Categories: Orthopaedics

Types of Knee Replacement Surgery

A knee replacement surgery may be the key to a healthier and more active lifestyle, as you can return to many activities that were too painful or difficult before the surgery. After the post-surgery recovery and rehabilitation, the replaced knee and surrounding muscles regain full strength within a few months.

A knee replacement isn’t necessary if you have osteoarthritis of the knees, but it becomes essential if the stiffness, pain, cramps, or discomfort affects your daily routine. When the disease doesn’t respond to the medications and other treatment options, the doctors suggest the replacement of the joint. Depending on the condition of the knee joint, age, health, and level of activity, orthopedic surgeons recommend the following knee replacement surgery:

  • Total knee replacement surgery
  • Partial (unicompartmental) knee replacement surgery
  • Complex or revision knee replacement surgery

Let’s briefly discuss all these four types of knee replacement surgery.

Total knee replacement (TKR) surgery

TKR is a traditional surgical procedure in which a surgeon replaces the joint surfaces with metallic artificial implants. The replaced joint is highly functional and nearly mimics the movements of the original human knee. With the recent advancement in the surgical field, the TKR procedure is now one of the safest and most effective standard orthopedic surgeries. This surgery is a four-step procedure, which includes:

  • Preparation of bones: In this first step, the surgeon removes the damaged cartilage surface and a small part of the underlying bone of the ends of the thighbone (femur) and shinbone (tibia).
  • Insertion of implants: After removing damaged bone, the surgeon position the metallic femoral and tibial parts on the bones and either cement or press-fit them to the underlying bones.
  • Re-adjusting the kneecap (patella): In this step, the surgeons resurface the underside of the kneecap and replace it with a plastic
  • Placing the spacer: This is the final step in TKR surgery in which the surgeon embeds a medical-grade plastic spacer between the metal components of the tibia and femoral implants. This spacer provides a gliding surface to the metallic knee to smoothly perform the knee movements.

After precisely press-fitting and adjusting the metallic surfaces, the surgeon closes the surgical area and bandages it.

Partial or unicompartmental knee replacement surgery

Partial knee replacement surgery is an alternative to a total knee replacement procedure when arthritis affects only one side of the knee (usually the inner side). The surgeons use minimally invasive or reduced invasive surgery to perform unicompartmental surgery and use smaller incisions than TKR surgery. The partial knee replacement surgery has quicker recovery and minimal postoperative complications.

After a thorough examination and evaluation that the knee is suitable for partial surgery, the orthopedic surgeon removes the damaged cartilage and bone, resurfaces it with the metallic implants, and places a spacer. The procedure is similar to TKR surgery, except unicompartmental surgery involves a part of the knee.

As partial knee replacement surgery is a minimally or reduced invasive procedure, the recovery time and hospital stay are lesser than TKR surgery.

The revision or complex knee replacement surgery

The person may require revision surgery if they have a second or third joint replacement in the same knee, severe arthritis, or failed previous knee replacement surgery. It is a complex surgery. The metallic implants used in this procedure have longer stems, which securely fix the metallic components into the bones.

The main goal of the above surgeries is to help relieve the excruciating pain in joints and muscles. After the surgery, most patients with proper rehabilitation can walk normally.

Dr. Surya Udai Singh, Senior Consultant and HOD – Orthopedics & Joint Replacement Surgery, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata

Narayana Health

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