Patient selection and counseling

When selecting patients for total knee replacement, it is important to assess both the chronological and the physiological patient age to gage longevity of the implant as well as perioperative co-morbidity risk. The severity of clinical and radiographic disease can factor into postoperative functional status and can also direct the surgeons in their implant selection. The number of potential complications has been reduced in recent years by optimizing the patient's health prior to surgery. Interventions such as preoperative antibiotics and aggressive postoperative DVT prophylaxis have also reduced the risk of complication. The surgeon considering total knee replacement in a patient needs to spend time with that patient to let him or her know about the expectations postoperatively as well as to summarize the risks of surgery.