Knee Replacement Surgery

Knee replacement surgery

Knee replacement is one of the most successful orthopedic surgeries performed today. Most patients experience reduced or eliminated knee pain, increased ability to move and an overall improvement in quality of life.

What is knee replacement surgery?

Knee replacement is where portions of the bones that form the knee joint are removed and replaced with artificial implants. It is performed primarily to relieve knee pain and stiffness caused by osteoarthritis.

Most people who get this surgery have advanced knee arthritis, in which the knee cartilage is worn away and the surface of the knee becomes pitted, eroded, and uneven. This is sometimes referred to as “bone-on-bone” arthritis. This causes pain, stiffness, instability and a change in body alignment. Knee replacement surgery can also help some people who have a damaged knee joint caused by an injury or other condition. (Find a best knee replacement surgeon in Jaipur )

What are the different types of knee replacement surgery?

There are two main types:

Total knee replacement, where the entire joint is replaced with artificial surfaces
Partial knee replacement, where only one damaged compartment of the knee is replaced

Total knee replacement is the more common of these two procedures.

Knee anatomy

To understand a total knee replacement, also known as total condylar knee arthroplasty, you must be familiar with the structure of the knee, a complex joint that consists of three bones:

The femur (thighbone)
The tibia (shinbone)
The patella (kneecap)

Strong ligaments connect the powerful muscles of the thigh and calf to the bones around the knee to control knee motion and function. Cartilage (such as the meniscus) and other soft tissues cover and cushion the bones to help them glide together smoothly.

When you bend or straighten your knee, the end of the femur rolls against the end of the tibia, and the patella glides in front of the femur.

When the cartilage that cushions the joint degrades or is worn away completely, the bones rub together and become scraped and rough. This causes inflammation known as osteoarthritis, which results in pain and stiffness that make walking and other movement difficult. The implants used in knee replacement are smooth like the surfaces of a healthy knee.

How is a total knee replacement performed?

First, the orthopedic surgeon makes an incision (cut) in the knee and moves the patella (kneecap) to the side. If any bone spurs (small bony growths) are present, as sometimes occurs in osteoarthritis, they will be removed.

Next, the two menisci between the femur and tibia are removed, as are the anterior cruciate ligament (ACL) and, in some cases, the posterior cruciate ligament (PCL). In some types of knee replacement, the PCL is retained.

During the main phase of the operation, the surgeon cuts and removes cartilage and some bone from the upper part of the tibia and lower sections of the femur. The femoral sections removed are two knobby protuberances called the femoral condyles. The tibia and femur are then capped with metal implants to create new surfaces for the joint. The surface of the femoral component mimics the shape of the original femoral condyles. If the kneecap has also degraded, the surface on its underside may also be cut away and replaced with a polyethylene (plastic) implant.

Finally, the various layers of tissue are repaired with dissolvable sutures and the skin incision is closed with sutures or surgical staples. A bandage will be wrapped around the knee and the patient is taken to recovery.

How do I avoid or postpone a knee replacement?

The choice on whether to have surgery to address arthritis of the knee joint depends on multiple factors, including:

the condition of the knee joint
the patient’s age and activity level
the patient’s limitations due to their condition

In cases where the damage from arthritis is minimal, and/or if the patient does not have significant pain in the knee, nonsurgical treatments by be tried, including:

physical therapy
NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen
weight loss to reduce pressure on the knee and, in turn, slow down the advancement of arthritis
One or more injection therapies, such as
- cortisone shots
- hyaluronic acid injections (viscosupplementation)
- experimental treatments such as stems cells or platelet-rich plasma (PRP)

For some patients, alternate, less invasive surgeries may delay the need for total knee replacement. This can include cartilage repair surgery, a knee osteotomy (such as a high tibial osteotomy) to realign the bone and reduce wear on the cartilage, or a partial knee replacement.

How do I know if I need knee replacement surgery?

You may need surgery if:

Your knees are stiff and swollen.
There is pain throughout the day, even at rest.
Walking, getting up or climbing stairs is difficult and painful.
Medication, injections and therapy do not offer enough relief.
Knee cartilage is so damaged and worn away that you are walking “bone on bone,” in which the bones of the joint are scraping together.

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