About the procedure

Total knee arthroplasty is one of the most frequently performed orthopedic procedures. The operation consists of removing the affected joint surfaces of the knee and replacing them with metal or polyethylene prosthetic components. This results in the elimination or significant reduction of pain and improved knee function and quality of life in general. Patients must be carefully selected to obtain maximum benefit from this procedure. It is usually performed in patients who have exhausted all options for conservative therapy and after extensive discussion about the risks and benefits of surgery.

Indications for Total Knee Arthroplasty

Total Knee Arthroplasty is an operation performed in cases of destruction of the articular cartilage of the knee. Causes of such destruction are usually advanced osteoarthritis, rheumatoid or inflammatory arthritis, post-traumatic joint degeneration, or osteonecrosis with cartilage damage. These diseases lead to pain and impaired function of the knee.

In the majority of cases, Total Knee Arthroplasty is a procedure that is undertaken when all conservative methods of treatment and therapy of the disease have been exhausted.

Total knee arthroplasty

At A Glance

Surgery Time

1-2 hours

Time off work

1-2 weeks

Hospital Stay

7 days

Washing

Shower after 1 week

Reasonably Mobile

1 day

Sleeping Position

Sleeping elevated on your back for 1 – 2 weeks

Exercise Including Gym

6 weeks

Bras & Garments

Worn for 2 weeks

Sexual Activity

Restricted activity after 4 – 6 weeks

Full Recovery

6-8 weeks

Driving

2 weeks

Frequently Asked Questions

Before the procedure

During the examination, the surgeon will collect detailed information about your health and condition (a questionnaire is filled out) and will ask you about the strength of the pain and the function of the affected knee.

The physical examination will measure the entire limb’s mobility, stability, strength, and alignment.

X-rays will be needed to determine the extent of the damage and deformity of the knee. Usually, a front view of the knee and a photo of the entire limb in the weighted position are required for good preoperative planning.

Sometimes, X-rays are not enough to determine the condition of the bone and soft tissues of the knee, and it is necessary to do other tests, such as an MRI.

Preoperative preparation

It is necessary to fill out the questionnaire that you will receive.

  • You will be assessed for your general health. Allergies, blood pressure, diabetes, and urinary and dental infections are checked.
  • Before the operation, some blood tests will have to be done (Hb, CRP, etc.)
  • It will be necessary to stop drugs such as NSAIDs, Aspirin, and Coumarin derivatives (Syntrom).

If you are overweight, it is good to lose it first.

How is the procedure performed?

The procedure usually lasts 1-2 hours. It is generally performed under general anesthesia or spinal anesthesia. The anesthesia team chooses the kind of anesthesia that will be used.

Access is standard or minimally invasive, depending on the patient’s medical indications and personal preferences.

It consists of five main steps:

  1. Bone Preparation: The damaged cartilage surfaces of the joint are removed with a small portion of the underlying bone;
  2. Positioning of the metal implants: these implants recreate the joint’s articular surfaces and are put in place of the removed cartilage. They can then be cemented or “press-fit” to the bone;
  3. Soft tissue balancing: the ligaments around the knee are treated with surgical methods to make the joint stable and functional throughout the range of motion;
  4. Resurface the patella: the articular surface of the cap is removed and replaced with a plastic component. Sometimes, this step of the procedure is optional;
  5. Placing a spacer: a spacer made of special medical plastic is placed between the metal components of the joint. That creates a smooth, sliding surface.

Total knee arthroplasty with navigation: we sometimes use computer navigation (Orthopilot). It is believed that using it can lead to better balance and function of the knee joint, fewer perioperative complications, and faster recovery in patients who want to perform more excellent physical activities.

Aftercare and recovery

You will stay in the hospital for the first five days to be monitored for early post-operative complications. The rehabilitation program begins the day after the operation. It consists of standing up and learning to walk with aids (crutches).

The stitches are removed after 14 days. It is important to anticipate where and how your stitches will be removed.

About 20 days after the operation, riding an ergometer can be started.

