In the United States the number of total knee replacements (TKR) more than doubled from 1999 to 2008. In 2008 alone there were over 600,000 TKR, which resulted in 134% more replacements than in 1999. A TKR is also referred to as a knee arthroplasty, and with the many advancements in surgical procedures and acquired knowledge over the years, it is a highly successful procedure.
The most common reason for a TKR is to repair damage to the knee joint as a result of osteoarthritis or rheumatoid arthritis, which accounts for over 90% of the operations.
When pain due to damage to the joint has become unmanageable and affects day to day activities, a total knee replacement may be necessary. A TKR is a an effective procedure for relieving pain, correcting any deformities, and helping with returning to normal activities.
Since first being introduced in 1968, TKR has become a well-established surgical procedure with excellent outcomes. With the use of minimally invasive techniques, there are small risks during and after the procedure. This allows for smaller incisions to be made, which minimizes the disruption of surrounding nerves, muscles, and tissues, which results in a less painful and quicker recovery.
Knee Surgery for Pain Relief
The knee is the largest joint in the body and consists of two articulation joints; one between the tibia and femur, and the other one is between the patella and femur. With the knee joint supporting the majority of the body’s weight, it is frequently affected with acute injuries, and osteoarthritis later in life.
The knee is also divided into three separate compartments which includes; the inner medial femorotibial, outer lateral femorotibial, and the patellofemoral compartment. Damage from osteoarthritis or other injuries can occur with one, two, or all three of the compartments.
The main reason for a knee replacement is to relieve pain when all non-surgical methods have been unsuccessful. When a replacement is being considered there are several options available depending on the location of the damage, symptoms, and patient’s condition.
While those who have severe damage often require a total knee replacement, there is also a partial knee replacement, which is also referred to as a unicompartmental knee replacement or bi-unicompartmental knee resurfacing. This type of surgery may be preferred if damage has occurred in just one of the compartments.
Reasons for Knee Surgery and Techniques
There are several different reasons why a total knee replacement may be recommended, such as severe pain or stiffness that restricts everyday activities, moderate to severe pain while resting, chronic inflammation or swelling that does not improve, a knee deformity, or a failure to improve with other treatments.
Unlike some medical procedures, with a TKR there are no weight restrictions or an absolute age to have the procedure performed. The type of surgery that is recommended is based on the patient’s disability and pain. While the majority of patients that receive a TKR range from 50 to 80 years old, each patient is evaluated individually, and replacements are successful at any age.
Currently there are few studies that compare traditional surgical techniques to minimally invasive surgery (MIS) with a TKR, but the general consensus is that MIS has several advantages. It is preferred by many surgeons because there is less muscle dissection and blood loss, less pain, a reduced hospital stay, quicker rehabilitation, and a rapid improvement with range of motion. Along with a shorter recovery time, there are also cosmetic benefits since smaller incisions are made, which results in less scarring.
If care is taken during the procedure, this can help ensure that any revisions that may need to be performed later will not adversely be affected because of this surgery. Recuperating from a knee replacement following traditional surgery is usually difficult and painful, as well as being lengthy, and in many cases a full range of motion is not able to be regained.
Total Knee Replacement Procedure
When all three of the knees compartments have been damaged by osteoarthritis, a total knee replacement is generally performed. With general anesthesia, the patient is sedated and monitored by an anesthesiologist throughout the procedure. The surgery itself generally takes from 1 to 2 hours for the bone and damaged cartilage to be removed, and the new plastic and metal implants to be positioned and aligned.
With the current surgical techniques and designs of prostheses, the range of motion a patient is expected to regain is from 0 to 110 degrees, which is short of the normal range in a healthy knee at 0 to 145 degrees. Those who receive a TKR will never regain a greater range of motion than they had preceding the surgery. However, prosthetic designs and surgical techniques are continuously being improved, which allows new challenges to be addressed.
Currently, over 90% of the modern TKRs are still functioning properly 15 years following the surgery, and proper care of the knee, as well as general health is important with the overall success of long-term outcomes.
One of the top knee replacement surgeons in Phoenix is Dr. Sumit Dewanjee with FXRX. As a Board Certified and Fellowship Trained orthopedic surgeon in Phoenix and Scottsdale, he has successfully performed hundreds of knee replacement procedures as one of the best knee replacement surgeons in Arizona.
Most insurance is accepted at the practice, call (480) 449-3979 today!
Reference:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150806/pdf/12570_2011_Article_66.pdf
