it to wear away over time, leading to pain, stiffness, and loss of function. A total knee replacement can help relieve pain and restore function.

Am I a Candidate for Total Knee Replacement?

Candidates for total knee replacement have pain and stiffness in the knee that limits daily activities. 

• It may be difficult to climb stairs, stand up and sit down, or even walk without assistance. 
• Pain often gets worse with activity. 
• Some patients also have pain while at rest. 
• In more severe cases, the knee can become deformed.
• When nonsurgical treatments, including anti-inflammatory medications, injections, or physical therapy don’t provide relief anymore, surgery may be the best option.

Total Knee Replacement Procedure  

Total knee replacement involves replacing the damaged portions of the knee joint with implants designed to recreate a normal, healthy knee.

• First, the damaged cartilage, along with a small amount of bone underneath, is removed to make room for the implants. 
• Metal implants are then positioned into the bone to help recreate the joint.
• In some cases, the kneecap may also be trimmed and resurfaced with a plastic button. 
• A plastic spacer is inserted between the two metal components to create a smooth surface for the implants when moving the knee.

Indiana Joint Replacement Institute surgeons use the same setup ─ including equipment, team, technology, and implants ─ to do total knee replacements procedures in either an ambulatory surgery center or a hospital setting, where patients can stay overnight if necessary. 

Our team considers medical condition, home situation, and social support factors to determine if a patient will be able to go home the day of surgery.

Advancements in Total Knee Replacements 

• Researchers are gaining a better understanding of the way the knee moves when you walk and go up and down stairs. 
• Indiana Joint Replacement Institute surgeons use advanced technologies, techniques, and knee implants that help replicate normal knee motion better than previous designs. 
• Patients report these implants are more stable and feel so natural they forget they have a knee replacement.
• Patients now recover within six weeks, instead of eight to ten weeks, and may move on from physical therapy after two or three weeks. 

Cemented vs. Cementless Knee Replacement

Traditionally, prosthetics have been held in place with bone cement. Advances in implant technology have produced knee implants with a textured surface that encourages bone growth to keep the implant rigidly fixed to the bone. 

Indiana Joint Replacement Institute surgeons have extensive experience with both cemented and cementless knee replacements, and will carefully consider which implant will best meet the needs of each patient after doing a thorough examination with detailed medical history.

Cemented Implants

Cemented implants are fixed into place with quick-drying bone cement that bonds the patient’s natural bone with the prosthetic. Cemented implants may be a better option for patients who have poor-quality bone due to conditions like osteoporosis, where bone growth may not be sufficient enough to hold the implant in place. They are also recommended for patients who are older, overweight, and less active.

Over time, the bone cement that holds the implants in place can break down and can leave behind debris which can irritate the tissues surrounding the joint and trigger an inflammatory response. This inflammatory response can cause osteolysis which weakens the bone and leads to further loosening of the implants. 

Cementless Implants

Cementless knee implants, also known as press-fit, have a rough, porous surface that encourages new bone growth. The new bone grows into spaces in the implant, holding it in place without cement. Because cementless implants use the patient’s natural bone to hold the implants in place, they may last longer and form a more permanent bond with the bone. Cementless implants may be particularly beneficial for younger, more active patients. 

Recovering from Total Knee Replacement Surgery 

After surgery, you may be able to go home the same day, after our outpatient surgery team clears you to return home safely with clear instructions.

• Physical therapy and exercise are critical. It is important to begin moving your new knee joint as soon as possible to prevent stiffness.
• If you stay in the hospital overnight, an on-site physical therapist will begin working with you the day after surgery. 
• Your outpatient physical therapist will continue to work with you to gradually begin walking and putting weight on the knee. Most patients are able to return to normal activities within three to six weeks.
• Pain medication can help manage pain during physical therapy.

Total Knee Replacement in Indiana

Indiana Joint Replacement Institute surgeons, led by Dr. R. Michael Meneghini, have extensive experience in total knee replacements, and are committed to utilizing the technologies and techniques that work best for each patient to relieve knee pain and dysfunction. 

Our hip and knee replacement team includes specially trained medical support specialists who assess and follow a patient’s progress from the initial evaluation to procedure, discharge and recovery. 

All of our surgeons, who are board certified and fellowship trained in hip and knee replacement, value character, integrity, and perspective as much as technical skill, and we are committed to treating each patient as if they are a member of our own family.

To schedule a consultation with a member of the Indiana Joint Replacement Institute team, please call 317-620-0232 or book an appointment online.