Knee Replacement - Partial and Total
The knee joint is formed by the lower end of the femur (thigh bone) and the upper end of the tibia (shin bone). The surfaces of the joint are covered by a smooth elastic tissue called cartilage. The cartilage allows the joint surfaces to glide smoothly and painlessly against each other. Damage to the cartilage and bone within the knee joint is called osteoarthritis. This can result from degeneration (wear and tear), trauma (fractures and ligament injuries), avascular necrosis (depletion of the blood supply to the bone) and inflammatory disorders (such as rheumatoid arthritis).
Patients who develop osteoarthritis of the knee joint can present with pain, stiffness, joint deformity and limping. This can sometimes be severe enough to affect daily mobility and one’s quality of life. The diagnosis of knee osteoarthritis is made after a thorough clinical assessment of the knee joint. X-rays and MRI scans are done to confirm the diagnosis. Occasionally additional blood tests may be done to find out the underlying cause of the osteoarthritis.
Patients with early osteoarthritis and mild symptoms may be treated non-surgically with a course of rehabilitation. However, patients with severe symptoms and advanced osteoarthritis may be candidates for surgical treatment, in the form of knee replacement surgery.
Knee replacement surgery involves replacing the worn out surfaces of the knee joint with prosthetic devices which are made of cobalt-chromium, titanium and polyethylene (medical grade plastic). If only one compartment of the knee is involved, then partial or unicompartmental knee replacement may be performed. In this procedure, only the affected part of the knee surface is replaced by prosthetic components. If more than one compartment of the knee is affected by osteoarthritis, then total knee replacement is carried out. In this case, all the surfaces of the knee are replaced by prosthetic components.
Such surgery is usually performed under general anaesthesia and may take about 2 hours to perform. A 3-4 stay in hospital is usually required after the surgery and 2-6 weeks of walking aid-assisted ambulation may be advised.
The rehabilitation process after the surgery is generally supervised by a physiotherapist, and consists of progressive range of motion exercises, muscle strengthening exercises, and functional therapy. The whole rehabilitation process may last to 3-6 months following the procedure. The success rate of knee replacement surgery has been reported to be 90%. The complications of this procedure include deep vein thrombosis, infection and prosthetic wear.
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