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Total Knee Replacement or Arthoplasty is a most common joint replacement surgical procedure where diseased joint is replaced with artificial implant. The knee is a center joint which provides motion at the point where the thigh meets the lower leg. The thigh bone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. Knee Replacement surgery is performed to relieve pain due to Osteoarthritis, rheumatoid arthritis or in the cases of Trauma.
Types of Knee Replacement:
There are different types of knee replacements available. Type of knee replacement is recommended depending up on the extent of damage, bone strength, age, life style and other medical conditions.
Total Knee Replacement
Total knee arthroplasty, also known as total knee replacement, is one of the most commonly performed orthopedic procedures. The normal knee joint functions as a complex hinge allowing primarily flexion and extension, but also rotation and gliding.
Damage to the cartilage of one or more compartments may be the result of osteoarthritis (idiopathic or post-traumatic), inflammatory arthritis (rheumatoid, psoriatic, etc.), vascular necrosis, tumors, or congenital deformities. Osteoarthritis and rheumatoid arthritis are the causes of the overwhelming majority of total joint arthroplasties. Modern total knee arthroplasty consists of resection of the diseased articular surfaces of the knee, followed by resurfacing with metal and polyethylene prosthetic components. This procedure results in significant pain relief, improved function and quality of life.
Unicompartmental Knee Replacement/ Partial Knee replacement
The knee is made up of three areas Medial, Lateral and Patella (the knee cap). It is a surgical procedure used to relieve arthritis in one of the knee compartments in which only damaged parts of the knee are replaced.
Partial knee replacement may reduce post-operative pain and have a shorter recovery period than total knee replacements. Also, UKA may have a smaller incision because the implants may be smaller.
Minimally Invasive Knee Replacement/ Non Surgical knee Replacement Surgery
Minimally invasive knee replacement is the most modern technique of treating a damaged knee joint. Minimally invasive total knee replacement involves the use of a smaller incision than the one used in traditional knee replacement. In the traditional method, the incision averages 8 to 10 inches in length. In minimally invasive knee surgery, the incision is only 4 to 6 inches long. Because there is less damage to the tissue around the knee, patients who undergo this procedure may expect a shorter hospital stay, a shorter recovery, and a better looking scar.
Causes of Knee Replacement Surgery
There are a number of conditions which may lead to the need for knee replacement; arthritis is the most common reason. A number of other factors contribute to joint disease including genetics, developmental abnormalities, repetitive injuries and obesity.
Osteoarthritis occur when cartilage on the gliding surface of the knee begins wearing away, causing pain and stiffness. When the cartilage wears away completely, the bones rub directly against each other causing decreased mobility and chronic pain.
Rheumatoid arthritis is disease in which the body’s immune system begins to attack the synovial covering causing it to become inflamed and overproduce synovial fluid (the fluid that lubricates your joints). More importantly, the process also causes damage and wear to the articular cartilage.
Traumatic arthritis results from a serious knee injury, such as a fracture, muscle damage or meniscus tear. The impact of the accident also causes mini trauma to the articular cartilage which over time, develops into osteoarthritis, causing knee pain and stiffness.
FAQ on knee replacement:-
What is Knee replacement surgery?
Knee replacement surgery is nothing but a process to remove the damaged cartilage. The surgery involves the replacement of unhealthy surface of knee joint by the metal & plastic implant. Knee replacement surgery can replace all or part of the knee depending on the affected area by arthritis.
Symtoms of Knee Replacement:
- Daily Knee Pain
- Stiffness in Knees
- Pain is so severe that it restricts you to do your daily work like walking
- Significant instability of knees
- If you are patient of severe arthritis since a long time and cannot move.
What causes knee pain?
There are many different causes of knee pain, including injury, arthritis and infection.
How soon can a patient return to normal active life after surgery?
One can patient start working after surgery.
Do I operate on both knees simultaneously?
This depends on the nature of the knee replacement.
What activities and sports can I participate in after a knee replacement?
- Cycling
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Aerobics
- Swimming
- Low-resistance
- Rowing Skiing machines
- Walking & climbing
How long do I need to keep a bandage on my incision?
5days bandage is required, which is removed before discharge from the hospital.
Type of Knee replacements?
There are two common types:
Bilateral- Bilateral knee replacement surgery means that both knees are replaced. Patients who have severe knee arthritis in both knees may be good candidates to undergo bilateral total knee replacement.
Unilateral – In unilateral Knee replacement surgery painful knee joint should be replacing (one or both of the medial and lateral compartments).
How the Knee Replacement is done?
The operation is done through an incision of 6-12 inches in the Knee area. The unhealthy surfaces of the lower end of thigh bone and the upper end of shin bone are removed. These are replaced by artificial surfaces known as "prostheses". Depends on the prostheses it needs to be cemented to the bone. At the end of the operation the skin is closed with stitches .A drain is used to remove the excess blood.
Anesthesia & Blood Transfusion?
General anesthesia or epidural anesthesia can be given. Almost all total knee replacement patients need blood transfusion.
Hospital Stay & Post Knee Replacement Care?
Five to seven days of hospital stay after surgery.
For the first few days avoid soaking the surgery wound in water until it has thoroughly sealed and dried. You should be able to resume most normal activities within three to six weeks following surgery. Minor pain with activity is common for several weeks. An exercise regimen & an iron rich balanced diet will help in speedy recovery to normal. Most people can drive on their own in 4 to 6 weeks after surgery. After surgery of total knee replacement, precautions to take are to avoid: # High demand & high impact activities # Repetitive lifting exceeding 50 pounds # Vigorous walking or hiking
Type of knee replacement?
The knee replacement is of two types Total Knee Replacement and Uni-compartmental knee replacement or known as unicondylar knee replacement or patellofemoral replacement. Total Knee replacement surgery replaces all three compartments of the Knee (Medial, Lateral and Patellofemoral compartment). Unicompartmental Knee arthroplasty involves replacing one or both of the medial and lateral compartments.
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