A total knee replacement or knee arthroplasty is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thighbone or femur abuts the large bone of the lower leg or tibia at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone/tibia is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic “button” may also be added under the kneecap surface. The artificial components of a total knee replacement are referred to as the prosthesis. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.
There are four basic steps to a knee replacement procedure which includes prepare the bone in which the damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone. Then Positioning the metal implants in which the removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or “press-fit” into the bone. Third step includes resurfacing the patella with a plastic button. Some surgeons do not resurface the patella, depending upon the case and at last inserting a spacer which is inserted between the metal components to create a smooth gliding surface.
The most common cause of chronic knee pain and disability is arthritis. Although there are many types of arthritis, most knee pain is caused by just three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
Osteoarthritis: This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
Rheumatoid arthritis: This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”
Post-traumatic arthritis: This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.
Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs
If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery.
Moderate or severe knee pain while resting, either day or night.
Chronic knee inflammation and swelling that does not improve with rest or medications
Knee deformity — a bowing in or out of your knee.
Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries
With ultra modern facilities leading hospitals in India performs following types of knee replacement surgeries:
Total knee replacement: This is the most common form. Your surgeon replaces the surfaces of the thigh bone and shin bone that connects to the knee.
Partial knee replacement/ Unicondylar Knee Replacement: If arthritis affects only one side of your knee, this surgery may be a possibility. However, it’s only right for you if you have strong knee ligaments.
Partial knee replacement can be performed through a smaller cut than is needed for total knee replacement which makes it a better and more preferred option by the doctors. One of the best advantages of this minimally invasive surgery is that the tissue damage is far less as compared to the total knee replacement. It recovers fast and the knee feels more natural. It allows squatting and cross leg sitting as well.
Kneecap replacement: This replaces only the under-surface of the kneecap, but some surgeons advise against this procedure, because total knee replacement surgery has a higher rate of success.
Complex knee replacement: This procedure may be needed if you have very severe arthritis or if you’ve already had two or three knee replacement surgeries.
Rotating Platform high-flex knee: The design of the high flex implants closely replicate normal knee. Rotating knee replacement implants can swing backward and forward giving the knee flexibility to move forward and outward. High flexion gives patient the freedom to the extent that the patient can even squat, cross leg and sit on the floor.