Types Of Total Knee Implants
Total knee replacement implants are not one-size-fits-all or even one-style-fits-all. Prosthetic implants vary greatly by design, fixation and materials.
Your implant may be a fixed- or mobile-bearing implant a PCL-retaining design or a PCL-substituting style. It may be fixed with bone cement or could be a cementless fixation design. The choice of implant will ultimately be made by your surgeon, based upon your physical situation, your age and lifestyle, the surgeons experience and the level of familiarity and trust he or she has with a specific piece of equipment and/or manufacturer.
Total Knee Implant Components: Although the overall designs of total knee implants vary, as discussed below, typical total knee replacement implants have three basic components: femoral, tibial and patellar.
- The femoral component is generally made of metal and curves around the end of the femur . There is a groove down the center of this part of the implant which allows the patella to move up and down as the knee bends and straightens.
- The tibial component is a flat metal platform with a polyethylene insert or spacer. This component varies in structure, depending on which type of surgery is performed.
- The patellar implant is a dome-shaped piece of polyethylene that mimics the kneecap. This implant is used in some knee replacements not in others.
A Knee Replacement That Could Last A Lifetime
Robotic surgery, cementless implant among advances that could lead to longer-lasting knee replacement
Dr. Geoffrey Westrich of Hospital for Special Surgery says advances in knee replacement surgery have benefited patients.
Newswise Forty-nine-year-old James Benfantes knee pain got so bad he dreaded walking from the train station to his job or even standing in line. Working out in the gym became all but impossible. He decided it was time for knee replacement surgery, and he did what many people do nowadays: he went online to get the latest information.
Mr. Benfante, who lives in Yorktown, New York, says he learned that robotic-assisted surgery enables orthopedic surgeons to perform the procedure with pinpoint accuracy, and this was important to him. The FDA-approved system starts with a CT scan to create a 3D virtual model of the patients unique anatomy. During the procedure, a robotic arm assists surgeons in performing an ultra-precise knee replacement customized for each patient.
Mr. Benfante wanted a joint replacement specialist trained in the use of the robotic system and found Dr. Geoffrey Westrich, director of Research in the Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery .
With biologic fixation, many joint replacement specialists believe that loosening over time could be less likely. A total knee replacement could potentially last much longer, even for a patients lifetime, Dr. Westrich says.
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About HSS
Common And Serious Complications Of Knee Replacement
While knee implants give many recipients a second chance at walking and living a more normal life, complications do occur.
Most problematic is a loosening of the implant, which can be caused by a defective implant or poor positioning at the time of surgery. Implant loosening is a primary cause for revision surgery.
Although rare, metallosis is possible after knee replacement surgery. Metallosis, also known as metal poisoning, can occur when metal implant pieces rub against each other and release tiny metal particles into the knee joint and bloodstream.
Common complications from knee surgery include:
- Swelling and stiffness
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Looking For Alternatives To Total Knee Replacements
We’re also funding research which is investigating alternative approaches to total knee replacement. For example, total knee replacement is not recommended for many young people. This study aims to develop a new method called ToKa®, which uses images of the patient’s joint and specially designed software to design a patient specific implant that will be made via 3D printing. If successful, this technique could prevent osteoarthritis patients from needing total joint replacement.
Knee Replacement As An Athlete Weighing The Pros And Cons
If you are a young athlete in your 30s or 40s I hope that TKR isnt something you need to consider. Surgeons can repair knees with outstanding results and can put NFL players back into action after severe knee injuries.
However, I have never heard of a professional player returning to any major sport after a complete knee replacement. Hopefully, if you are young and experiencing knee pain in your 30s and 40s like I was, you can play through the pain and put off TKR as long as possible.
I know in my case and at my age, I would not resume running or playing basketball. I am content to be able to participate in the more senior activities that I choose now.
Even though I have a new knee I have a 68-year-old body and it no longer functions the way it did when I was 30 or 40.
If you are a younger patient, its important to know that you likely wont be able to participate at a high level of sport. You might lose a step or two, but if TKR goes well, your knee will be pain-free.
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Are There Alternatives To Knee Replacement Procedures In Ireland
This is the best solution for severe and continuous aching of the knee, but the following are some non-surgical alternatives you may consider first:
Whilst the information presented here has been accurately sourced and verified by a medical professional for its accuracy, it is still advised to consult with your doctor before pursuing a medical treatment at one of the listed medical providers. This content was last updated on 28/11/2020.
Are Newer Knee Implants Much Different From Old Ones
Yes. There are newer high-flex knee designs that allow greater safety during deep knee bending. There are also newer gender-specific total knees made to fit the anatomical differences in the knees of men and women. All knee replacement components that we used incorporate these modern design features.
