Best Options for Your Knee Replacement Surgery
As the largest joint in the human body, the knee is susceptible to injury from a hard fall or sharp twist or damage from progressive wear and tear.
If you're not responding well to conservative (non-surgical) treatments for your knee pain or your symptoms are severe and debilitating, you may be a candidate for knee replacement surgery.
Your options will be either total replacement or partial replacement of the knee joint. Here's what you need to know and what specific techniques and procedures you'll have to consider.
Total Knee Replacement
Total knee replacement (TKR) involves removal of bone surfaces that may be damaged and replacement of the knee joint itself with an artificial implant. TKR may be recommended to ease pain from degenerative arthritis (rheumatoid arthritis and osteoarthritis), post-traumatic arthritis following a serious knee injury, or severe injury to the knee joint. It's typically a four-step process that includes:
Removing damaged cartilage and bone on the femur (thighbone) and tibia (shinbone)
• Attaching or affixing a metal tibial and femoral implants to the bone
• Connecting a plastic "button" to the kneecap (patella)
• Inserting a spacer between the artificial femur and tibia to allow for smooth knee movements.
Posterior Stabilized Total Knee Replacement
During this type of replacement, a large ligament (cruciate ligament) that supports the knee is removed if it is damaged or unable to provide sufficient support. It's replaced with a cam and post (special artificial components).
Cruciate-Retaining Total Knee Replacement
With this specific method, the cruciate ligament is kept in place if it's still able to provide support to the knee. An artificial joint specially designed to protect the ligament and allow for normal flexion is used.
Partial Knee Replacement
Usually recommended for younger and healthier patients with minimal knee & hip damage, partial knee replacement (PKR) retains the part of the knee that's still healthy and capable of providing support.
Also referred to as a uni-compartmental knee replacement, the procedure is targeted at the part of the knee that's causing the most discomfort (the medial, lateral, or patella femoral compartment). Metal and plastic parts are used to replace any bone and cartilage that's removed.
Traditional Knee Surgery
During traditional knee surgery, a large incision is made either from the front of the knee towards the middle or from the front to the side, depending on where the damaged part is located. The large quadriceps tendon usually has to be cut to access the knee. Full recovery typically takes about 3-4 months.
Minimally Invasive Knee Surgery
Smaller incisions (about 3-4 inches in length) are used during minimally invasive knee procedures. It's also less invasive since the kneecap is pushed to the side rather than turned over, meaning the quadriceps muscle doesn't need to be significantly cut to allow for access.
There's also a quadriceps-sparing method that may be performed without the need to cut this muscle at all.
The midvastus technique goes under the muscle instead. Usually performed on patients whose knees bend outwards, the lateral approach also spares most of the quadriceps muscle. With such procedures, patients often enjoy:
Shorter recovery times
• Faster healing
• Better range-of-motion following recovery
Computer-Assisted Knee Surgery
Computer-assisted surgery (CAS) combines traditional and newer, minimally invasive techniques. CAS procedures involve the creation of a computer-generated 3-D model of the knee. The detailed model often allows for a more precise fit of artificial components and better alignment.
Most of the knee surgeries performed today are total replacements. Regardless of the type of surgery you need, the increasing use of minimally invasive techniques means you may enjoy a faster recovery and have few complication risks.
After you have your surgery, it's just as crucial to actively participate in physical therapy to recondition supporting muscles, tendons, and ligaments. If you have a total replacement and follow basic guidelines for care, your "new knee" may last 15 years (the current average) or more after your surgery.