Knee joint is the largest joint in the body that helps us to perform daily activities like walking, running, climbing, sitting and lying down. The knee joint helps in balancing the body weight and helps in smooth ambulatory movements. Injuries to the knee joint and degenerative diseases of the joint like arthritis may restrict the joint from performing its normal function thereby making it difficult for an individual to perform his or her daily activities. There would be pain and stiffness in the knee joint and in some cases it may get worse, restricting the movement.
The treatment for knee pain varies and depends on the degree of pain, movement restriction and the underlying cause. Usually, the knee pain that is caused due to the overuse or minor injury is treated very commonly using the conservative measures, including rest, medication and physical therapy. In some cases the knee joint may be severely damaged and the conservative treatment methods may not help in improving the condition. The pain may get worse and could reach a point where the mobility may be restricted thus affecting the daily life of the individual. In such a scenario an individual may have to see a joint replacement specialist or an orthopedic surgeon who after doing a physical examination, a thorough evaluation and testing may recommend a knee joint replacement surgery (also known as knee replacement).
Knee replacement surgeries have been performed successfully over the past 3-4 decades and have helped in relieving people from joint pain, stiffness, restricted mobility and lead a better quality of life when other conservative treatment modalities have not been of much use.
What is a knee joint ?
To understand the procedure and its outcomes one must have an idea of the normal anatomy of the joint (understand the structure and parts of knee joint) and the diseases affecting the normal function of the same.
The knee joint bears the weight of the entire body by smooth articulation of the bones of the knee. The knee joint is a classic example of a hinge joint/synovial joint and is made up of 4 bones namely, the femur, the tibia, the fibula and the patella. These bones are covered with an articular cartilage which acts like a cushion to protect the wear and tear of bones during function and permits smooth movement of the joints. The ligaments which connect to bones provide stability to the joint. The functions of a knee joint include flexion, extension and rotation.
The knee joint is one of the most complex “simple” structures in the human body. The knee joint is also amongst the strongest and key joints in the human body. The knee, otherwise known as the tibio-femoral joint, is basically a synovial hinge joint between three bones of the legs: the femur (thigh bone), the tibia (shin bone), and the patella (or the knee cap).The knee joint is also made of three basic compartments or sections.
- The Medial Compartment- Inner half of the knee joint
- The Lateral Compartment- Outer half of the knee joint
- The Patellofemoral Compartment- The part behind the knee cap
What happens when the knee joint is injured or affected by a disease ?
Knee joint is one of the most constantly used joints in the body and also bears the body weight and hence this joint is subjected to continuous wear and tear. When the knee is injured or is affected by a condition namely arthritis (inflammation of the joints), the normal movements of the joint is affected. Daily activities like walking, climbing stairs, gardening or sitting for a long time are affected and the patient experiences pain and tenderness of the joints. The cause of this discomfort is the damage to the cartilage resulting in pain during the joint movement.
The most common origin of this joint pain is arthritis (inflammation of the joint space). Arthritis usually affects the older age group and more cases are reported in female gender. There are about more than 100 variants of arthritis reported in literature, the most common ones being osteoarthritis and rheumatoid arthritis. Osteoarthritis is attributed to be an outcome of wear and tear of the joints and is usually reported in the older age group, rheumatoid arthritis on the other hand is considered to be an auto immune disease.
What is knee replacement surgery ?
A knee replacement surgery is the foremost surgical procedure where in a part or the complete knee joint is replaced by an artificial joint.
When do you have to consider knee replacement surgery as a treatment option for you ?
You may be a suitable candidate for a knee joint replacement when you find you have difficulty in walking, bending or doing daily activities. If the knee pain is severe and not relieved with even a change in pain medications, physical therapy, or exercise, as well as restricting mobility severely, that is an indication for surgery. If you are experiencing chronic knee pain causing discomfort, stiffness in the knee, bending of knees during walking which is not relieved on medication and physical therapy, consultation with a physician, an orthopedic surgeon and a rheumatologist would be of help in deciding the treatment.
The diagnosis of a chronic knee problem is made with the support of a thorough clinical examination, medical history and radiographic (X-ray/CT scan / MRI) evaluation.
Will I be sleeping during the knee replacement surgery ?
The knee replacement surgery is performed under the influence of general anesthesia or spinal anesthesia, with or without sedation.
What does the knee replacement surgery involve ?
During the surgical procedure, the surgeon exposes the knee joint and recontours the knee bone by eliminating any damaged part of the involved bones which in turn are replaced by an artificial implant to permit the joint movement. Knee Replacement replaces the surfaces of the knee with plastic and metal. The femoral (thigh bone) replacement is a smooth metal component, which fits snugly over the end of the bone. The tibial (shin bone) replacement is in two parts: a metal base sitting on the bone and a plastic insert. If essential, the patellar surface (that part under the knee cap) is removed and fitted with a plastic button, however mostly the patella (the knee cap) is satisfactory, and may not require surgery.
