KNEE SURGERY

Knee prosthesis


Total knee replacement is a perfectly codified orthopaedic surgical procedure. It aims to restore joint function by replacing worn knee surfaces with artificial metal alloy implants.
To obtain optimal, lasting results, three conditions must be met
essential :
- A rigorous preparation before the operation
- A technical production by a specialist surgeon with a team trained in this type of surgery
- A well-managed rehabilitation to regain strength and mobility

Our teams of knee surgery specialists will be with you every step of the way.


knee picto

Why have a knee replacement?

Has your knee joint been damaged? Do you experience daily pain, stiffness or difficulty walking? Replacing the joint with a total or partial prosthesis can be an effective solution.

The main causes of joint damage leading to osteoarthritis of the knee are :

  • Osteoarthritis disease The natural ageing of cartilage and joint surfaces is sometimes much earlier or more severe in some patients. Certain genetic factors are probably involved.
  • Overweight Overweight and obesity: it is clear that being overweight or obese is a factor that favours the degradation of knee joint cartilage and therefore the onset of osteoarthritis. This has been proven time and time again in medical literature.
  • Trauma history kneeA fracture of the tibia or femur, a rupture of the cruciate ligaments, damage to the menisci: all these traumatic events will alter the normal biomechanics of the knee joint and eventually cause damage to the cartilage. This will encourage the onset of osteoarthritis.
  • Past surgeryOsteoarthritis of the knee joint: particularly in the context of the knee trauma mentioned above, a history of cruciate ligament reconstruction, fracture repair, etc. will ultimately encourage the development of osteoarthritis of the knee joint.
  • Inflammatory diseases such as rheumatoid arthritis 
  • Patellar instability Osteoarthritis: recurrent dislocation of the patella also encourages the development of patellofemoral osteoarthritis, i.e. between the patella and the femur. This is because episodes of dislocation cause damage to the cartilage. This is why it is important to stabilise a patella when it is highly unstable.
  • Osteochondritis / osteonecrosis of the femoral condyle Bone fracture: this is a disease that often develops in childhood or adolescence. It involves a defect in the vascularisation of the cartilage and bone, generally in the femur. In childhood, the condition is known as osteochondritis, whereas in adulthood it is known as osteonecrosis. In childhood, osteochondritis often has a favourable outcome, with complete recovery. Otherwise, the bone fragment does not heal, leading to osteoarthritis of the knee later in adulthood.  

The aim of knee replacement surgery is to eliminate pain, restore mobility and improve your quality of life.

perop centric knee osteoarthritis
ptg at osteoarthritis

What is a knee prosthesis?

A knee prosthesis is a three-part implant designed to replace the worn surfaces of the femur, tibia and patella. 

It reproduces the shape and function of the natural knee joint.

There are different types of knee prosthesis depending on indication :

  • Total knee replacement The three surfaces of the joint are damaged and therefore replaced: that of the tibia, that of the femur and that of the patella. Only a few millimetres of bone are removed. The bone structure itself of the femur and tibia is of course preserved. The lateral ligaments, patellar time and quadricipital tendon are all preserved.
  • Unicompartmental prosthesis Partial replacement: in this case, only one compartment of the knee is damaged: a partial replacement is performed. It is usually the medial femorotibial compartment that is replaced. More rarely, the femoral, lateral tibial or patellofemoral compartments are replaced.

There are several possible technical choices for the fitting of a knee prosthesis:

  • A knee prosthesis with a conventional instrument set adapted to the patient's morphology
  • A knee prosthesis with navigation.
  • A knee prosthesis with customised cutting guides
  • A knee prosthesis with robotic assistance
  • A made-to-measure knee prosthesis

The choice of type of prosthesis and surgical technique depends on a number of factors: 

  • your knee joint damage: is it complete or partial osteoarthritis?
  • your morphology: in some cases a custom-made prosthesis is more suitable, for example for unusual anatomies (genetic diseases...)
  • your surgeon's technical choices

Depending on the situation, our team uses a conventional ancillary, a navigation system, robotic assistance or, exceptionally, a custom-made prosthesis.

The course of knee replacement surgery

Your operation is planned on a personalised basis using some of the tests carried out prior to your knee operation (calibrated X-rays, 3D reconstruction scanner, MRI if necessary).

If the operation is planned to use customised cutting guides, a made-to-measure prosthesis or robotic assistance, then the planning is done 5 to 6 weeks in advance in collaboration with a technical engineer. 

You will be admitted to hospital the day before or the morning of the operation. 

The day of the operation :

  • Anaesthesia Knee surgery: knee surgery is performed under general anaesthetic or spinal anaesthetic (epidural). You should discuss this with the anaesthetist beforehand during the anaesthetic consultation.  
  • The knee is prepared for the operation 
  • The incision is made in front of the knee to gain access to the joint. The patella is reclined to the side and the lateral ligaments, patellar and quadricipital tendons are protected. 
  • If navigation or robotic assistance are used, locating pins are fitted and a map of the knee is made to record all the anatomical parameters of the knee: morphology, axes, laxity, etc. 
  • Bone preparation: bone cuts are made to prepare the surfaces to receive the implants. 
  • Fitting implants: fixed to the bone with surgical cement or impaction. 
  • Farming:the patella is repositioned, the different anatomical planes are sutured. 
  • In the evening:resuming walking on the same day as the operation with the physiotherapist and two walking sticks. 

The procedure lasts on average from 60 to 90 minutes. 

A Fast Track recovery protocol is put in place to help you get back on your feet.

knee prosthesis

What is the recovery period for knee replacements?

Mobilisation of the knee begins on the same day or at the latest the day after the operation, under the supervision of a rehabilitation team.

The main stages of recovery :

  • Short hospital stay: 2 to 4 days on average.
  • Hospitalisation at home: nursing care is provided by a nurse at home, as is physiotherapy with a physiotherapist. We can organise hospitalisation at home.
  • A rehabilitation centre: a three-week stay in a rehabilitation centre is also possible. Contrary to popular belief, a stay in a rehabilitation centre does not improve results compared with treatment at home.
  • Rehabilitation: the rehabilitation period for an operated knee lasts between two and three months. It is important to recover joint amplitude and sufficient muscle mass (the quadriceps in particular).
  • Icing: we recommend icing the knee regularly during the day for the first three to four weeks.
  • Autonomy walking: this is acquired in a few weeks, and canes are generally kept on for three weeks. 
  • Back to physical activity exercise: this is a gradual return. Physical activities are resumed step by step as the muscle reinforcement progresses. Sports activities can generally be resumed from the fourth or fifth month.
  • Driving: we recommend that you do not drive before the fifth week.

Perseverance and motivation: the patient's participation in rehabilitation exercises is essential if optimal joint function is to be restored.

Where to have an operation in Paris?

Our teams work in a number of leading establishments in Paris:

For consultations:

  • Espace Médical Vauban
  • IMSS - Institut Médical Sport Santé
  • ARAGO Clinic

For interventions:

  • ARAGO Clinic

You will be cared for by recognised specialists: Dr Kerboull, Dr Sailhan and Dr Zilber, experts in hip surgery.

clinical entrance

Knee replacement is now a reliable and effective solution for treating disabling joint pain. Accurate assessment, appropriate surgery and rigorous rehabilitation are the keys to your success.

Don't wait to improve your quality of life: contact our specialist team for personalised care.

Contact us for a consultation