Knee Replacement

Knee Replacement or Arthroplasty

A surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain andreduce disability. Knee replacement is still considered an “elective” procedure for most. Recently a NY times article noted, about 12 percent of adults in the United States have painful arthritic knees that limit mobility. Yearly more than 640,000 have them replaced with artificial joints at a cost well in excess of $10 billion a year. Knee replacement surgery may be partial or total.

Knee Anatomy

The knee joint is comprised of three bones, the Femur or thigh bone, the tibia one of the two leg bone and the patella or knee cap. Several muscle groups function during motion and ligaments provide support, cushion and connectivity. With the passage of timer post significant trauma the knee joint may degenerate and become inflamed due to osteoarthritis. The condition becomes chronic with on-going severe pain affecting activities of daily living. The most common reason for knee replacement surgery is to relieve severe pain caused by osteoarthritis. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have knee pain even when at rest. 

What Should Be Tried Before Deciding to Go Under The Knife?

When conservative care such as exercise to strengthen the muscles, to improve range of motion, coupled with appropriate medication FAIL to improve the situation, knee replacement, either total or partial,  in a properly selected patient becomes a viable treatment consideration.  Extreme obesity increases the loads on the knees and may lead to arthritis. Some people require weight loss to reduce stress on arthritic knees. Others benefit from lubrication injection with hyaluronic acid which may help for up to six or more months. Other injections consist of corticosteroids, which reduce inflammation, can provide more immediate relief. Steroid injections are not repeated too often as they may also cause joint damage.

Knee Replacement Hardware

Knee implants are made of metal alloys often titanium, ceramic material, or strong plastic components. Implants are designed to replace the surfaces of up to three bones, the lower end of the femur, the top of the tibia and the back surface of the patella.  

Age Consideration

Knee replacement hardware have a time limitation of up to 15 years. The age of patients  who are considered for replacement  range of 50- 80 years old. While the technology has improved, people with life expectancy of 20-30 years may be discouraged from knee replacement. The key should be quality of life enhancement and improvement in activities of daily life.

Post Surgery Recovery

After knee replacement careful structured exercise is a MUST. Post surgery patients are encouraged to walk as soon as the day after surgery. Using crutches and cane may continue for up to 6-8 weeks. An exercise regimen begins in bed next day post surgery. Post surgical swelling and pain may last for 6-8 weeks or in some cases as long as year. Gradually other stretching and strengthening routines are added to help restore function and balance.  

Goals and Quality of Life  

Total knee replacement or partial knee replacement leads to a higher quality of life, less pain, and better mobility.

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Author: Moses Jacob, DC