What are the types of knee replacement surgery ?
A knee replacement surgery procedure is also known as the knee arthroplasty. Knee replacement surgery involves removal and reshaping of the joint space where the damaged or the diseased cartilage is either resurfaced or removed and is replaced by artificial metal implants. Knee replacement surgery can be categorized as follows.
- Partial Knee Replacement Surgery
- Total Knee Replacement Surgery ( TKR )
- Minimally Invasive Knee Replacement Surgery
In a partial knee replacement a part of the knee joint is replaced and resurfaced where as in a total knee replacement more areas of the knee joint are reshaped and replaced by artificial implants. The total knee replacement does not mean the replacement of the entire joint with the artificial implants.
In a standard knee replacement surgical procedure an incision of around 8-11 inches is made to expose the joint whereas in minimally invasive procedure the size of the incision is reduced to 4-6 inches. Generally, a knee replacement procedure itself takes roughly around 1 to 2 hours. The length of the procedure may also depends on the severity of the joint damage.
The knee replacement procedure is carried out under spinal anesthesia or general anesthesia. Not all patients may be fit to undergo all types of above mentioned knee replacement surgeries. Your doctor (orthopedic surgeon) would suggest the most appropriate type of knee replacement surgery after doing a thorough evaluation and testing.
How long will I take to get back on my feet ?
Most probably, the surgery will require you to continue in bed on the day of your surgery. You will require this to recover from anesthesia as well as the effects of surgery. However, from the next morning itself you can attempt to get up, be seated in a chair or semi-recliner and should be able to walk with a walker or crutches within a few days. The recovery depends on the type of knee replacement. Most patients that receive a uni-compartmental (or a 1/2 knee) will be able to be mobile in the hallways on the very first day itself.
In most of the cases, patients are able to resume normal daily activities within 6 weeks. However, it may take 4 to 6 months or up to an entire year to fully recover and realize complete benefits of a knee replacement surgery.
Is my age going to affect the knee replacement surgery ?
Age is an important consideration, though it is not a problem. If you are in satisfactory health otherwise and have the wish to continue an active, productive then it is a good choice for you. You should check with your personal or orthopedic physician for his/her opinion.
How long do I have to stay in the hospital after knee replacement surgery ?
Most knee surgery patients will be in the hospital for an average of 3 to 5 days following a total knee replacement surgery. However, patients with a uni-compartmental (or a 1/2 knee) can exit the next day. This will be assessed if you can reach several goals before you are discharged. Ultimately, the doctors will decide, based on if you are having a safe recovery. This time can vary with each patient.
What is the success rate of knee replacement surgery ?
Knee replacement surgery is being performed lately with increased technological advances and has greatly relieved individuals from knee joint pain, restricted mobility, and discomfort.
What care do I have to take after the knee replacement surgery ?
After the knee surgery, the patient is kept under observation for several hours. After that the patient would be shifted to the ward (patient’s hospital room). From there on the physical therapy and exercises are initiated. The average length of stay in the hospital for a knee replacement surgery is generally 5 to 6 days. The patient may have to continue the physical therapy for at least 4-5 weeks after the knee replacement surgery before he/she could resume the normal daily activities. Apart from the skills and expertise of the medical team, quality of prosthesis/implant, technology and overall health condition of the patient, the success of the knee replacement surgery would also depend largely on how well the patient follows his/her orthopedic surgeon’s instructions (post-surgery care guidelines) at home during the first few weeks after the surgery has been done.
The knee replacement surgery definitely would entail a dedicated change in lifestyle and rehabilitative exercises to aid in the artificial joint movement. You will need physiotherapy or physical therapy in your home for the initial three weeks after the surgery. Then once you are recovered, you can continue physiotherapy at your hospital for another three weeks. The uni-compartmental knee recipients can usually go directly for six weeks of outpatient therapy. The length of time necessary for physiotherapy varies with each patient and your doctor will make your schedule accordingly.
As mentioned at the beginning of this article, knee replacements have been performed for over than 3-4 decades and advances in the surgical procedure and the quality of implants have helped many patients affected with chronic knee pain across the globe to lead a more active and better quality of life. Appropriate physical therapy, exercise and weight management play a crucial role in maintaining proper strength and mobility of the new knee. Your orthopedic surgeon or the joint replacement specialist would explain you as to what to expect from your knee surgery and how to take care of your new knee joint. Take special precautions to avoid falls and injuries. After a successful knee replacement surgical procedure, the patients are relieved of joint pain and joint stiffness causing discomfort. The main outcome of a successful knee replacement surgery is improved the mobility of the knee joint and relief from any stiffness, discomfort or pain.
How to find and reach orthopedic surgeons for knee replacement surgery ?
Now you can find and reach orthopedic surgeons from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple orthopedic surgeons, get cost estimates for knee replacement surgery from different hospitals, compare things and then choose an orthopedic surgeon for knee replacement surgery.
Find, reach and choose an orthopedic surgeon for knee replacement surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