Depending on individual progress, walking with crutches is usually discontinued after a month.

Driving is allowed three months after the operation.

Sports activities are allowed after a minimum of 6 months.

Recovery from this operation is better if specialized rehabilitation occurs, so we advise you to anticipate where you will have it.

Having realistic expectations regarding the possibilities of activities after Total Knee Arthroplasty is essential. A well-fitted prosthesis will provide unlimited walking, swimming, driving, golfing, light hiking, cycling, dancing, and other non-stressful sports. The knee replacement will last many years with appropriate modifications to your activity.

What are the risks of the operation?

The most common complication of Total knee arthroplasty is deep vein thrombosis (DVT), which can lead to pulmonary embolism. To eliminate this risk, all patients are prophylactically prescribed medication.

Other risks are infection and malfunction (poor functioning) of the prosthesis. It would help reduce the disease risk if you had no dental or urinary infections before Total knee arthroplasty.

Implant problems: Although implant design, materials, and surgical techniques are constantly improving, issues like wear of the articular surfaces and loosening prostheses are possible. Modern prostheses allow about 140° range of motion, but sometimes this cannot be achieved due to fibrosis on the knee. Patients with limited range of motion before surgery are at greater risk of not reaching full joint range of motion.

Our team is highly specialized and experienced in performing knee arthroplasty, including minimally invasive and computer-assisted techniques. We use preoperative planning for each of our cases. Revision surgery for failed, infected, or loose dentures is performed successfully at our center.

The implants we use are of the highest quality and have the highest rating in the world registry of knee arthroplasty implants.

How much does an arm lift cost?

Prices are formed individually after an online consultation and depending on the patient’s personal needs. Once we know what you want, you will receive our offer within 24 hours. You also can check our PRICE LIST.

How do we work

Once you reach out to us, we will send you the necessary documents for completion and return. Additionally, you will need to provide X-Ray or MRI scans.

Upon receiving these documents and scans, we will schedule an online consultation with the surgeon. This consultation can occur within the next 3-5 days or at a time convenient for both you and the surgeon. It’s important to note that this consultation is provided free of charge.

During the consultation, you will engage in a comprehensive discussion about the surgical procedure. The surgeon will address any questions or concerns you may have, including pre-surgery preparations, potential risks, and other relevant issues.

We recommend preparing a list of questions regarding the procedure before the actual consultation.

Within 48 hours of the consultation, we will present you with available dates for booking. These dates will be tailored to your preferences.

Since our surgeries have fixed package prices, you’ll have 3-4 days to contemplate your decision. If you decide to proceed and agree to the terms and conditions, you must make a prepayment of 20-30% of the total procedure cost within 48 hours. This prepayment secures your reservation for the procedure. The remaining balance should be settled the day before the surgery following a preliminary examination at the hospital.

If you need to cancel the procedure, this must be done at least 30 days before your scheduled flight to initiate the deposit refund process. Cancellation within the last 30 days before your flight requires a valid reason supported by evidence to receive a refund. If your reason is acceptable, your funds will be returned, with a 50 euro administrative fee deducted. You can also change the procedure date with at least 30 days’ notice.

If you decide to cancel within 1 or 2 weeks before your flight with supporting evidence, you’ll receive a 50% refund of the deposit amount.

Upon arriving in Bulgaria, one of our staff members will meet you at the airport. Depending on your flight time, they will either take you to your hotel or directly to the hospital.

Upon arriving in Bulgaria, one of our staff members will meet you at the airport. Depending on your flight time, they will either take you to your hotel or directly to the hospital.

After the procedure and rehabilitation program, when you’re in stable condition and ready to return, our employee will accompany you back to the airport. Throughout your stay, our staff will be at your service.

If you wish to extend your stay for additional rehabilitation or other purposes, we can accommodate your requirements.

You will receive a comprehensive recovery plan.

Online consultations with your surgeon will be arranged at the 1st, 3rd, and 6th months of your recovery.

We will provide all necessary documents, which will be translated from Bulgarian to English, and you can contact us anytime for assistance.

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