The first knee replacement was performed in 1968. Since then, improvements in material selection and techniques have greatly increased its effectiveness. The study of biomaterials by biomedical engineers has led to advancements in more accurate sizing, the option of patella femoral replacement, better instrumentation as well as components that allow an increased range of motion and a lower wear rate have since been developed and implemented. During this period the collaboration between surgeons and engineers produced many developments in the design of the prosthesis. Today this procedure is safe and established even if in continuous development. The progress in technologies and the use of new materials let researches try again old-fashioned techniques from the past in order to be improved.The most common reason for knee replacement is that other treatments (weight loss, exercise/physical therapy, medicines, injections, and bracing) have failed to relieve arthritis-associated knee pain. The goal of knee replacement is to relieve pain, improve quality of life, and maintain or improve knee function Scope Possible disadvantages of knee replacement surgery include replacement joints wearing out over time, difficulties with some movements and numbness. A replacement knee can never be quite as good as a natural knee – most people rate the artificial joint about three-quarters average (Marian et al.,2021) Most knee replacements aren’t designed to bend as far as your natural knee. Although it’s usually possible to kneel, some people find it uncomfortable to put weight on the scar at the front of the knee. There may be some numbness at the outer edge of the spot. This usually improves over about two years, but it’s unlikely that the feeling will ultimately return to normal. A replacement knee joint may wear out after a time or may become loose. , total knee replacement can help relieve pain that emanates from arthritis restoring the normal mobility of an individual. The procedure involves removing the damaged bone and cartilage from the thigh bone, shin bone, and kneecap and replacing it with an artificial joint made of metal alloys, high-grade plastics and polymers. However, despite having its advantages, total knee replacement surgery carries several risks such as infection, blood clots in the leg veins or lungs, heart attack, stroke and nerve damage. The artificial knee can also wear out due to excessive use. Excess glue is squeezed out to the side as the element is pressed into place and removed. The cement hardens quickly, the incision is closed using several layers of sutures, and a bandage is applied

1. Background
In the early 1970s, the condylar knee was developed
independently in the United States and overseas. The
concept of replacing the tibiofemoral condylar
surfaces with cemented fixation and preservation of
the cruciate ligaments was developed and refined.

2. Objectives
 The most common reason for knee replacement is
that other treatments (weight loss, exercise/physical
therapy, medicines, injections, and bracing) have
failed to relieve arthritis-associated knee pain. The
goal of knee replacement is to relieve pain, improve
quality of life, and maintain or improve knee function

3. Scope
A narrow tube with a tiny camera on end will be
inserted through one of the cuts. The camera is
attached to a video monitor that lets the surgeon see
inside the knee. The surgeon may put other small
surgery tools inside your knee through further cuts.
The surgeon will then fix or remove the problem in
your knee.

4. Limitations
 Possible disadvantages of knee replacement surgery include
 Replacement joints wearing out over time
 Difficulties with some movements
 Numbness.
 A replacement knee can never be quite as good as a natural
knee – most people rate the artificial joint about three-
quarters average (Marian et al.,2021)

5. Delimitations
 Some delimitations include:
 Chronic knee pain is the main reason most people
finally decide to have a knee replacement
 Pseudotumor and Tissue Damage Caused by Metal Ions
in the Blood.
 Device Failure Caused By Allergies
 Increase in risk of Heart Attack, Stroke, and Bleeding
Stomach Ulcers
 Increases the Risk of Hip Fracture

6. Justification
 Knee replacement surgery is usually
necessary when the knee joint is worn or damaged
so that your mobility is reduced and you are in
pain even while resting. The most common reason
for knee replacement surgery is osteoarthritis.
Other health conditions that cause knee
damage include rheumatoid arthritis.

7. Literature review
 We discuss the assessment of surgery outcomes
based on data for revision surgery from national
joint-replacement registries and patient-reported
outcome measures. Widespread surveillance of
existing implants is urgently needed alongside
the carefully monitored introduction of
new implant designs

8. Theory
According to (Price et al., 2018), knee-replacement surgery is frequently done and
highly successful. It relieves pain and improves knee function in people with advanced
arthritis of the joint. The most typical indication of the procedure is osteoarthritis. We
review the epidemiology of and risk factors for knee replacement. Because
replacement is increasingly considered for patients younger than 55, improved
decision-making about whether a patient should undergo the procedure is needed.

9. Materials and Methods
 The implant materials used must meet several criteria:
 They must be biocompatible; that is, they must not be rejected by the
body.
 They must also be able to duplicate the knee structures they are
intended to replace.
 They must be strong enough to take weight-bearing loads, flexible
enough to bear stress without breaking, and able to move smoothly
against each other as required.
 They must retain their strength and shape for a long time.
 The metal parts of the implant are made of titanium- or cobalt-
chromium-based alloys. The plastic parts are made of medical-grade
polyethene.

