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What Is Replaced In Knee Replacement Surgery

Conditions That Can Be Treated With Knee Replacement

What is knee replacement surgery?

Knee replacement can be used to replace a knee joint affected by a range of conditions including:

  • Severe osteoarthritis
  • Ligament damage or infection that leads to severe osteoarthritis
  • Rheumatoid arthritis
  • Crystal deposition diseases such as gout and pseudogout
  • Avascular necrosis death of bone following loss of blood supply
  • Bone dysplasias disorders of the growth of bone.

How Long Will A Replacement Knee Last

Wear and tear through everyday use means your replacement knee will not last forever. However, for most people it will last at least 15-20 years, especially if cared for properly and not put under too much strain.

Revision knee replacement surgery is usually more complicated and a longer procedure than the original surgery. There is no set limit to the number of times you can have revision surgery, but it is widely accepted the artificial knee joint becomes less effective each time it is replaced.

How To Prepare For A Hip Or Knee Replacement

Should you decide joint replacement is your best option, you will be asked to attend one of our joint replacement classes to help you prepare for surgery. At the class you will meet with our nurse practitioner and physical therapists for details about your procedure, your hospital stay and the pre- and post-operative instructions.

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What Happens When I Get A Total Knee Replacement

Dr. Woodson performs knee arthroplasty using the Mako robotic-arm surgical system. First, he makes a CT scan of your damaged or diseased knee. The Mako system translates the CD into a 3-D image so that Dr. Woodson can pre-plan your surgery.

On the day of your operation, while youre under general anesthesia, he makes small incisions in your knee. He then inserts the miniature camera and tiny, flexible surgical instruments that are attached to the Mako system.

The camera allows Dr. Woodson to see a magnified, 3-D image of the operating area on a screen. He uses highly precise movements to guide the surgical tools as he removes diseased cartilage and bones, preparing them for a Triathlon Total Knee implant. During your recovery period, Dr. Woodson recommends physical therapy.

Making The Knee Incision

Knee Replacement Surgery Photograph by Jim Varney/science ...

The surgeon makes an incision across the front of your knee to gain access to the patella, more commonly referred to as the kneecap. In a traditional knee replacement, the incision is usually about 8 to 10 inches long. In minimally invasive knee surgery, the incision is usually about 4 to 6 inches long. The jury is still out as to whether or not the pros of the smaller scar outweigh the cons of a smaller surgical area. Talk to your doctor about which procedure is right for you.

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What Happens During Total Knee Replacement

Your provider can help explain the details of your particular surgery. An orthopedic surgeon will perform the surgery aided by a team of specialized healthcare professionals. The whole procedure may take a couple of hours. In general, you can expect the following:

  • Most likely, you will be given spinal or general anesthesia so that youâll sleep through the surgery and wonât feel any pain or discomfort during the procedure. Or you may receive local anesthesia and a medicine to keep you relaxed but awake.

  • A healthcare professional will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.

  • You may receive antibiotics, during and after the procedure, to help prevent infection.

  • Your surgeon will make an incision over the middle of your knee, cutting through your skin and underlying tissue.

  • He or she will remove the damaged portions of your thigh and shin bone, removing a little of the bone beneath as well.

  • Next, metal implants are placed into the joint space, usually cementing them into the remaining bone.

  • In most cases, your surgeon will also remove part of the underside of the kneecap.

  • A plastic spacer is inserted into the space between the metal implants, for ease of movement.

  • The layers of your skin and muscle will be surgically closed.

  • What Can I Expect At Hss

    Hospital for Special Surgery has been at the forefront of modern knee replacement since the operation was first introduced in the late 1960s. We have led the field ever since in a number of ways:

    • : HSS has been ranked the No. 1 hospital for orthopedics by U.S. News & World Report for 11 years straight.
    • Along with high rankings in patient satisfaction, HSS performs the most knee replacements with the lowest reported infection rates in the United States.
    • Research and advancement: Smaller incisions, new implant materials and design, and sophisticated instrumentation have been â and continue to be â the areas of expertise of the hip and knee replacement surgeons of the HSS .
    • HSS routinely uses the latest surgical techniques and technology, such as robotic-assisted and computer-assisted surgery.
    • : Isolating the anesthesia to a particular body area helps avoid the potential problems that may accompany a general anesthetic. These techniques have been developed and refined by the HSS . Learn more about

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    Answers To Questions About Knee Replacement Surgery

    Knee replacement surgery shouldnt be taken lightly. One orthopaedic surgeon explains what you need to know about the procedure.

