Nowadays, there are options for someone who needs knee replacement surgery.
Like other surgeries, knee replacement surgery is chosen when medications and other therapies, such as stem cell and blood platelet therapy, fail to bring relief for a knee that’s been damaged by arthritis or trauma.
Total Knee Replacement
Total knee replacement is the most common option chosen for people who need knee surgery. The first operation took place in 1968, and improvements have continued since then.
Knee prosthetics are now so sophisticated that they can be custom made for the individual patient. They very closely replicate the function and range of motion of a real knee.
There are two kinds of total knee replacement. In one, the surgeon removes the posterior cruciate ligament.
This is a ligament that supports the back of the knee. The doctor inserts a cam and post mechanism to do the job of this ligament.
In the other knee replacement operation, the posterior cruciate ligament is spared, but the surgeon inserts a grooved, artificial joint to help support it.
During either total knee replacement, the surgeon prepares the bone by removing cartilage, a spongy material that cushions the joint and resculpting the ends of the thighbone and the shinbone.
They then press fit or cement the metal prosthetic, and insert a button beneath the kneecap and a spacer beneath the metal in the patient’s leg bones.
The surgeon can choose open surgery, which has a 12 inch long incision or laparoscopic surgery, which has an incision that’s only three to four inches long and causes less trauma to the knee and the surrounding structures. The patient loses less blood, is at lower risk for complications and has a shorter recovery period.
Partial Knee Replacement
Partial knee replacement is done to correct a knee that can’t function properly due to damage from medial arthritis. This type of arthritis strikes the inside of the knee and is the most common type of osteoarthritis of the knee.
Partial knee replacement surgery spares more of the natural structures of the knee. The incision is also smaller than that used for open total knee replacement surgery and puts the patient at lower risk for complications.
Before the prosthetic is plced, the surgeon makes an incision in the knee and examines it to see how extensive the damage is.
If there’s a lot of damage, the surgeon may perform a total knee replacement. They have already discussed this with the patient during a consultation.
If partial knee replacement surgery is chosen, the damaged part of the knee is replaced by a prosthesis made of metal and plastic. As in total knee replacement, the surgeon prepares the bone and removes the cartilage before inserting the prosthetic.
The patient is encouraged to get out of bed and walk around soon after their surgery, both to prevent post-surgical thrombosis and the depression that sometimes accompanies surgery.
The doctor also recommends a physical therapist to help the patient adjust to their new knee. Full recovery takes from six to eight weeks. Most patients do make a full recovery and are eventually able to use their new knee painlessly.