The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. Your knee can become damaged by osteoarthritis resulting from wear and tear over time, by rheumatoid arthritis, psoriatic arthritis, or by injury/trauma to the knee. Rest, medication, and therapy are the first lines of treatment, but knee replacement surgery — also known as knee arthroplasty — can help relieve pain and restore knee function for those whose cartilage is too damaged to respond to conservative measures. Although surgery always comes with risks, knee replacement surgery continues to be one of the most predictably successful of all major operations done for any problem. It is however a major surgery and should only be considered when other nonsurgical options are not adequate.
Knee Replacement Procedure
In general, knee replacement surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. Knee replacement would be more accurately called knee resurfacing in that only the surface of the femur and tibia are removed and then capped by metal. The ends of the bone are precisely shaped to exactly match the shape of the artificial components. These artificial components mimic the shape of the normal bone. A highly wear resistant plastic insert is placed as the cushion between the two metal components. Usually a total knee replacement also involves capping the surface of your knee cap (patella) with polyethylene. A good result from the operation is very dependent on the accuracy of contouring of bone and placement of components.
What to Expect From Knee Surgery
Recent improvements in materials and techniques have made total knee replacement a common and highly successful surgery, with around 300,000 being performed every year in the U.S alone. The vast majority of people who undergo knee joint replacement surgery have dramatic improvement in pain and range of motion. Approximately 95% of patients after recovering from knee replacement report enough improvement that they would repeat the decision to have surgery. In addition to routing life activities, such activities as walking, cycling, dancing, golf and tennis are comfortable for the majority of patients.
Knee Surgery Rehabilitation
Post-operative hospitalization averages 1 to 3 nights, depending on the health status of the patient. Most people require crutches or a walker for 1 to 3 weeks and a cane for 1 to 3 weeks after that. The average need to see a physical therapist is for 4 to 6 weeks and the time to a better knee overall than before surgery for most patients is about 4 to 6 weeks. Time to safely driving a car is typically 2 to 4 weeks and average time off work is also approximately 4 weeks.
About Dr. Roberson
James Roberson, MD is professor and chairman of the Department of Orthopaedics at Emory. He specializes in total joint replacement of the hip and knee. Dr. Roberson completed his residency training at Emory University followed by a fellowship at Mayo Clinic. He has been practicing at Emory since 1982.