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Information in this segment has been assembled to help you better understand the anatomy and function of the knee and the degenerative changes associated with arthritis, to prepare you for total knee replacement surgery, and to provide guidelines for post operative care. The long term goal of total knee replacement surgery is to provide relief of pain, restore normal activities of daily living and enhance your quality of life.
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[/vc_column_text][vc_column_text]The three bones that comprise the knee joint are the femur (thighbone), the tibia (shinbone), and the patella (kneecap). The knee may be described as a modified hinge joint, similar to the hinge on a door. However, the knee not only bends back and forth like a hinge, it has a complex rotational component that occurs with flexion and extension of the knee. The knee is a major weight-bearing joint that is held together by muscles, ligaments and other important soft tissue. Cartilage is the material inside the joint that provides shock absorption the knee during weight-bearing activities such as walking or stair climbing.[/vc_column_text][vc_column_text]Book Appointment[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/3″][vc_single_image image=”4929″ img_size=”full” alignment=”center” style=”vc_box_shadow_border”][/vc_column_inner][/vc_row_inner][vc_empty_space][vc_row_inner equal_height=”yes”][vc_column_inner width=”1/3″][vc_single_image image=”4930″ img_size=”full” alignment=”center” style=”vc_box_shadow_border”][/vc_column_inner][vc_column_inner width=”2/3″][vc_column_text]
[/vc_column_text][vc_column_text]Arthritis in the knee joint occurs as a result of degeneration of the cartilage in your knee. Osteoarthritis is commonly referred to as “wear and tear” arthritis and is the most common cause for total knee replacement surgery. Due to osteoarthritis, the cartilage in the knee breaks down over time and the result is a severely damaged joint surface with bone rubbing on bone. This process may occur as a result of previous trauma to the joint, ligament instability, or abnormal stresses to the joint. Rheumatoid arthritis is an inflammatory process that results in erosion of the articular cartilage and subsequent damage to the knee joint surface.[/vc_column_text][vc_column_text]Book Appointment[/vc_column_text][/vc_column_inner][/vc_row_inner][vc_empty_space][vc_empty_space][vc_row_inner equal_height=”yes”][vc_column_inner el_class=”box-effect” width=”1/2″ css=”.vc_custom_1644991758193{background-color: #eeeeee !important;}”][vc_column_text]
Listed below are several non-operative, conservative options to consider for treatment of the arthritic knee.
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Total knee replacement surgery is considered when all other conservative meas¬ures have failed to provide successful intervention and may be performed for the following reasons:
Total knee replacement surgery is a common procedure performed on more than 600,000 people worldwide each year. With recent advancements in surgical tech¬nique and implant design, patients have experienced dramatic improvement in knee pain, function, and quality of life. Furthermore, most patients can now expect their implants to last up to a decade or more, allowing for years of active, healthier, pain-free living.
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Once you and your orthopaedic surgeon have decided to proceed with surgery, there are several activities that must occur prior to surgery, including the following:
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This section will give you a brief overview of the activities that will occur on the day of surgery:
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[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][lvca_tabs][lvca_tab tab_id=”Implant Components” tab_title=”Implant Components”]In the knee replacement procedure, each prosthesis is made up of four parts. The tibial component has two elements and replaces and the top of the shin bone or tibia. This prosthesis is made up of a metal tray attached directly to the bone and a high-density plastic spacer that provides the bearing surface. The femoral component replaces the bottom of the thigh bone or femur. This com¬ponent also replaces the groove where the patella or kneecap rides. The patellar component replaces the surface of the knee cap, which rubs against the femur. The patella protects the joint, and the resurfaced patellar button will slide smoothly on the front of the joint. In some cases, surgeons do not resurface the patella.
[/lvca_tab][lvca_tab tab_id=”Bearing Surfaces” tab_title=”Bearing Surfaces”]One of the keys to a successful implant is its ability to withstand the rigors of daily activity, and central to that is the quality of the artificial surfaces that slide against each other, or articulate, in the new joint. In knee implants, bearing surface options have been somewhat limited over the last few decades. The standard substance used for the femoral component is cobalt chrome, a metal alloy typified by its tough¬ness and biocompatibility. However, even this high-quality industry standard has its shortcomings. Over time, this metal surface can become roughened by bone and bone cement particles trapped between the femoral component and the plastic tibial insert.
This roughened surface, when rubbing against the plastic component up to two million times per year, can more quickly wear out your implant. When that happens, you will have to undergo surgery to replace the plastic piece, the femoral compo¬nent, and possibly even the tibial component. For this reason, implants have been shown to last between 10 and 15 years in the human body. The most exciting material to enter orthopaedics in recent years is OXINIUM° (oxi¬dized zirconium.)This remarkable new material combines the strengths of ceramic and metal, such as wear-reduction and strength, but does not have the weakness¬es, such as limited implant options and the possibility of fracture.
Zirconium is a biocompatible metal, similar to titanium. When the zirconium alloy undergoes a unique heating process, the surface of the metal transforms into a ceramic. Even though the new ceramic surface is 4,900 times more abrasion resistant than cobalt chrome, it retains the toughness and flexibility of the underlying metal. Because it can achieve this remarkable reduction in implant wear without sacri¬ficing strength as actual ceramic com¬ponents do, OXINIUM° implants have the potential to last significantly longer, thus possibly reducing the need for future corrective surgeries. When articulating on standard plastic tibial components, OXINIUM° knee implants reduce wear by 85-percent compared to cobalt chrome.[/lvca_tab][lvca_tab tab_id=”The Procedure” tab_title=”The Procedure”]
Knee replacement surgery typically takes between one and two hours to complete. This section will provide you with a brief, easy-to-understand description of the surgical procedure:
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After your surgery is completed, you will be transported to the recovery room for close observation of your vital signs, circulation, and sensation in your legs and feet. As soon as you awaken and your condition is stabi¬lized, you will be transferred to your room. Below is an example of what you may see when you wake up:
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In a small percentage of patients, as with all major surgical procedures, complica¬tions can occur. Below is a list of potential complications and steps you can take to prevent their occurrence:
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Thrombophlebitis: also known as deep vein thrombosis (DVT), this problem occurs when the large veins of the leg form blood clots and in some instances, become lodged in the capillaries of the lung and cause a pulmonary embolism. The following steps may be taken to avoid blood clots:
Important: If you develop swelling, redness, pain, and/or tenderness in the calf muscle, report these symptoms to your orthopaedic surgeon or internist immediately.
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Although great precaution is taken before, during, and after surgery, infections do occur in a small percentage of patients following knee replacement surgery. Steps you can take to minimize this risk include the following:
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Because your lungs tend to become “lazy” as a result of the anes¬thesia, secretions may pool at the base of your lungs, which may lead to lung congestion or pneumonia. The following steps may be taken to minimize this risk:
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In some cases, the mobility of your knee following surgery may be significantly restricted and you may develop a contracture in the joint that will cause stiffness during walking or other activities of daily living. The following steps must be taken to maximize your range of motion following surgery:
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Replacement Surgery
In order for you to meet the goals of knee replacement surgery, you must take ownership of the rehab process and work diligently on your own, as well as with your physical therapist, to achieve optimal clinical and functional results. The reha¬bilitation process following total knee replacement surgery can be quite painful at times. However, if you commit to following your program and overcome the chal¬lenges in rehab, you will succeed in meeting the goals you set when deciding on surgery. The following outline will summarize the process you will adhere to during rehabilitation:
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