10. Materials and Methods
• Some implants are made of ceramics or ceramic/metal mixtures
such as oxidised zirconium. These implants typically weigh
between 15 and 20 ounces.
• The artificial knee is a prosthesis (a mechanical device designed to
replace a natural body part).
• The femoral component is made of metal and is shaped to match the
femoral condyles that are part of the natural knee joint.
• The tibia component replaces the top surface of the tibia for the
lower leg bone. It mainly consists of a metal tray that firmly holds a
plastic bearing surface that will go out against or articulate against
the metal femoral condyle of the femoral component.

11. Materials and Methods
• At the lower end of
the femur, the metal
femoral component
curves around the
end of the femur
(thighbone).
• It is grooved so the
kneecap can move up
and down smoothly
against the bone as

12. Materials and Methods
• For additional stability, the metal portion of the
component may have a stem that inserts into the
centre of the tibia bone—the back surface of the
patella.
• The patellar component is a dome-shaped piece
of polyethene that duplicates the shape of the
patella (kneecap). In some cases, the patella does
not need to be resurfaced (Saccomannoet
al.,2019).
• Components are designed so that metal
continuously interfaces with plastic, providing
smoother movement and minor implant wear.

13. Results and Discussion
 The operation to replace an arthritic knee begins with an incision
down the front of the knee.
 Once this incision is made, the patella is dislocated and inverted
so that the inside of the knee joint is visible to the surgeon, and
there is enough room for the surgeon to work inside the knee.
 The soft tissues are held back out of the way using metal
detractors. Once the knee joint is visible, the surgeon must
remove the arthritic joint surface of the knee joint, including the
femoral condyles, the tibial surface and the patellar surface.
 Achieving the right balance in these two areas is critical to both
the knee's function and determines how long it will last.

14. Results and Discussion
 Once the surgeon is satisfied that the correct size of the
components has been chosen and that the balance has been
optimised, the permanent members are fixed into position.
 Sometimes, a special cement is used to attach the metal
components to the bone, and the adhesive is placed between the
bone and the metal.
 Once each joint cover has been removed, each part is
temporarily placed in position, and the knee is assessed
for stability and mobility. The new knee is tested to
ensure that it has the best range of motion possible and
that the knee is neither too loose nor too tight.

15. Results and Conclusion
 Excess glue is squeezed out to the side as the element is
pressed into place and removed.
 The cement hardens quickly, the incision is closed using
several layers of sutures, and a bandage is applied.
 Full recovery from an artificial knee replacement usually
takes about three months (Wainwright et al., 2021.
 The surgeon uses exceptional cutting guides attached
to the bone and got a bone saw that removes the
joint surface and shapes the bone so that the
standard artificial components fit correctly.

16. Conclusion
 In conclusion, total knee replacement can help relieve pain that
emanates from arthritis restoring the normal mobility of an
individual.
 The procedure involves removing the damaged bone and
cartilage from the thigh bone, shin bone, and kneecap and
replacing it with an artificial joint made of metal alloys, high-
grade plastics and polymers.
 However, despite having its advantages, total knee replacement
surgery carries several risks such as infection, blood clots in the
leg veins or lungs, heart attack, stroke and nerve damage.
 The artificial knee can also wear out due to excessive use.

17. References
 Marian, Max, Christian Orgeldinger, Benedict Rothammer,
David Nečas, Martin Vrbka, Ivan Křupka, Martin Hartl, Markus
A. Wimmer, Stephan Tremmel, and Sandro Wartzack. "Towards
the understanding of lubrication mechanisms in total knee
replacements–Part II: numerical modelling." Tribology
International 156 (2021): 106809.
 Price, A. J., Alvand, A., Troelsen, A., Katz, J. N., Hooper, G.,
Gray, A., ... & Beard, D. (2018). Knee replacement. The
Lancet, 392(10158), 1672-1682.

18. References
 Saccomanno, Maristella F., Giuseppe Sircana, Giulia Masci,
Gianpiero Cazzato, Michela Florio, Luigi Capasso, Marco
Passiatore, Giovanni Autore, Giulio Maccauro, and Enrico Pola.
"Allergy in total knee replacement surgery: Is it a real
problem?." World Journal of Orthopedics 10, no. 2 (2019): 63.
 Wainwright, T. W., Gill, M., McDonald, D. A., Middleton, R. G.,
Reed, M., Sahota, O., ... & Ljungqvist, O. (2020). Consensus
statement for perioperative care in total hip replacement and total
knee replacement surgery: Enhanced Recovery After Surgery
(ERAS®) Society recommendations. Acta orthopaedica, 91(1), 3-
19.