    When cartilage inside the knee joint starts to break down, a person may begin to experience pain.

    If you were to look inside a healthy knee joint youd see a thick cushioning of cartilage that covers and protects the ends of your bones, as well as another type of cartilage, called the meniscus, that acts like a shock absorber between the bones, says Andrew Urquhart, M.D., a professor of orthopaedic surgery at Michigan Medicines Comprehensive Musculoskeletal Center.

    The meniscus keeps the knee joint stable and helps evenly spread out the weight the knee joint bears, but when a persons knee cartilage is deteriorating, the bones rub together and they may experience pain when walking or weight bearing.

    To treat a painful knee, Urquhart mentions there are a few options.

    I think many patients jump to surgical options, but we recommend every patient start with diet and exercise or physical therapy before considering knee replacement surgery, he says.

    Total knee replacement surgery involves capping off the thigh bone and shin bone with metal and inserting a plastic bearing, or artificial joint, in between the bones where cartilage would normally exist. In some patients, a plastic cap is inserted over the kneecap .

    Urquhart notes that the surgery shouldnt be taken lightly.

    Recovering From Knee Replacement Surgery

    Knee Replacement Surgery | What to Expect

    For the majority of people knee replacements are very successful. There is a lot of evidence from research showing that patients have less pain and are much more mobile after surgery and this often greatly improves their quality of life. Outcomes are getting better too, as more research is carried out on what the best operation is and how to reduce the risk of complications.

    However about 8 people out of 100 are unhappy with their knee replacement 2-17 years later. If they have had to have their knee replaced a second time , they are twice as likely to be unhappy with the outcome.

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    Whats The Difference Between Partial Knee Replacement And Total Knee Replacement Ive Also Heard Of Resurfacing The Knee What Does That Mean

    Urquhart: A partial knee replacement is performed on patients who have intact ligaments and pain isolated to the inside portion of the knee. Performing surgery on that inside portion of the knee, called the medial compartment, can result in relief of symptoms and the patient not needing surgery on the entire knee joint, thus the partial title.

    All knee replacement surgeries involve some amount of resurfacing, or replacement of the knees cartilage. Patients usually hear about resurfacing for hips, which is a type of total hip replacement surgery. At Michigan Medicine, we dont currently recommend hip resurfacing for a variety of reasons and encourage patients who need surgery to have a stemmed total hip replacement with implants that have a good registry track record instead.

    What Are Knee Replacement Implants Made Of

    The selection of knee replacement prosthesis design and materials depends on each individual patient. The main implant components are made of metal â usually titanium or chrome-cobalt alloys. The implants are fixated in place either with a cement bonding agent or by osseointegration, in which a porous metal stem extends into the tibia and the patient’s natural bone grows into it. A plastic platform or spacer will be inserted between the tibial and femoral implant surfaces. The spacer is made of polyethylene.

    Most femoral components are made of metal alloys or metal-ceramic alloys . The patellar component is plastic . The tibial insert component is also plastic . The tibial tray component can be made of the following materials:

    • cobalt chromium

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    Reasons For Knee Replacement Surgery

    The most common reason to undergo knee replacement surgery in Singapore and worldwide is to treat degeneration from osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis caused by severe injury. Knee replacement surgeries are generally suitable for people who experience:

    • Severe knee discomfort that causes difficulty in performing everyday tasks
    • Chronic knee inflammation
    • A knee deformity, where you may notice an arch on the inner or outer side of the knee
    • Pain that impacts your quality of life, including your mental wellbeing.

    If medication or physical therapy has not been effective in treating your knee stiffness and pain, your doctor may recommend total or partial knee replacement surgery as the best treatment option. Be sure to talk to your orthopaedic doctor to check if you are eligible for the procedure.

    What Makes Tria A Top Destination For Knee Replacement Surgery

    Knee replacement surgery

    You wont be pushed toward surgery. Youll get an accurate diagnosis and expert answers to help you decide whats best for you. In many cases, we recommend treatment options other than surgery.

    Hospital, hotel or at home choose your recovery option. Most patients choose to go straight home after surgery if they meet the criteria and their insurance covers it. Others opt for the Hotel Recovery Program and receive care in an environment thats quieter and more comforting than a traditional hospital room. Theres no out-of-pocket cost with hotel recovery and its less expensive than a hospital stay.

    Confidence. Choose from surgeons considered among the best not just in Minnesota, but the entire Midwest. One year after surgery, 97% of our patients reported walking downstairs with little to no difficulty.

    From consultation to recovery, were here to help you through the knee replacement process. Ready to explore your options? Were here to answer all of your questions.

