Summit Uses Implants With The Best Track Record For Successful Outcomes
Because the most reliable outcome data is based on patient trials, Summit uses implants with a proven track record for safety based on extensive patient data. We are always monitoring emerging new implants, and we follow the trials, says Dr. Breien. We cant guarantee how long your implant will last. But we can tell you that we use the implants with the most substantial data supporting safety and good outcomes. Thats what I would want for myself, and thats what I recommend to my patients.
Prosthetic Pieces Become Loose From The Bone
Partial knee replacements can loosen over time from the bones they are attached to. In other words, the glue or grout that connects the prosthetic knee parts to your bones can weaken or disconnect.
This often creates the classic start-up pain, whereupon rising from a seated position creates moderate to severe pain in the joint. As you walk, gravity and pressure can re-seat them in position and the pain may lessen somewhat.
Your Knee Has Become Deformed
If your arthritis is advanced, it can affect the way you walk, which can also lead to further problems elsewhere in your body.
As arthritis progresses, the knee may become bowed or knock-kneed, Heckmann says. If this type of deformity develops over time, a knee replacement may be indicated.
In addition, people with arthritis may also lose the ability to straighten their knee, according to Heckmann. If this occurs, you should seek an evaluation with an orthopaedic surgeon, as this loss of motion may be permanent, even after the knee has been replaced, he adds.
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Similar Conditions That Affect The Knee
Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.
Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.
Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.
Knee Joint Infections
Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:
- severe pain
- fevers and
Again, a joint infection is a serious condition that requires immediate medical attention.
Which Type Should I Have
Your surgeon will discuss this with you. It will depend on how much of your knee is affected by arthritis – it may not be possible to know this until your surgeon has started your operation.
If you have a partial knee replacement it is more likely that you will need to have it done again, than if you have a total knee replacement . Sometimes the reason for choosing to have a partial knee replacement is that it leaves the option to have a TKR at a later date. However it’s also more likely that you will need to have your total knee replacement re-done, if you had a partial knee replacement done before having your total knee replacement.
There are over 150 different designs of knee replacement and some of the differences between all the different types and makes of knee replacement parts aren’t known, particularly how they perform in the long term. In many countries, registries have been set up so that anyone who has had a knee replacement is entered into the register. The information collected is used to monitor how their replacement is performing. In the UK, patients also enter information about their health and quality of life before and after their operation.
A study of over 500 patients with osteoarthritis of the inner part of their knee has compared the effectiveness of total and partial knee replacement. The two groups were followed up five years after surgery, and asked to complete questionnaires about pain, activity and day-to-day living.
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Alternatives To Knee Replacement Surgery
Most experts suggest exhausting your conservative alternatives before committing to a full knee replacement surgery. This is especially true for those that dont fit the criteriafor optimal candidacy. Knee surgery is a permanent alteration to your body, therefore once the decision is made, if the results werent what you were expecting there really isnt any going back. Approximately 20% of knee replacement patients say they are unsatisfied with the final result3. For a comprehensive overview of all the treatments available for knee osteoarthritis, check out our osteoarthritis treatment guide.
Why Revisions Are More Complex
Revision replacement is difficult for several reasons. First, when someone has surgery, scar tissue develops, and soft tissues become less identifiable. Performing the second surgery is always more difficult. Second, when performing a knee replacement, bone is removed. When performing a revision knee, often more bone has to be removed, and some may be lost as a result of the problem with the implant. Maintaining adequate bone to support the new implant can be a challenge. Finally, obtaining a knee that is flexible enough to allow for motion, yet stable enough to keep you steady, is also more difficult in revision situations.
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Why Would I Need Surgery
Osteoarthritis is the main reason why people go for knee replacement surgery. The age-related condition is very common and occurs when cartilage — the cushion between the knee and the bone joints — breaks down.
Other reasons include:
- Rheumatoid arthritis: Rheumatoid arthritis is when the bodyâs immune system attacks and destroys the lining of the knee.
- Deformities: People with bowed legs or âknock-kneesâ often get surgery to restore the position of the knee.
- Knee injuries: A broken bone or torn ligaments around the knee sometimes will result in arthritis that causes great pain and limits your movement.
What Does The Doctor Do Prior To Revision Surgery
When the decision for revision knee replacement is made, the surgeon will do a thorough clinical exam and order and laboratory tests. If infection is suspected, aspiration of the knee may be required. The aspirated fluid will then be sent to a laboratory for analysis to identify the specific type of infection.
