Knee Replacement Facts, Symptoms, Treatment.
Knee replacement is surgery for people with severe knee damage. Knee replacement, or knee arthroplasty, is a surgical procedure in which the diseased surface of the knee is replaced by artificial materials.
The surgery can be performed for partial or a total knee replacement. The recovery period may last upto 6 weeks or longer and usually involves the use of aids (e.g. walking frames, canes, crutches) till recovery. There is substantial postoperative pain involved and includes vigorous physical rehabilitation.
When and Why do you need knee replacement?
The indications for knee replacement are many. Below mentioned diseases are some of the reasons you would need Knee Replacement. These hamper day to day activities:-
1. Severe osteoarthritis
2. Advanced Rheumatoid arthritis
3. Psoriatic arthritis
5. Serious valgus or varus deformity (knock knees or bow legged)
What are the Pre-Operative preparations before surgery?
Knee replacement is major surgery. Before surgery, joints adjacent to the diseased knee are carefully evaluated. Routine blood tests, liver and kidney function tests and urine tests are evaluated for signs of anemia, infection, or abnormal metabolism. Chest X-ray and ECG are performed to exclude significant heart and/or lung disease which may preclude surgery or anesthesia.
All the medications that the patient is taking is reviewed, especially blood thinners.
How is the surgery done?
There are majorly two types of knee replacement surgery, depending on the disease process and degree of knee affected.
1. Total Knee Replacement (TKR) :
The surgery involves exposure of the front of the knee, with detachment of part of the muscles of the thigh. The knee cap is displaced to one side of the joint allowing exposure of knee joint. The ends of these bones are then accurately cut to shape using cutting guides. Metal components are then impacted onto the bone or fixed using cement.
A round ended implant is used for the femur, mimicking the natural shape of the bone. On the tibia the component is flat, although it often has a stem which goes down inside the bone for further stability.
2. Partial knee replacement :
Partial knee replacement or Unicompartmental arthroplasty (UKA) is an option for some patients. The knee is generally divided into three "compartments": medial (the inside part of the knee), lateral (the outside), and patellofemoral (the joint between the kneecap and the thighbone). Most patients with arthritis severe enough to consider knee replacement have significant wear in two or more of the above compartments and are best treated with total knee replacement. A minority of patients have wear confined primarily to one compartment, usually the medial, and may be candidates for unicompartmental knee replacement. Advantages over total knee replacement is that it include smaller incision, easier post-op rehabilitation, better range of knee movement and less complications. Patients suffering from Rheumatoid, Lupus, Psoriatic or marked deformity are not candidates for this procedure.
What are the complications of the surgery?
The most serious complication is infection of the joint, which occurs in <1% of patients. Deep vein thrombosis (blood clots in the leg veins) occurs in up to 15% of patients. Nerve injuries occur in 1-2% of patients. Persistent pain, failure to achieve full range of motion or stiffness occurs in 8-23% of patients. Prosthesis failure occurs in approximately 2% of patients at 5 years.
Who can do this surgery?
Knee replacement surgery is done by orthopaedic surgeon, generally those who are specialised or dedicated themselves to Joint replacement surgeries.
How can MediAngels help?
MediAngels is the world`s first global e-hospital catering to the needs of every patient and make available easy access, to the ever expanding super-specialty at your doorstep.
You can consult MediAngels Global Medical Experts in Orthopaedic – Joint Replacement for their opinion from the comfort of your home. You can even have your blood tests ordered, sample collected and reports delivered at your doorstep.
1. Leopold SS. Minimally invasive total knee arthroplasty for osteoarthrits. N Engl J Med. 2009, Apr 23;360(17):1749-58.
2. Plamer, SH; Cross MJ (2004-01-30). "Total Knee Arthroplasty". eMedicine