Total Knee Joint Replacement

A total knee replacement involves the removal of the natural structures of the joint and replacing them with prostheses made of metal and medical-grade plastic. The first knee replacement was performed in the 1960s and technique has been improved ever since. Today, total knee replacement is a straightforward, safe and very effective procedure to eliminate much of the pain and disability associated with degradation of the knee joint.

When Should a Patient Consider Knee Replacement Surgery?

There is no definite time when the replacement surgery should be undertaken. Each patient compensates differently for their disability as a result of knee pain. And many patients wait quite a while before they decide to pursue a knee joint replacement option. However, objectively, the criteria for undergoing a knee replacement surgery would include:

• Severe knee pain, stiffness and disability that does not allow the patient to perform normal daily activities. Whether it is difficulty walking, or interference with other activities, this is the primary reason for undergoing replacement
• Deformity of the knee
• Failure of other more conservative treatments including Cortisone shots and physical therapy

The most common condition leading to joint replacement is arthritis. There are three kinds of arthritis:

Osteoarthritis is wear-and-tear of the knee joint. Osteoarthritis typically affects patients in middle to older age, but the average age at which osteoarthritis first presents has dropped significantly in recent decades. Osteoarthritis is also exacerbated by inflammatory and hormonal changes due to adipose or fat tissue that accumulates as we gain weight.

Rheumatoid arthritis is an inflammatory condition that starts to degrade the cartilage in the joints. It can be autoimmune – a chronic disorder in which the body’s immune system fights itself. Poorly managed rheumatoid arthritis can progress to degeneration of the joint, requiring knee replacement surgery

Post-traumatic arthritis involves degeneration of the joint due to a previous injury. This is very common with fractures and serious tendon injuries within the knee. Most cases of post-traumatic arthritis are mild to moderate and can be managed with bracing and lifestyle change. Severe cases of post-traumatic arthritis with chronic pain may be treated with a knee replacement.

Age is not as often a contraindication as it once was, and many patients, even in their 80s, receive successful knee replacements. However, general health conditions including metabolic disease and type-2 diabetes may preclude some patients from surgery until these conditions are under control.

Risks and Considerations of Knee Replacement Surgery

Knee replacement surgery is still major surgery, no matter how safe and effective it has become. Therefore, it does come with some risk. These risks can be mitigated by employing an orthopedic surgeon such as Dr. Manning who has extensive experience with knee problems and joint replacement.

There is some risk associated with general anesthesia which is used during a knee replacement procedure. Other risks include infection, blood clots, injury to surrounding vasculature, or failure of the implant. Dr. Manning will discuss these and other specific risks during consultation.

General Outcomes for Knee Replacement Surgery

As mentioned before, the technique used in modern knee replacement surgeries has improved to the degree that the procedure is extremely effective and safe. Patients often get satisfaction almost immediately after surgery. Longer-term, knee replacement offers the patient another chance at normal activity in day-to-day life.

Please contact our office and schedule a consultation with Dr. Manning to learn more about any replacement surgery