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Total Knee Replacement

Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis.

Arthroplasty is a field of medicine which deals with the surgical reconstruction and total replacement of degenerated joints. Arthroplasty uses artificial body parts (prosthetics). Arthroplasty literally means “the surgical repair of a joint”.

When the articular cartilage of the knee becomes damaged or worn out, it becomes painful – the patient finds it extremely hard to move the knee. The bones, rather than sliding over each other with the minimum of friction, rub and crush together.

If an artificial prosthesis is surgically implanted, the patient will feel much less pain, possibly none, and his knee will move properly.

Replacement surgery in a damaged knee joint by placing an artificial prosthesis will alleviate pain and help better movement of the knee.

Today, every year, over 600,000 knee replacement surgeries are carried out in the United States and more than 70,000 in England and Wales. Most patients are seniors – aged over 65 years.

For most patients, a replacement knee surgical procedure will last for at least 15 to 20 years, especially if cared for properly and not put under too much strain. More than 90% of people who have total knee replacement surgery experience a dramatic decrease in knee pain and a significant improvement in their ability to perform common activities of daily living.

However, total knee replacement will not let you do more than you could before you developed, for example, arthritis.

Reasons to perform knee replacement surgery

Today, a knee replacement surgery is considered a routine operation. Below are the three most common reasons for the procedure:

Osteoarthritis: This type of arthritis is age related – caused by the normal long wear and tear of the knee joint. The majority of patients are over 50; however, younger people may be affected. This is a type of arthritis caused by inflammation, breakdown, and the gradual and eventual loss of cartilage in the joints – over time, the cartilage wears down. When the bones rub against each other for a few years, they may compensate by growing thicker, but this will result in more friction and more pain.Rheumatoid arthritis: It is also called inflammatory arthritis, occurs when the membrane surrounding the knee joint is inflamated and thick. This inflammation becomes chronic and will damage the cartilage causing soreness and stiffness.Post-traumatic arthritis: This type of arthritis is due to a severe knee injury. When the bones around the knee break or the ligaments tear, this will affect the knee cartilage. Sometimes, surgery is the best option.

When is knee replacement surgery recommended?

Knee surgery is recommended for older people, although adults or teenagers of any age can be candidates for the procedure, since they are physically active and will more rapidly wear the joint out. The weight, gender, or age of the person is never a factor when considering knee replacement surgery. Whether or not to perform surgery is nearly always based on the severity of pain and degree of disability of the patient.

If should be noted that knee replacement surgery that occurs earlier in life usually means further surgery later on. However, several studies have proven that knee replacement surgery performed before severe stiffness and pain set in is associated with better outcomes.

When considering the option of knee replacement surgery, doctors take into account a number of symptoms:

Severe knee pain or stiffness: Do symptoms seriously undermine the patient’s ability to carry out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair, etc?

Moderate but continuous knee pain: Is pain present while sleeping or resting?

Chronic knee inflammation and swelling: Does the swelling not improve after taking medications or resting?

Do drugs cause unpleasant side effects?

Knee deformity: Is there is a noticeable arch in the inside or outside of the knee?

Nothing else worked: The doctor has prescribed medications and physical therapy without any substantial improvement.

Depression: Depression can be a serious, debilitating and devastating illness. Chronic pain and problems with mobility can eventually lead to depression, especially if the patient cannot do normal daily or social activities properly. Replacement knee surgery may prevent depression from occurring, or help get rid of it.