Other variations in total knee implants include a ceramic oxinium surface, the rotating-platform knee, and other brands marketed by implant companies. Discuss this with your surgeon and medical team they will help you make an informed choice.
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What Is A Total Knee Replacement
Total knee replacement is a type of surgery to replace a damaged knee joint. A minimally invasive surgery uses a smaller cut than a traditional total knee replacement. This type of surgery typically requires special tools so that the surgery team can see and do the procedure through the smaller incision.
The knee has several parts: the lower end of the thigh bone , the upper end of the shin bone , and the kneecap . A smooth substance called cartilage caps the ends of these bones and keeps the bones from grinding together. When there is damage to the knee joint, these bones may scrape together abnormally and cause pain.
During minimally invasive total knee replacement, your surgeon makes an incision to access your shinbone and thigh bone. Next, he or she removes a portion of the bones that make up the knee joint. Your surgeon replaces these bone parts with metal components that recreate the joint surface. A layer of plastic is placed between the metal components for smooth gliding.
Minimally invasive total knee replacement often takes place under general or spinal anesthesia.
Knee Replacement Surgery | Q& A with Savya Thakkar, M.D.
Differences Between Total And Partial Knee Replacement
Knee replacement surgery is recommended when conservative treatments like physical therapy, braces, steroid injections and anti-inflammatory medication fail to alleviate pain.
If a patient requires surgery on both knees, its called a bilateral knee replacement. The two procedures can be done simultaneously or doctors may choose to use a staged bilateral approach that schedules the second surgery several days, weeks or months later.
The decision to have a total versus a partial knee replacement is based on a doctors recommendation after a full patient evaluation is performed.
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Do You Use The Same Model Of Knee Implant For All Knee Replacements
No. Each patient situation is unique, and the type of implant chosen depends on many patient variables, including age, gender, weight, bone dimensions, ligament condition, bone quality, anticipated activity level, and occupational history.
In older patients with weak and osteoporotic bone, for example, the best choice may be a cemented model supplemented by design features that will support external knee ligaments. On the other hand, for a healthy young person with physically demanding job, the ideal model may be an uncemented total knee design that allows as much bone preservation as possible.
In patients who have had knee replacement in the past and are in need of repeat surgery, it is often necessary to use more complex models, to reconstruct deficient and missing bone.
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 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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Devices Features And Manufacturers
When researching implants for knee replacement, it is important to realize that while devices used in total knee replacement surgeries are the most common, there are also devices designed for partial knee replacement surgery. Of these two types of procedures, partial knee replacement is less common, and addresses less than 10 percent of knee replacement patients. Unlike a TKR, a partial replacement requires removal of only part of the bone in the knee joint. Manufacturers produce variations of devices to address both surgical options, and your surgeon will let you know whether a total or partial replacement is appropriate.
Here are some of the device features that may guide you and your surgeon to the right selection:
- range of motion
- customizability: size and shape
- stability
- your activity level
Speak to your surgeon about features that are important for you, and know that each device is designed for different types of patient needs, level of joint disease, and anatomy.
The history of a device and its success rate can prove comforting. Some manufacturers share this information. Your surgeon may be able to attest to past results or guide you to useful information online.
Here are some of the leading TKR devices. Weve included summaries of product information from device manufacturers. Its best to visit manufactures sites to understand device features and benefits in more detail.
Are There Different Kinds Of Knee Implants
Yes. There are several different types of knee replacements. All of them are variations of the basic design introduced more than 30 years ago, which is called the total condylar posterior stabilized knee. The choice of implants depends on factors such as the status of ligaments and the amount of deformity in the knee. Usually, surgeons use a high-flex design that is safe for deep knee bending. The implants come in gender-specific versions engineered to match the knee anatomy of men and women. As new designs in total knee replacements are developed, we expect surgeons to adopt them only after carefully considering the advantages, safety, and scientific merits of such designs.
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Exercises To Help Increase Knee Motion And Strength
Once you are fully recovered from knee replacement surgery, it is important that you continue with an exercise program. A physical therapist will personalize a knee rehabilitation program to help you reach certain goals. Dont start a new exercise program without your doctors approval.
Weve come up with 7 helpful exercises that promote safety, build strength, and increase range of motion that you can practice at-home after a knee replacement surgery.
Can Ceramic Parts Be Used In Knee Replacements
Yes. The advantage is the lower wear rate of ceramics when compared to metals. In the United States, ceramic knees are used on a limited basis since the Food and Drug Administration has not approved them for general use. Several years ago, we conducted one of the few clinical trials in the country on ceramic knees.
