Total Knee Replacement
The most common cause of chronic knee pain is arthritis. A total knee replacement, also called arthroplasty, is a surgery used when a patient’s knee is severely damaged by arthritis causing daily activities to become hard to perform. A patient’s arthritis can often progress to a point where there is pain with walking, climbing stairs, and even resting. Knee replacement surgery can help to relieve pain, restore function and make an impact in a patient’s life. Annually, there are 580,000 knee replacement procedures performed in the US. With new innovations and advancements, total knee replacements have continued to improve over the past decade with more capabilities, improved results, and longevity than ever before.
The knee joint is formed by the junction of the femur, tibia, and patella, which are all lined with articular cartilage. This cartilage along with the menisci protects and cushions the knee joint. Additionally, the knee joint is held in place by ligaments, which give the knee its stability. Knee arthritis, or the painful inflammation and stiffness of the knee joint, causes degeneration of the cartilage within the knee. There are three types of arthritis: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Osteoarthritis is the wear and tear of the cushioning surfaces of the knee overtime. Rheumatoid arthritis is an autoimmune disease causing chronic inflammation and cartilage breakdown in the knee. Lastly, post-traumatic arthritis is caused when a serious knee injury damages the cartilage of the knee overtime.
At the time of your appointment, the surgeon will take a detailed history, perform a physical exam, and take x-rays of your knees. From these x-rays, the severity of degeneration can be assessed. Individualized treatment plans, outcomes, and expectations will be discussed with the surgeon at this time and a plan will be put into place.
Conservative treatment of arthritis related knee pain is almost always exhausted before a total knee replacement is considered. Treatment plans include injections, medication, weight loss, physical therapy, strengthening, or bracing. Knee replacement surgery is not a decision to be taken lightly and needs significant planning, commitment, and rehabilitation to have a successful and positive outcome.
Surgical management of severe arthritis can be either a partial knee replacement or a total knee replacement depending on your specific condition. During surgery, the damaged bone and cartilage of the knee are removed, resurfaced, and replaced with an artificial knee joint. With current advancements, 90-95% of total knee replacements last 10 years and 80-85% last 20 years. Activities allowed after recovery from a total knee replacement include walking, swimming, golfing, driving, light hiking, biking, and other low impact sports. The goal of this procedure is for the patient to successfully return to daily activity with improvement in symptoms and a better quality of life in 6-9 months. A general guideline of Total Knee Replacement rehabilitation can be found within the Rehabilitation Protocols.