In addition to X-rays, other imaging modalities may be helpful, such as bone scans, or . These advanced imaging technologies can demonstrate changes in the position or condition of the prosthetic components as well help to pinpoint the cause, location and the amount of bone loss to help plan for the surgery.
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Ask Dr Breien: How Long Will A Knee Implant Last
Dr. Breien explains how patients have some control over the life of their knee implant.
Osteoarthritis affects an estimated 27 million Americans. Although the risk of developing this disease increases with age, it is not a disease confined to the elderly. At Summit, we treat patients in their 20s and 30s for osteoarthritic conditions. When conservative treatments fail and patients consider a knee replacement, they want to know how long they can expect their knee implant to last.
Revision Total Knee Replacement
According to what I have read, total knee replacement is one of the most successful procedures in all of medicine. In most cases it allow patients to live an active pain free life.
A knee replacement can fail for several reasons. Symptoms may include pain, swelling, stiffness, and lack of stability.
If your knee replacement fails or wears out your doctor may recommend that you have a second surgery called revision total knee replacement. In this procedure, your doctor will remove some or all of the parts from the original implants and replace them with new parts.
Just like your first surgery, the goal of revision surgery is to relieve pain and improve the function of your knee.
Revision surgery is longer and a more complex procedure.Most patients who have revision surgery experience good long-term outcomes.
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Learn More About A Total Knee Replacement Today
If youd like to continue reading about a total knee replacement, aside from how long an implant will last you, we encourage you to head over to this page where we discuss everything you need to know about total knee replacement surgery.
Still not sure if youre a good candidate for a total knee replacement? Take our fast, free knee function assessment and youll have an answer within minutes.
Knee Replacement And Tennis
A recent study on knee replacement and tennis tracked patients five to 15 years after their surgery. What was ultimately found from the study was that playing of tennis had no negative effects on the joint.
Patients were coming back for their annual review . . . and were participating in a range of prohibited activities. There were patients competing in tennis, but there was no wear, no dislocations, no loosening, and no revisions, said study author Dr. Samuel Joseph.
The doctor is an orthopedic surgeon at Linacre Private Hospital in Melbourne, Australia.
Yes, there are patients running marathons and participating in triathlons after knee replacement surgery, he added.
Each year there are around 600,000 knee replacements performed in the United States alone, according to the U.S. Agency of Healthcare Research and Quality.
The procedure acts to replace the natural, damaged joint with a prosthetic version of the joint which is made of metal and plastic.
This can be a result of severe arthritis, trauma, or other forms of joint damage.
This particular study focused on 355 knee replacement patients who continued their participation in sports after surgery.
Over 100 of these patients also participated in high impact sports. 139 of this focus group did not partake in regular sporting activities.
Three patients who did not participate in regular sports did need to have their artificial joint modified or replaced as it loosened over time.
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Kinematically Aligned Vs Mechanical Knee Replacements
Dont let the technical terms overwhelm you.
In a kinematically aligned knee replacement, the implants are custom fit to a patients knee joint to restore your natural alignment.
On the other hand, a mechanical knee replacement uses a one-alignment-fits-all approach and positions the implant in a place best suited for the average patient.
Many patients with mechanical knee replacements report that the natural alignment of their knee and leg are often thrown off as result.
When this happens, patients end up wearing away other joints since the body must compensate and work around the new implant.
These issues are less likely with a kinematically aligned knee.
Thanks to the customization that comes standard with this surgery, your body wont have to readjust.
And since its not having to do that, you wont wear down your knee replacement as fast. That means youll be well on your way to reaching the 20+ year mark with your implant.
To learn more about the differences between each surgery, we encourage you to check out this article.
Many patients also wonder whether being too active lowers the durability of their total knee replacement. Well answer this question next.
How Does A Partial Knee Replacement Wear Out
A partial knee replacement is an excellent long term and durable reconstruction for treating bone-on-bone arthritis in the knee that is localized to just one area of the joint. There are certainly many potential advantages to a partial knee replacement, for those who are a candidate, and this has been covered in other blog topics that we have discussed. In general, a partial knee replacement should last as long as a full knee replacement would, and a partial replacement is not meant to be done as a bridge to a full knee replacement later. Patients can typically expect years or decades of excellent function and pain relief from a partial knee replacement, but eventually additional wear and tear can lead to the need for additional treatment of your knee. The definitive treatment for a failed partial knee replacement, if all conservative treatments have failed, is typically to convert or change the partial knee replacement to a total knee replacement, but there are different indications for doing this.
