Joint replacements without question are one of the major medical innovations of the past hundred years.
A Total Knee Replacement (TKR) replaces an arthritic knee joint. The femoral (thigh) component is metal; The lower tibial (upper leg ) component is high grade polyethylene plastic; Commonly, the arthritic knee cap surface is also replaced with a plastic button.Thus, the new joint is metal bearing on plastic. While some TKR’s are designed for bony ingrowth to secure them to the bone, most are attached with a medical acrylic cement.
The arthritic joint surfaces are removed -by cutting the old joint out with a power saw. We use guides to insure accurate cuts and the above components fit into these cuts -held by the cement.
Total Knee Replacements have evolved over my career. During my formal orthopedic training and my fellowship in Joint Replacement Surgery at Boston’s Massachusetts General Hospital, this procedure was relatively new and the technique was not as streamlined as it is today. For example, then, many of the saw cuts to remove bone were eyeballed and were made freehanded. Today the cutting guides are much better perfected and easier to use ,so that the cuts are much more accurate and components fit much better than in the past. This leads to better fitted and more secure components, thus resulting in better longevity.
Years ago, we told patents that the TKR would only last around a dozen years. Today, a TKR could last 25-30 years.
The surgery is major and patients need to stay in the hospital for several days. Physical Therapy are recommended for 2-4 weeks and full recovery may take several months. Like any surgery there are potential, albeit,rare complications. But most people do very well and ultimately are very pleased . With a relatively pain free knee, they can get their lives back.
Who needs a Knee Replacement ? Usually people who are at least in their 50’s. In rare circumstances, younger people with severe arthritis may need a TKR, but we try told hold off on older patients as the components do not last forever. In younger patients, the likelihood of a second revision operation later in life is likely where as it is less likely in a 60 year old. Obviously, one should have advanced arthritis and joint destruction on an x-ray.(see photo below )
But, the main indications are pain and limited function. Unable to walk more than a few blocks or around a Mall without increased pain is the usual indication.
I have been performing Total Knee Replacements for years and most of my patients have been very happy with my care and with the results. If you think that you need one, come in to see me and I will discuss the operation in greater detail.
Please note: these articles are for general information. They are not intended to serve as medical advice or treatment for a specific problem. Diagnosis and treatment of a problem can only be accomplished in person by a qualified physician.