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    Implanting The Tibial Component

    The bottom portion of the implant, called the tibial tray, is fitted to the tibia and secured into place using bone cement. Once the tray is in place, the surgeon will snap in a polyethylene insert to sit between the tibial tray and the femoral component, and act as a kind of buffer. This insert will provide support for your body as you bend and flex your knee.

    Medical Issues To Consider

    Prior to the operation, you will need to discuss a range of issues with your doctor or surgeon, including:

    • Thorough assessment of your knee joint, which may include x-rays and other imaging techniques.
    • Your medical history. If you are elderly, you will need to undergo tests to make sure you are fit for the operation. These tests may include an electrocardiogram and blood tests.
    • Inform your doctor about any drugs you may be regularly taking, particularly drugs that affect the bloods ability to clot such as aspirin or Warfarin.
    • Your expectations you need to understand that although the prosthesis is sophisticated, it cant replicate the full function of a healthy knee joint.Possible complications of surgery will also be discussed.

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    What Does Knee Replacement Surgery Involve

    Our skilled physicians at MedStar Health offer a few different approaches to knee replacement surgery. These may include:

    • Partial knee replacement: In partial knee replacement, your surgeon removes only the damaged portion of your knee, leaving the healthy parts untouched. Only one compartment is replaced, compared with three compartments in a full knee replacement.

    • Total knee replacement: When there is extensive knee osteoarthritis, total knee replacement surgery, is performed. With this procedure, the entire surfaces of the femur, tibia, and patella is replaced and deformities of the leg and knee can be corrected.

    Do You Have To Come To The Hospital For Total Knee Replacement Surgery

    Total Knee Replacement Surgery – MedStar Union Memorial

    Urquhart: Knee replacements in healthy patients do not require a hospital stay. In fact, we now offer the surgery at the Brighton Center for Specialty Care, one of our outpatient specialty clinics.

    Patients have the surgery performed in one of the operating rooms at the facility and then are moved into a recovery area where they are monitored and work with physical therapy to be safe to go home. The center has the ability and staffing to monitor patients overnight, if needed. Then the patient is able to finish their recovery at home.

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    Reasons For The Procedure

    Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.

    Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.

    Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.

    If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:

    • Anti-inflammatory medications

    • Cortisone injections into the knee joint

    • Viscosupplementation injections

    • Weight loss

    There may be other reasons for your doctor to recommend a knee replacementsurgery.

    Minimally Invasive Total Knee Replacement

    Some medical centers perform minimally invasive surgery for a total knee replacement, also called min-incision joint replacement.

    This surgery allows surgeons to cut less muscle and tissue, which leads to less blood loss, increased range of motion and a shorter hospital stay. Many patients go home the same day and the recovery process is usually much quicker than traditional total knee surgery.

    However, minimally invasive knee replacement is not for everyone. In general, the best candidates for this kind of surgery are younger and in better health. Older patients, those who are overweight or patients who have undergone knee surgeries in the past may be less suitable for minimal incision procedures.

    Because it uses a much smaller incision, minimally invasive knee replacements have a higher risk for poor implant placement compared to traditional total knee surgery. Other common complications include nerve and artery injuries, wound healing problems and infection.

    Only specialized medical centers typically offer this surgical option. An orthopaedic surgeon should explain the complete process, the benefits and the potential risks to help the patient decide which surgical option is the best fit.

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    When A Knee Replacement Is Needed

    The usual reason that someone has a knee replacement is because they have very painful arthritis in their knee.

    You should always bear in mind that a knee replacement is a major operation and you should really only be considering it when you have run out of other options. A doctor can tell you that you have arthritis in your knee and they can tell you that you could have a knee replacement but only you can decide if the time is right for you. Most people who decide to have a knee replacement are already taking painkillers every day but are still not able to walk far and need to use a stick.

    Looking at all of the research on knee replacements , it would seem that the people who do best after a knee replacement are the ones with severe arthritis but not so bad that the joint is completely destroyed. This could be because it’s really important to have strong muscles around the knee in order to make the best recovery and people who have the most advanced disease tend to have very weak leg muscles.

    Symptoms will often vary from day to day for no apparent reason. This is really common. Some people think their symptoms vary according to the weather or according to how much they have been doing – but it can be completely random.

    Sometimes you will be aware of a grating or grinding feeling coming from your knee. This is called crepitus. On its own this does not necessarily indicate a serious problem with your knee.

    Which Type Should I Have

    Knee Replacement Surgery Photograph by Jim Varney/science ...

    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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