We love to enjoy our lives, but excruciating knee pain and stiffness may impact daily activities, such as walking, climbing stairs, and standing up from bed, especially in the mornings.
Osteoarthritis is the most common cause of knee pain in elders. But during the past few years, the average age of developing knee problems has decreased and become common in the young population. This shift is due to a poor lifestyle and increased junk food consumption.
Continuous joint pain interferes with daily activities. Many people are now opting for knee replacement to enjoy their life. Let’s discuss what knee replacement is.
Knee replacement or knee arthroplasty is a surgical procedure in which the damaged surface of knee bones is removed and resurfaced with a prosthesis. An orthopedic surgeon generally recommends knee replacement surgery when conservative methods such as medications and physiotherapy fail to provide relief.
Indications of knee arthroplasty
The main objective of any knee replacement surgery is to alleviate the pain caused by the damaged knees. Some indications of surgery are:
- Arthritis of the knee joint
- The trauma of knee bones and cartilage
- Avascular necrosis of the knee
- Wearing of knee cartilage
- Malalignment of knee bones
- Severe damage of the knee joint associated with worsening of pain and functions
Total knee arthroplasty (TKA) is the final treatment option for most knee joint problems when other conservative methods are of no use. The first line of any knee joint pain treatment is minimally invasive approaches such as cartilage trimming, ligament surgery, replacing only arthritis parts, and others.
Contraindications of knee replacement
Knee replacement surgery is a very effective treatment. But still, some conditions are absolute contraindications for knee replacement surgery.
- Knee sepsis
- Severe infection at the joint area
- Poor functioning extensor muscles
- Severe vascular disease
- Knee bones fused
- Back knee or genu recurvatum condition
Types of knee replacement surgery
In a knee replacement surgery, the damaged ends of the knee bones and cartilage are removed and replaced with artificial prosthetic materials such as metal and plastic parts. Depending on the treatment required, there are four types of knee replacement surgeries:
- Total knee replacement: In total knee replacement surgery, the surgeon replaces the entire joint surface and cartilage with artificial surfaces.
- Partial replacement or Uni-compartmental or uni condylar knee arthroplasty: In a partial knee replacement, the surgeon replaces damaged bone and cartilage of one compartment with the prosthetic bone and cartilage. This surgery is advisable for a patient with arthritis only in one knee compartment rather than a complete knee joint.
- Knee cap replacement (patellofemoral arthroplasty): An orthopedic recommends this surgery in person with a damaged kneecap. Patellofemoral arthroplasty: It is a short surgical procedure. Recovery time is fast and long-term results are better with the knee cap replacement.
- Complex or revision knee replacement: Total knee replacement is successful surgery. But with time or due to any reason, knee replacement may fail. When it happens, doctors generally recommend second surgery called revision knee replacement surgery to alleviate pain, swelling, and stiffness. In this surgery, the surgeon removes either the entire or some parts of the original prosthetic joint and replaces it with the new prosthetic material.
Risk of knee replacement surgery
With the latest advancements, knee replacement surgery has minimal risks. But still, some complications may occur, such as:
- Blood clot formation in the leg. This clot can further travel to other organs such as the brain and lungs and lead to fatal embolism in the brain and pulmonary embolism
- Chronic knee pain
- Bleeding into knee joint
- Secondary infection in the knee joint
- Nerve damage in the knee area
- Blood vessel injury
Benefits of knee replacement surgery
Several possible advantages of knee replacement surgery are:
- Relief from the excruciating pain and stiffness of joints
- Better mobility
- Ease in doing everyday activities
Disadvantages of knee replacement surgery
- Surgery is only effective in severe case of arthritis. So if someone has mild arthritis, it is not a treatment of choice.
- Post knee replacement, people may not do all activities as someone with a normal knee.
- Sometimes clicking noise may come from replaced knee
- Sometimes a person may feel a little uncomfortable while putting weight on their replaced knee
- Some persons feel numbness around the knee.
- Replaced knee joint may wear out or become loose with time, thus requiring a repeat knee surgery.
Due to recent advancements, knee replacement surgery has high success rates. But still, the decision to undergo knee replacement surgery lies in the patient’s hand. The doctor can only suggest the surgery with all possible benefits and complications to patients.
Dr. (Prof.) B.S. Murthy | Director & Senior Consultant – Orthopaedics, Spine Surgery | Dharamshila Narayana Superspeciality Hospital