After years of medication, therapy, and conservative medical management, the day may finally arrive when you and your doctor see the obvious. It’s time for a knee joint replacement, known as knee arthroplasty.
This surgery has different effects on people. Some wake up from the operation in less pain than in years. Others have a difficult time with rehabilitation. Wherever you fall on the scale, your knee joint will be in much better condition than before.
Before advising replacement, your doctor will assess your knee’s stability, strength, and range of motion. X-rays and perhaps other tests will help your physician determine whether he should recommend replacing your knee. There is a variety of prostheses available to fit your needs.
Replacements don’t last forever, though. They do sometimes fail. Daily stress will break down the most reliable alternative. High-impact activities and excess weight are two of the most common stressors.
Complete Knee Replacement
Replacement of the entire knee joint is a conventional surgery. In the US, orthopedic surgeons perform about 600,000 knee replacement procedures each year. The replacement procedure removes damaged bone and cartilage from the thighbone, shinbone, and kneecap. The surgery replaces both sides of the joint.
A prosthesis, a replacement knee, consists of metal alloys, polymers, and high-grade plastics. It replaces damaged sections. This surgery will take from one to three hours.
In the past few years, a new surgical tool has revolutionized the surgery for a complete knee replacement, the robotic arm-assisted surgery.
The surgeon is still in control of the surgery; it is not performed by a robot. Using CT scans and the robotic arm, the precision of the surgeon has improved from 97 percent to 99 percent. The incisions are smaller, and the recovery time is shorter. Using these new tools, knee replacements are now available to younger patients, from their 40s rather than more than 60 years old. In addition, since the knee is more accurately measured, the joint feels more natural to the patient.
Unicompartmental Knee Replacement
Unicompartmental or Partial Knee Replacement (PKR) replaces only one side of the knee. The surgeon makes a smaller incision and removes less bone, but the replacement doesn’t last as long as a total knee replacement.
Surgeons usually choose PKR for patients with damage to only one side of the knee joint. Rehabilitation is more straightforward than with a total knee replacement as there are less blood loss and a lower risk of blood clots and infection.
In a PKR operation, the surgeon makes only a small incision to gain access to the affected compartment. He then removes damaged cartilage and bone tissue from the femur and tibia in the arthritic area.
Patellofemoral Knee Replacement
The patellofemoral replacement surgery replaces the kneecap. The surgeon creates a surface under the kneecap. Next, the surgeon makes a groove in your thigh bone so that the kneecap replacement will fit snugly.
Bone cement usually holds the new kneecap in place. Your new knee must slide up and down on that groove smoothly. If this doesn’t work the way it should, the replacement could wear out quickly.
Recovery is quicker than with a knee replacement. You must begin exercises that bend the knee immediately. When you can put your full weight can on the knee, doctors recommend using crutches or a walker for the first few weeks.
In the past decade, patients have had better luck with a replacement lasting longer. Most should have good results for at least the first decade after replacement. Many of the failures seem to be because of the deterioration of the bones. If this is the case, your condition may worsen, and a knee replacement may be necessary.
Your Knee Joints
Your knee joint connects your thigh bone (femur) to the shin (tibia). It connects with smaller bone, the fibula. Those and the kneecap from the bony structure of your knee.