The knee is a "hinge" joint where the thigh bone (femur) and the shin bone (tibia) meet. The knee cap (patella) glides over the femur when the knee moves. In a healthy joint, a layer of smooth cartilage cushions the bone ends, working together with muscles, tendons and ligaments to allow you to bend your knee easily. Arthritis-particularly "wear-and-tear" arthritis or osteoarthritis-as well as certain knee injuries and diseases can damage the cartilage, causing the bones to rub together and leading to pain and stiffness.
In a total knee replacement, the damaged ends of the bones are removed and replaced with a prosthesis made of metal and plastic. A partial knee replacement for patients with damage on only one side of the joint can delay or prevent a total knee replacement. These artificial parts allow the joint to move smoothly so the patient experiences pain relief and a better quality of life. Knee replacement can also help restore motion to the joint, straighten the leg and improve stability.
Patients with arthritis of the knee may find relief in a number of non-surgical and surgical treatments before considering joint replacement surgery. The goals of these treatments are to relieve pain, to increase mobility and restore quality of life. Patients often undergo some combination of the following:
- Exercise and Life Changes
- Assistive Devices - Orthotics, Cane
- Injections - Cortisone, Viscosupplementation (Lubricants)
- Alternative Therapies
- Proximal Tibial Osteotomy - To straighten the tibia, correct bow-leggedness and prevent further wearing of cartilage.
Knee replacement may be recommended if the pain and stiffness of the joint is severe and other treatments have not brought sufficient relief. Our doctors will conduct a thorough medical examination that includes x-rays, strength and range-of-motion tests and a series of questions to determine whether a partial or total knee replacement is right for you.
Recent advances in surgical technology make it possible to perform minimally invasive joint replacements. Traditional knee replacement surgery involves an 8-12 inch incision. Various minimally-invasive techniques allow the joint to be replaced with less cutting and manipulation of muscles, tendons and ligaments around the joint. There are other potential advantages to minimally invasive surgery that help make the surgery safer and allow patients to enjoy a faster and less painful recovery. Our doctors will discuss with you whether you are a candidate for minimally invasive knee replacement surgery.
Partial Knee Replacement
Partial knee replacement may be possible for patients with damage to one part of the joint. Doctors refer to this limited damage as a Unicompartmental knee or "Uni" knee. In a partial knee replacement, only the diseased parts of the knee are removed and replaced; the healthy portions are left untouched. Successful partial knee replacements can delay or eliminate the need for a total knee replacement. They also allow a greater range of movement than standard (non-high-flex) total knee replacements.
Benefits of partial knee replacement surgery include a smaller incision (2-3 inches), shorter hospital stay (often 24 hours or less), and faster recovery and rehabilitation.
Mini-Incision Total Knee Arthroplasty (TKA)
Mini-incision total knee arthroplasty (TKA) offers a less invasive alternative to traditional knee replacement surgery. The incision made during a mini-incision TKA does not extend as far up the quadriceps muscle as in traditional surgery, allowing patients to bend their knee more easily after the procedure. Additional potential benefits include smaller incisions, less disruption of tissue during surgery, and the ability to perform more rehabilitation exercises sooner after surgery. Some patients also experience less post-operative pain.
Quad-sparing total knee arthroplasty (TKA) allows the knee joint to be replaced without cutting the quadriceps muscles or tendon, which control the bending of the knee. This means that patients experience less pain during recovery and rehabilitation and can return to daily activities faster. Other advantages of quad-sparing TKA include smaller and less conspicuous incisions, potentially less blood loss during surgery, shorter rehabilitation, and a shorter hospital stay.
Zimmer Gender Solutions Knee
The Zimmer Gender Knee™ is the first replacement knee joint designed specifically for women. As opposed to standard knee prostheses, which are designed based on an average of male and female knee measurements, the Zimmer Gender Knee has a slimmer profile, permits greater movement of the kneecap, and is contoured to fit women's anatomy.
Knee replacements today last about 20 years in 85-90% of well-selected patients. Occasionally, an implanted prosthesis does not function as well as it was intended to. In this case, revision surgery may be performed to adjust or replace the mechanism.
Which surgery is right for me?
Every patient is different. We will talk with you and provide you with information about what surgeries you qualify for, how your procedure will be performed, how to prepare for it, and what you can expect during your recovery.