The most common cause for chronic knee pain is osteoarthritis. Due to injury or age related degeneration, cartilage within the knee begins to wear away, resulting in inflammation and pain. Often times, conservative treatments options may be useful in relieving stiffness and pain, however in the event these methods do not resolve the problem, partial or total knee surgery might be recommended.
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Frequently Asked Questions
How does the knee work?
The knee is a “hinge joint”, composed of three major bones: the lower end of the femur, upper end of the tibia, and the patella (kneecap). The end of each of these bones is covered by protective cushioning known as articular cartilage. C-shaped wedges known as menisci are located between the femur and tibia, providing shock absorption for the joint. The knee is stabilized by 4 major ligaments: The anterior and posterior cruciate ligaments which stabilize the femur and tibia, as well as the medial and lateral collateral ligaments which further stabilize the femur. This joint receives lubrication from a watery substance referred to as synovial fluid released from a thin layer of synovial membrane which covers the remaining surfaces of the knee. Ideally every anatomical component works in harmony, however in the event of traumatic injury, degeneration, or chronic pain, surgical intervention may be necessary.
What kind of knee replacement surgeries are there?
There are two major approaches to knee replacement surgery.
Partial Knee Replacement may be performed when injury or damage is confined to a certain part of the knee. During this surgery, the medial (inside) or lateral (outside) or kneecap itself is surgically repaired. During partial knee replacement, a small incision is made. Healthy tissue is maintained, while damaged tissue is removed and prosthetic parts are inserted into the knee. These components are composed of high grade metal or plastic, with either fixed or mobile bearings depending on the compartment undergoing surgical repair.
Total Knee Replacement is the most common form of knee replacement surgery. Medical advancement has become so precise, joint replacement can be tailored specifically to the patient based on activity level, weight, and body symmetry. The four components of knee replacement surgery include removing damaged articular cartilage from the bone, positioning and fitting metal components on the joint surface, and inserting a metal spacer in order to restore smooth range of motion to the joint.
What is knee replacement surgery used to treat?
Knee replacement surgery is extremely common. It is often used to treat pain associated with cartilage degeneration or injury such as arthritis and osteoarthritis, osteonecrosis (loss of blood flow to the bones) and traumatic injury resulting in damage to the bone or ligaments and by extension the cartilage.
What is the difference between partial and total knee replacement surgery?
Partial knee replacement is commonly the treatment of choice for patients with lower arthritic damage in the knees. Range of motion may be better preserved due to the conservation of surrounding bone and tissue within the knee. Partial knee replacement typically results in a speedier recovery. Total knee replacement requires a larger incision and recovery period. Individuals experiencing more extensive osteoarthritis or damage to the cartilage may benefit from total knee replacement surgery.
Who qualifies for knee surgery?
Generally, less invasive methods including non-prescription medication such as ibuprofen, cold and heat compression, activity modification, and individualized stretching and exercise are used as alternatives to surgery. However, in the event these approaches do not work, surgery may be necessary. Individuals experiencing osteoarthritis, chronic pain, stiffness, or loss of mobility may be candidates for partial or total knee replacement. Individual evaluation may help determine the correct course of treatment.
What type(s) of anesthesia will be used?
Regional Anesthesia: Often referred to as a nerve block, this type of anesthesia is injected into the nerves surrounding the surgical site. Sedation is often used in combination with regional anesthesia to ensure relaxation and comfort. Regional anesthesia is often used during arthroscopic procedures.
General Anesthesia: This type of anesthesia requires the intravenous administration of anesthesia in conjunction with inhaled gases resulting in a state of total unconsciousness. This prevents any pain or discomfort during the procedure. An anesthesiologist will be present to determine the correct dosage and types of anesthesia based on your physicality and medical history, as well as to monitor your vital functions.
What will recovery be like?
Partial Knee Replacement: Post-surgical hospital stays typically last 1-2 days. Movement is encouraged the day following surgery. After discharge, physical therapy is typically necessary for 2-4 weeks. Low impact activities may be restored after approximately 6-8 weeks, however high impact activity may require a longer recovery time. Stiffness and pain may be present. Your doctor will prescribe pain medication accordingly.
Total Knee Replacement: Hospital stays following total knee replacement make take up to several days. Pain and stiffness may be present. Your doctor will prescribe pain medication accordingly. You may be given compression boots, blood thinners, and support equipment. Mild exercise is encouraged the day following surgery. Physical therapy is often included in the treatment plan. Normal activity is commonly restored within 3-6 weeks following surgery. Activities such as golf, walking, driving, biking, and swimming are realistic expectations in your long term recovery.
What should I expect prior to surgery?
Prior to surgery, patients will receive a medical examination. You will be asked to abstain from eating after midnight the day of surgery. Your doctor will consult with you regarding any medications or supplements you may be taking prior to surgery.