Posts Tagged ‘total knee replacement’

Knee Replacement Surgery

Knee SurgeryThe 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, MDJames 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.

Related Resources

Total Knee Replacement
Revision of Total Knee Replacement
Unicompartmental Knee Replacement

Types of Knee Replacements

Knee ReplacementThe knee is the largest and most complex joint in the human body. It is also one of the most important joints, playing an essential role in carrying the weight of the body in a given direction. It is formed by the lower part of the femur, the tibial plateau and the knee cap, and enables hinge and rotating movements as the connection between the upper and lower leg.

When the knee joint is damaged, people can experience pain, swelling and decreased range of motion. This can make it difficult to perform daily tasks like standing, climbing stairs or walking. If the knee doesn’t respond to activity modification, anti-inflammatory medications and injections, knee replacement surgery may be a viable option. Your doctor may recommend knee replacement surgery if you have severe knee pain and disability from rheumatoid arthritis, osteoarthritis, or traumatic injury, and will make a determination based on the damage to your knee, bone strength, age, lifestyle and other medical conditions you have.

There are two types of replacement surgeries: total knee replacement and partial knee replacement, with total knee replacement surgeries comprising more than 90 percent of today’s procedures. During both surgeries an orthopedic surgeon will replace the damaged knee with an artificial device (implant). Although replacing the total knee joint is the most common procedure, some people can benefit from just a partial knee replacement.

Partial Knee Replacement
The knee is made up of three areas or compartments: medial and lateral (the sides of your knee) and patella-femoral (the knee cap). When fewer than three of these areas need to be replaced, it is called a unicompartmental or partial knee replacement.

Partial knee replacement isn’t suitable for everyone because you need to have strong, healthy ligaments within your knee. However, if only one side of your knee is affected, then partial replacement may be a possibility. Partial knee replacements can often be carried out through a smaller cut (incision) than a total knee replacement, and are typically less complicated than total knee replacements. This almost always means a quicker recovery and better function while giving the same level of pain relief as a total knee replacement.

Total Knee Replacement
Most total knee replacement surgeries resurface the bones at the top of your shin bone (tibia) and the bottom of your thigh bone (femur) with an implant made of metal and plastic parts. The end of the femur and top of the tibia are resurfaced and capped with a metal implants. There is a plastic or polyethelene spacer between the two metal components so the articulating surface is metal on plastic. A total knee replacement may also involve replacing the surface of your knee cap (patella) with polyethelene, although many surgeons prefer to leave it in its natural state because it will be less likely to fracture. When fit together, the attached artificial parts form the joint, relying on the surrounding muscles and ligaments for support and function.

After Knee Replacement Surgery
The average hospital stay after knee joint replacement is usually two to four days, and the vast majority of people who undergo knee joint replacement surgery have dramatic improvement in pain and range of motion. Once muscle strength is restored with physical therapy, people who have had knee joint replacement surgery can enjoy most activities although running for exercise not recommended. . The duration of physical therapy can vary, but typically outpatient therapy lasts from one to two months.

About Dr. Reimer

Nickolas Reimer, MDDr. Nickolas Reimer is an assistant professor of Orthopaedic Surgery at Emory University. He specializes in the treatment of musculoskeletal tumors, total hip and total knee replacements and revision surgeries.

Learn all about Hip or Knee Replacements

The decision to get a hip or knee replaced is a difficult one for many patients.  Hip and knee replacements are typically advised only when all other options have not worked for you.  If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements.  He will be available to answer questions such as:

• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?

Come prepared to ask your questions and learn more about your options!

CHAT TRANSCRIPT

About Dr. Bradbury

Thomas Bradbury, MD

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory.  He specializes in hip and knee arthroplasty.  He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

Related Resources