Joint Replacement (Knee)
What Is Total Knee Replacement Surgery?
The knee is a hinge joint, like the ankle and elbow, and is considered the largest joint in the body. The knee is the joining of the lower part of the femur (thighbone) with the top of the tibia (shinbone). The bones, including the patella bone (kneecap), are joined by cartilage and ligaments, like the anterior and posterior cruciate ligaments (ACL and PCL).
When these components incur serious wear and tear to the bone and cartilage of the knee joint through injury, osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, it can lead to chronic pain in the knee. Sometimes, this pain is best mitigated through surgical intervention.
Total knee replacement, also called total knee arthroplasty, is frequently performed to relieve a patient's knee pain associated with osteoarthritis and similar conditions. Knee replacement is one of the most commonly performed joint replacement surgeries. Even in knees that are severely damaged, it is often highly successful and can bring significant improvement to one's quality of life.
Total knee replacement can provide significant pain relief and restore function and range of motion of the knee.
Who Is a Good Candidate for Joint Replacement of the Knee?
Total knee replacement is usually an elective surgery. Your surgeon will assess your pain and movement levels. If your knee hurts when you are using it for simple tasks, such as climbing the stairs, as well as when you are not using it, such as when you are sitting or lying down, it is an indication that surgery is a good option for you. Knee arthroplasty is best for people who are over 40 years old and who have knee arthritis in more than one area of their knee.
Visiting a medical doctor is recommended to discuss knee replacement if your condition meets any of these criteria:
- The pain in your knee prevents you from participating in your favorite recreational activities
- You have attempted conservative methods with no success
- You have knee pain that keeps you awake at night
- You have knee pain that limits your ability to carry out necessary daily functions, such as climbing stairs or standing up
What to Expect During Your Appointment
Your surgeon will discuss your health history and perform a physical exam. He or she may also take X-rays, typically while you are standing up so that the way your knee joint functions while bearing weight can be assessed. This provides important information that your surgeon will use to determine the best treatment for you, whether it be a joint replacement or something else. This process will help your doctor determine if you have osteoarthritis, another form of arthritis, or damage to your cartilage or ligaments.
With mild knee pain, your surgeon may suggest anti-inflammatory medications before recommending a knee replacement. You may also require other pain medications for more severe knee pain. Other nonsurgical options include exercises, steroid knee injections, or using walking support, such as a cane. If you are obese or overweight, your surgeon will likely suggest healthy weight loss to see if that reduces your pain and inflammation.
Long-term results of total knee replacement are generally considered excellent. You should seek out an experienced surgeon to perform your total knee replacement. This clinician should not only be skilled at performing the surgery but should also be knowledgeable about choosing patients who are appropriate for the procedure. While many patients are candidates for the technique, only an experienced, skilled surgeon knows for sure who will benefit most from the procedure.
What to Expect During Your Knee Replacement Surgery
Total knee replacement is performed while you are under general anesthesia. First, the surgeon makes an incision in the front of your knee and removes the damaged cartilage of your joint from the surface of your bones. Next, he or she shapes these surfaces so they can hold metal or plastic artificial joint components. (A knee replacement is sometimes called a knee resurfacing, because only the surface of the bones is actually replaced.)
Then, an artificial knee is inserted into the area and attached to the femur (thighbone), tibia (shinbone), and kneecap (patella), using a special material. The undersurface of the kneecap may also be cut and resurfaced, and finally, a spacer is placed between the components so they can move and glide easily.
You will go to a recovery room while your anesthesia wears off, and you will be monitored. If your total knee replacement is performed on an outpatient basis, you will be released the day of your procedure to recover from home after you are cleared to do so by your surgeon. Otherwise, you may have a short hospital stay.
Your Recovery and Living With Your New Knee
You should be able to stand and move around one day post-surgery. Typically, patients begin physical therapy for their recovery by using parallel bars to practice walking. Next, you will transition to a walking device, such as crutches or a walker. After six to eight weeks, when your knee can support your body weight and after your body has built muscle strength, you should be able to perform most normal weight-bearing and low-impact movements and daily activities with little or no pain. You will need to avoid high-impact activities to prolong the lifespan of the joint prosthesis.
Be sure to attend all follow-up appointments. As with any surgery, there is a risk of infection, blood clots, or other complications. Sometimes, the range of motion may be more limited than was expected, and knee scarring can occur. Additionally, over time, implant surfaces become worn and the artificial joint may loosen from use. Previously, a revision total knee arthroplasty would be needed around 10 years after the initial surgery. With current surgical techniques, knee implants have long-lasting lifespans of 15 – 20 years.
Other Forms of Knee Replacement
Partial knee replacement is a surgical procedure where only part of the knee is replaced. There are several forms of partial knee replacement, including unicompartmental, patellofemoral, and robot-assisted. This form of knee replacement is less invasive than a full knee replacement surgery and is recommended more often for younger or more active patients with less extensive arthritis or other damage in their joint.
Total knee replacement can also be performed using state-of-the-art robotic-arm assisted technology, which enables the surgeon to perform surgery with added precision for a quicker recovery.
Exceptional Care at University Orthopaedic Surgeons
Our years of experience and advanced training devoted to the care of orthopaedic issues, including those of the knee, make us who we are, but our compassionate care of our patients is what makes us dedicated to you. Our knee replacement specialists at University Orthopaedic Surgeons, Dr. Michael Eilerman, Dr. E. Michael Holt, Dr. Michael McCollum, Dr. Philip McDowell, and Dr. Brian Tonne, are unparalleled experts in accurately diagnosing and effectively treating knee injuries and conditions in a broad range of patients, and they continuously strive to exceed our patients' expectations in the delivery of care.
To consult with a University Orthopaedic Surgeons knee replacement surgeon, please request an appointment online or call (865) 546-2663 for our UT Medical Center and Sevierville offices or (865) 218-9300 for our West Knoxville office.