The knee is the largest joint in the body, and without a healthy knee everyday activities can become restricted. Typically, nonsurgical treatment such as pain medications and joint support is initially recommended. For patients who do not see results from nonsurgical treatment total knee replacement surgery should be considered.
Knee replacement surgery is a safe and effective way to relieve pain, and correct leg deformity. Damaged cartilage is one of the main causes of chronic knee pain. Cartilage in the knee serves as a cushion between the femur and the tibia – when the cartilage begins to wear away or become damaged arthritis begins to develop.
There are three types of arthritis that can cause chronic knee pain and disability: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
Osteoarthritis is known as a “wear and tear” type of arthritis and is typically seen in patients 50 year or older. This is the most common type of arthritis that Dr. Millett sees in his practice. The cartilage in the knee begins to soften and wear away over time. In severe cases the bones can begin to rub against one another (bone on bone) causing extreme pain and stiffness.
Rheumatoid Arthritis is a less common form of arthritis and is known as “inflammatory” arthritis. Rheumatoid arthritis a disease of the synovial membrane that surrounds the joint and becomes inflamed – this inflammation can cause cartilage loss, pain, and stiffness.
Post-Traumatic Arthritis follows a serious knee injury. Given the active patient population that Dr. Millett treats, this type of knee arthritis is also very common. Fractures that have gone into the knee joint, tears in cartilage or ligaments (ACL tears, PCL tears) or knee dislocations can cause damage to the cartilage over time leading to pain and limited function.
Prior to deciding to have knee replacement surgery Dr. Millett will require a medical history, physical examination, x-rays and in some cases a MRI. Once this work-up has been completed the correct treatment options will be presented and assessed.
Knee Replacement Surgery
Knee replacement surgery, also known as total knee arthroplasty replaces the damaged joint. Knee replacement does not replace the bones, but resurfaces the bones.
There are three basic steps in knee replacement surgery:
- The surface area of the knee joint is prepared by removing the damaged cartilage at the ends of the femur (thigh bone), tibia (shin bone) and patella (knee cap) along with a small amount of underlying bone.
- The removed cartilage and bone is then replaced with metal components that recreate the surface of the joint. The metal parts are cemented or “press-fit” into the bone.
- A medical-grade plastic spacer is then inserted between the metal components to create a smooth gliding surface.
More than 95% of people who have knee arthroplasty experience a dramatic reduction or complete resolution of knee pain and a significant improvement in the ability to perform daily activities. Most can return to sports such as golf, skiing, hiking, biking and some return to full, unrestricted activities such as waterskiing and basketball.
After Knee Replacement Surgery
- Total knee replacement surgery will likely require a stay in the hospital for a few days post-operatively. Below are some things to remember about what to expect, as well as some helpful hints during the recovery process immediately following the procedure:
- Initially, after knee replacement surgery you will feel some pain, but you will be provided with pain medication to make you feel as comfortable as possible.
- In some cases, Dr. Millett may prescribe support hose, inflatable leg covering (compression boots), and blood thinners to prevent blood clots and compressive wraps at the knee to decrease swelling.
- Foot and ankle movement may be encouraged immediately after surgery to increase the blood flow into your leg muscles.
- Typically, patients begin exercising their knee the day after surgery. Physical therapists will instruct you about specific movements to exercise and strengthen the leg and restore knee movement.
- Normal daily activities will typically resume 3 to 6 weeks after surgery.
- Full, unrestricted activities are typically allowed after 4 months.