Osteoarthritis of the knee is a degenerative disease that wears out the cartilage of the knee, leading to pain, difficulty walking and deformity. In some cases, exercise, pain medications and lifestyle changes such as losing weight and not eating certain foods have proven successful in controlling the disease. However, if the cartilage is completely worn away, the ends of the bones become rough and cause pain, stiffness and decreased range of motion. Walking and everyday activities may be difficult, and pain may even progress to the point where you feel it even while sitting and lying down. In this case, surgery may be indicated.
Historically, if the situation just described does not respond to pain medication, cortisone injections or physiotherapy, your doctor would recommend a total knee replacement or total knee arthroplasty. In this type of procedure, the orthopaedic surgeon removes the damaged cartilage and bone from the femur (thighbone), the tibia (shinbone) and the patellar (kneecap). He then positions the new prosthesis made of metal, plastic and polymers. Persons over age 60 are usually good candidates for this type of surgery, but teenagers suffering from juvenile arthritis have also had total knee arthroplasty. Nowadays, a surgeon has a wide variety of designs to choose from to suit your age, weight, activity level and health.
For patients whose arthritis is confined to one section of the knee, a partial knee replacement may be sufficient. This minimally invasive procedure is also called unicompartmental knee arthroplasty, and like the total knee replacement, is considered for patients whose condition has not responded to conservative treatments such as medication, injections, exercise and weight loss. It is also indicated for patients whose ligaments are intact, who are inactive and who are not obese.
The partial knee replacement has some advantages over the total knee replacement:
- Smaller incision.
- Less blood loss because there is less bone removal and less dissection, making blood transfusion unnecessary.
- Quicker recovery time – Patients may even be discharged on the same day or the day following surgery. Functional recovery at home is also much shorter compared to weeks following a total knee replacement.
Most knee replacement joints replicate your natural knee’s ability to roll and glide as it bends, and patients usually see a dramatic improvement in function and pain following surgery.