Lets talk about some of the ways in which a partial knee replacement may wear out or require revision surgery:
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Signs Of Knee Replacement Failure
No one likes to hear the word failure when you are scheduled for surgery. Those of us who made the decision to have total knee replacement did so because we were looking forward to having a functional, pain-free knee.
The last thing we wanted were complications that needed additional medical care or further surgery.
Doctors are not perfect. When I was a youngster, I thought teachers, police and doctors could do no wrong. As I aged, I learned that everyone is human and can make a mistake. Even your surgeon.
There are other factors besides physician error that can cause complications after surgery. In the sections below, I will discuss some things that could go wrong during the knee replacement process.
Remember, there are several things that you can do prior to knee replacement surgery to improve the chances of a successful outcome. Building leg strength, stretching, exercising and weight management are a few pro-active steps you can do to increase the probability of success.
My experience, as well as my discussions with TKR veterans, leads me to believe that the vast majority of knee replacement surgeries have a positive outcome.
A Word About The Newest Knee Replacement Implants
One temptation of patients and surgeons alike is to be attracted to the newest knee replacement on the market. Undoubtedly, this implant will claim to function better and last longer than other knee replacements. While these newer implants may be better, it is also important to understand they do not have long-term data on how well these implants will function over time.
Ask any orthopedic surgeon about the implants they have seen come and go over the course of their career. Just because an implant is newer does not necessarily mean it is better.
Patients and surgeons should try to find an appropriate balance between modern design and not being a ‘test’ patient. Your surgeon can help guide you to an appropriate knee replacement that is best for you.
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Is There A Knee Replacement Alternative
The Centeno-Schultz Clinic has been injecting bone marrow concentrate which contains your own stem cells for the last 16 years in the treatment of knee arthritis. The goal is to help patients avoid knee replacement surgery and the complications therein. We recently published a similar RCT to the one described above where the less invasive injection-based technique was compared to physical therapy. More than 2/3rds of the patients met the functional criteria for success at 2 years out . Our real-time patient registry provides an in-depth analysis of our results based upon the area of the body, function, pain reduction over time. To learn more please click here.
Any new advances? Absolutely! We have been meticulous in the treatment of patients with knee osteoarthritis. This starts with acknowledging that the body is a complex system with many moving parts that work together. For the best results, we evaluate the patient in total as opposed to just the knee. We use the SANS approach. We evaluate Symmetry, Articulation, Neurologic, and Stability. To learn more about this comprehensive approach please click here.
Care After The Operation
Please give some thought as to how you will be looked after once you have had the operation, well in advance. Most people like to be independent, but you are going to need support with day-to-day activities for a while. If you have an able-bodied partner, this might fall to them, but otherwise you may need a friend or relative to come to stay with you for a while. Some people may arrange to stay in a care home until they have their mobility and independence back.
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How Do You Prepare For Correction Of A Loose Knee Replacement
Before surgery, your physician will examine your overall health and assess anesthesia risks. This evaluation will also include:
- A full physical examination
- A full medical history, including any prior surgeries or ongoing health conditions
- Blood tests
- Other imaging tests
Your physician will ask about any medications or supplements that you may be taking and instruct you on which ones to stop taking prior to the surgery. You will also be asked about any allergic reaction to anesthesia or medications. Finally, a consolidated report of the above tests and evaluation will be submitted to your surgeon for reference before undertaking the surgery.
What About Exercise Following A Knee Replacement
Exercise and sport are recommended after knee replacement, apart from contact sports, which may weaken the cement and lead to loosening of the joint components. Recreational sports including golf, tennis and skiing will gradually become possible depending on how fit and sporty you were before the operation. Cycling is a very good way of building up strength and mobility after knee surgery.
Exercising the main muscle groups around your knee is very important both before and after having a knee replacement. You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your knee. Try to perform these exercises regularly, for instance for 10 minutes six to eight times a day. However, its important to find a balance between rest and exercise so you dont overwork your knee. Its a good idea to get advice from your doctor or physiotherapist about specific exercises before you begin.
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