Total Knee Replacement
Knee arthritis is very common. After attempting to treat one’s arthritis with non-operative forms of treatment such as weight loss, medications, physical therapy, bracing, activity modification, assisted devices, and injections, the next step in treatment is typically surgery. Total knee replacement (or total knee arthroplasty) is one of the most successful orthopedic procedures of the twentieth century. This is due to the substantial pain relief and restoration of function a patient feels after surgery. Knee replacement procedures were first introduced in 1968 and since then vast improvements in surgical techniques and the materials used to reconstruct the knee have greatly increased its effectiveness. Current statistics show that over 600,000 knee replacements are performed each year in the United States.
During the operation, the surgeon moves your kneecap (patella) aside and cuts away damaged bone and cartilage, which are then replaced with metal and plastic components. The components combine to form a synthetic (but biologically compatible) joint that mimics the movement of your natural knee.
With newer implant designs and improved surgical techniques, patients are having less pain, faster return to function, and shorter hospital stays (many can even be done as an outpatient procedure). Total knee replacements can be expected to function well for over 20 years in about 80% of patients.
4 Signs you May Benefit From a Knee Replacement
Arthritis pain tends to be deep and achy in nature. It typically does not radiate. Most knee pain is caused by three types of arthritis: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
- Osteoarthritis is an age-related “wear and tear” type of arthritis. It usually occurs in patient 50 years of age or older, but may occur in younger patients as well.
- Rheumatoid arthritis causes the synovial membrane that surrounds the knee joint to become inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness.
- Post-traumatic arthritis can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.
When patients have severe knee pain, they limit their range of motion to prevent causing discomfort in the knee. With time, the ligaments and muscles about the knee contract resulting in stiffness and loss of motion. The stiffness can limit a patient’s everyday activities, including walking, climbing stairs, bending or kneeling, and getting in and out of chairs. Ultimately, a patient’s pre-op range of motion determines his or her post-op range of motion, so it is important to keep as much motion in the knee prior to surgery.
Medical words that end in “itis” typically refer to some form of inflammation. In severe arthritis, the ends of the bones lose all their cartilage, and start to rub on each other producing inflammation. The inflammation results in swelling and pain. It is common for patients to notice that their knee swells after certain activities.
The arthritic cartilage and underlying bone have been removed from the knee and resurfaced with metal implants on the femur (thigh bone) and tibia (shin bone). A plastic spacer has been placed in between the metal implants. The undersurface of the patella is also cut and replaced with a piece of plastic.
The arthritic cartilage and underlying bone have been removed from the knee and resurfaced with metal implants on the femur (thigh bone) and tibia (shin bone). A plastic spacer has been placed in between the metal implants. The undersurface of the patella is also cut and replaced with a piece of plastic.
