Total Knee Replacement
What is Total Knee replacement
Knee replacement surgery replaces parts of injured or worn-out knee joints. The surgery can help ease pain and make the knee work better. During the surgery, damaged bone and cartilage are replaced with parts made of metal and plastic.
Knee replacement, or knee arthroplasty, treats damaged knee joints with metal or plastic implants. It’s a common procedure that’s very effective at reducing pain and stiffness from injury or arthritis. After knee replacement and recovery, you can get back to everyday tasks and activities you enjoy.
Types of knee replacement surgery
Total knee replacement (TKR): Surgery involves the replacement of both sides of the knee joint. It is the most common procedure.
Surgery lasts between 1 and 3 hours. The individual will have less pain and better mobility, but there will be scar tissue, which can make it difficult to move and bend the knees.
Partial knee replacement (PKR): Partial replacement replaces only one side of the knee joint. Less bone is removed, so the incision is smaller, but it does not last as long as a total replacement.
Cause
Osteoarthritis: The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
Rheumatoid arthritis: This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness.
Post-traumatic arthritis: Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.
Treatment
Nonsurgical treatment
Some knee replacement infections are superficial, which means that the infection has reached the skin and tissue around the joint but does not affect the artificial joint itself.
Surgical treatment
Debridement: This is a surgical washout of the joint. Any contaminated soft tissue is removed, and the artificial joint is cleaned. Plastic liners or spacers in the artificial joint may be replaced. The doctor will prescribe IV antibiotics to be taken after surgery.
Staged surgery: This involves a series of surgeries to remove and replace the artificial joint. This may be necessary if the infection has developed months or years after the original knee replacement.
Removal of the artificial joint: When the infection is deep and long-lasting, the artificial joint will need to be removed.
Joint washout: Washing helps get rid of infected soft tissue in the joint.
Placement of antibiotic spacer: This helps maintain joint space and keeps the joint aligned while the infection is treated.
IV antibiotics: These help kill the infection. The doctor may prescribe a course that lasts up to 6 weeks.
What are the Advantages of Knee Replacement?
Long-term, you may still feel some discomfort and have to limit high-impact activity to protect the replacement joint.
But knee replacement can relieve a lot of the pain and help you move much better. More than 90% of people who have a total knee replacement still function well 15 years after surgery.
Prevention
Using antibiotics: These should be given immediately before, during, and after surgery for up to 24 hours.
Keeping operation time short: A short operation time reduces the length of time the wound is open and vulnerable to infection.
Reducing the number of people present: Limiting the number of people and limiting the number of times they come and go may reduce the bacteria in the room and decrease the risk of infection.
Using sterile equipment: The theatre, instruments, and artificial joint should all be sterilized.
Risks
Knee replacement surgery, like any surgery, carries risks. They include:
Blood clots: Surgeons typically recommend blood-thinning medications to prevent this risk. The most common location for blood clots is in the leg. But they can travel to the lungs and become deadly.
Nerve damage: Nerves in the area where the implant is placed can be injured. Nerve damage can cause numbness, weakness and pain.
Infection: Infection can occur at the incision site or in the deeper tissue. Surgery is sometimes needed to treat an infection.