Knee Replacement
Knee replacement or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis.It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis.In patients with severe deformity from advanced rheumatoidarthritis, trauma, or long standing osteoarthritis, the surgery may be more complicated and carry higher risk.Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.
Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly.
Knee replacement surgery can be performed as a partial or a total knee replacement.[In general, the 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.
The operation involves substantial postoperative pain, and includes vigorous physical rehabilitation. The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility.
Partial knee replacement
Partial knee replacement, also called a unicompartmental knee arthroplasty,' is a surgery that may be considered for treatment of osteoarthritis of the knee joint. Traditionally, patients have undergone total knee replacement for severe arthritis of the knee joint. In a total knee replacement, all cartilage is removed from the knee joint, and a metal and plastic implant is substituted.
The partial knee replacement surgical procedure has generated significant interest because it entails a smaller incision and faster recovery than traditional total joint replacement surgery. Partial knee replacement, also called unicompartmental knee replacement' and 'minimally invasive knee surgery,' removes only the most damaged areas of cartilage, and replaces these surfaces.
What is the problem with most patients for the partial knee replacement?
Most patients who seek surgical management have arthritis that is too advanced for the minimally invasive partial knee replacement procedure. Because surgical treatment is considered a 'last-resort' by most patients, by the time surgery is necessary, their arthritis is too advanced to consider this minimally invasive procedure. If partial knee replacement is done in a patient who is a poor candidate, failure rates can be high, and conversion to atraditional total knee surgery may be more difficult.
What is the benefit of the partial knee replacement?
A traditional knee replacement surgery involves an incision about 8 inches over the front of the knee. There is more significant dissection necessary to complete the procedure compared to the unicompartmental knee surgery. In the minimally invasive partial knee replacement, the incision is about 3 inches, and the amount of dissection and bone removal is much smaller.
Because of the extent of dissection and bone removal necessary for a total knee replacement, the need for a blood transfusion is relatively common. With the unicompartmental knee procedure, a blood transfusion is infrequently needed, and patients do not need to consider giving blood preoperatively.
Both the time in hospital and the time to functional recovery are less with the partial knee replacement. Patients are known to have been discharged on the day of the procedure, although most often patients are discharged on the first or second post-operative day. With traditional total knee replacement, patients seldom leave before three or four days in the hospital, and often require a stay in an in-patient rehabilitation unit.
Total joint replacements of the hip and the knee have become an extremely successful and relatively common way to relieve pain and restore motion to these joints. As a result of these successes, approximately 200,000 knees and hips are replaced annually in the United States. Because of their physical improvement after surgery, people who have a total joint replacement often expect to be able to participate in any and all types of activity. However, by engaging in certain strenuous activities, a patient can potentially destroy the artificial joint. As younger and younger people have joint replacements, failure of artificial joints is becoming an increasing problem. Although people who have a total joint replacement should limit their participation in some sports after surgery, they can participate in a wide variety of activities that will not damage their new joint.
Causes of failure
All joint replacements will fail if given enough time and activity. Most joint replacements fail because the replacement becomes loose or because of osteolysis (bone loss around the artificial joint). These two reasons for failure are intimately related and, for the most part, are due to wear of the joint's weightbearing surfaces. Wear of the joint generates debris. In response to this debris, osteolysis occurs and the replacement subsequently loosens. These failures may require surgical revision.
The word 'arthritis' means 'inflammation of the joint.' Most people think of arthritis as the wearing away of cartilage in a joint -- this is the end result of inflammation within the joint. Over time, the inflammation can lead to cartilage loss and exposed bone, instead of a normal, smooth joint surface.
The most common type of knee arthritis is osteoarthritis. This is often referred to as "wear-and-tear" arthritis, and it results in the wearing away of the normal smooth cartilage until bare bone is exposed. Other types of arthritis include rheumatoid arthritis, gouty arthritis, and lupus arthritis.
For more details please contact:
Dr. Prateek Gupta (Senior Surgeon)
Arthroscopy Surgery Clinic
C2/5 Safdarjung Development Area (SDA),
Aurobindo Marg, New Delhi - 110016
INDIA
Telephones: +91 9810852876, +91 11 26517776
24 x 7 Helpline & Appointment: +91 9810633876
Email: sportsmedicinedelhi@yahoo.com,
sportsmedicineclinics@gmail.com
Website: http://www.sportsmedicineclinicdelhi.com/arthroscopy.htm