What is a total knee replacement?
A total knee replacement is not really a replacement, it is more of a resurfacing of the knee. The end of the thigh bone is shaved off and a metal cap is put in its place, held onto the bone with cement. The top of the shin bone is shaved off and a metal tray is placed, held onto the bone with cement. A plastic (polyethyelene) liner is snapped into the metal tray. The metal cap articulates with the plastic liner. A portion of the knee cap is shaved off and replaced with a plastic button.
The new knee is designed to bend and in most cases patients regain the amount of bend they had prior to surgery and may even end up with a little bit more motion. It is not always possible to improve the amount of bend and sometimes patients may actually lose a little bit of motion if there is a lot of scar tissue.
Click here for a video animation of the Biomet Vanguard total knee replacement
When are you ready for a knee replacement?
When the pain or stiffness becomes severe and you lose the ability to perform normal daily activites such as going on walks, going to the store or getting in and out of the car. People may also notice difficulty with other types of activities such as golfing, playing tennis, riding a bicycle or going on hikes. Most patients have tried over the counter medications, a cortisone injection or viscosupplementation. The "need" for a knee replacement goes beyond the xray and just because your xray may show arthritis, you may not "need" one until your quality of life is dimished. Patients usually know when they are ready for a knee replacement.
What is a minimally invasive knee replacement?
Minimally invasive surgery is a buzz-word used in orthopedic surgery used to convey the concept of doing the same surgery through a smaller incision. The real goal is to disrupt less tissue while doing the surgery, thus hopefully causing less pain and less scar tissue formation after surgery. This may lead to a quicker recovery and may improve the final outcome such as the range of motion. While we do perform minimally invasive knee replacement surgery, more goes into than simply a smaller incision.
What is Rapid Recovery Joint Replacement?
The rapid recovery program is more than just a minimally invasive surgery. It includes:
1. Educating the patient prior to surgery
2. Preoperative physical therapy consultation
3. Coordinating a team focused on the care of joint replacement surgery
4. Minimally invasive surgery
5. Effective pain control protocols that decrease pain while minimizing postoperative nausea/vomiting
6. Early postoperative physical therapy evaluation and mobilization
7. Clinical pathways that help standardize the postoperative experience
8. Efficient discharge planning
How long will my knee replacement last?
This is an important question that many people want to know. The real question however is what is the chance that I will need another surgery? While most people do not outlive their knee replacement, many do unfortunately require a redo or what we call a revision knee replacement. The plastic liner may wear out in 12-15 years, but most last longer than this. There are many other reasons for requiring a revision knee replacement such as infection, loosening of the implant from the bone and ligamentous instability. For these reasons, we recommend routine followup with an orthopedic surgeon, especially after 10-12 years, in order to track how the replacement is holding up.
At Joint Specialists of WNC, we are fellowship trained and highly experienced in revision knee replacement surgery. We are in fact a referral center for Western North Carolina for complicated first time knee replacements and revision knee surgery. We look forward to serving the residents of Hendersonville, Asheville, Brevard, Rutherfordton, Western North Carolina and the Upstate with high quality, compassionate orthopedic care. Please come visit us.
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