Ceramic parts are useful in the rare cases of a true metal allergy in selected patients. Ceramic components will likely become more common in the future. At the time, ceramic materials in total knees are more common overseas. Balancing the very low wear rates of ceramics is the fact that we do not have enough scientific data from U.S. studies to support their routine use in total knee replacements as of yet.
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The Joint Last Implants
After scouring the data, they found seven models which failed to make the cut with the worst performer being the Preservation Unicondylar fixed knee replacement, which was used in 398 operations and had a failure rate of 15 per cent. The list in full:
- Preservation Unicondylar
- Oxford Partial Knee Unicondylar
- MG Uni Unicondylar
- Rotaglide + Cement
- Profix Cement
While the research revealed that knee replacements were more prone to failure than their hip counterparts, it also revealed that the majority of knee replacements used in the UK were far more durable. 51 were below the 5% threshold, and 16 of them had failure rates lower than half the benchmark.
As a patient or potential patient what can you do to ensure you get the best shot of a long-lasting and successful knee replacement? After all, its not as if you can run your finger down a shelf and pick out the one you like. Your best defence as with all surgical procedures is to be fully prepped. Ask your knee surgeon which implant is being used, and definitely ask about its success rate.
Use Pain Medications With Care
Except in very rare cases, the American Association of Hip and Knee Surgeons advises against using opioid medications for knee osteoarthritis. Opiate pain relievers, in addition to being addictive, are not proven to address knee pain over the long term any better than nonsteroidal, anti-inflammatory drugs .
Though safer than opioid drugs, NSAIDs arent for everyone, and experts advise caution in using them. Even over-the-counter drugs like naproxen and ibuprofen can have side effects, so check with your doctor.
You can get an increase in blood pressure with NSAIDs. Larger studies have linked some of these pain relievers with a small increase in the risk of heart attack and the more you take, the more likely you are to have heartburn, stomach irritation or even bleeding ulcers.
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An Artificial Meniscus May Soon Be Available
If you are suffering from knee pain following meniscus surgery or are without viable treatment options, the NUsurface®Meniscus Implant may provide an alternative option, once it has approval from the U.S. Food and Drug Administration. NUsurfaces design mimics the function of the natural meniscus and redistributes weight across the knee joint. The implant is made from medical grade plastic and, as a result of its unique materials, composite structure, and design, does not require fixation to bone or soft tissues.
NUsurface can potentially address the treatment gap of those who are too old for meniscus repair and too young for total knee arthroplasty. U.S. clinical trials completed enrollment in June 2018, and the company expects to file for U.S. Food and Drug Administration approval soon.
What You Need To Know About Knee Replacement In Ireland
Arthroplasty or Knee Replacement is a surgical procedure involving the exchange of a damaged and weakened knee joint with an artificial one. It is commonly performed for different types of arthritic knee diseases such as osteoarthritis, rheumatoid arthritis, and psoriatic arthritis mostly brought on with old age. Other causes can be accidents which lead to meniscal tears, joint dislocation, ligament tears, and cartilage damage. Osteoarthritis is the most common cause of knee replacement. Genu Valgus and Genu Varus can also be treated by the surgery. Arthroplasty can either be partial or complete depending upon the degree of damage.
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Why Might I Need A Total Knee Replacement
You might need a total knee replacement if you have significant damage to your knee joint. Different types of medical conditions can damage this joint, such as:
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Osteoarthritis
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Injury or fracture of the knee joint
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Bone tumor in the knee joint
This damage might be very painful and limit your normal activities. The procedure may help decrease your pain, improve your joint mobility, and quality of life. Usually, healthcare providers only recommend total knee replacement when you still have significant problems after trying more conservative treatments, like pain medicines and corticosteroid shots .
Talk with your doctor about the benefits and risks of having minimally invasive total knee replacement instead of traditional total knee replacement. Minimally invasive total knee replacement uses a smaller incision than a traditional knee replacement, so it may lead to less pain and decreased recovery time. It is not yet clear whether the procedure leads to an increased risk of certain complications, though.
In some cases, you may have other surgical options, like shortening the bone or a partial knee replacement. Talk with your doctor about the risks and benefits of all your options.
Whats It Like To Have A Total Knee Replacement
While there are a few different ways to perform a total knee replacement, the procedure itself has just a few steps:
- The patient is placed under anesthesia and vital signs will be monitored. An incision is made in the knee to reach the joint
- During surgery, the knee joint is prepared by removing the damaged cartilage from the tibia and femur
- Metal implants are inserted in place of the cartilage that is removed to rebuild the surface of the knee joint
- A spacer made of medical-grade plastic material is inserted so the new metal prosthetic will glide smoothly against the joint
- Metal components are attached to the ends of the femur and tibia
- The incision will be repaired and the patient will leave the operating room to go to recovery
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