Overview
Your knees are among the largest and most important joints in your body. They connect your thigh bone (femur) with your leg’s shin bone (tibia).
Knees bear your body weight and enable you to bend and twist your legs. Unhealthy knees often interfere with your ability to perform basic movements such as standing, walking, jumping, or bending.
The constant motion and pressure on your knees leave them exposed and vulnerable to many injuries. The pain and disability caused by severely damaged knee joints and surrounding structures may be eased through a partial or total knee replacement procedure.
Without functioning knees, you could not perform many routine activities such as standing, bending, or walking. Injured knees often produce life-limiting symptoms like pain and stiffness. Severely damaged knees can be restored through partial or total knee replacement.
Anatomy
The knee is a large joint, connecting bones such as your kneecap, thigh bone, and shin bone. The knee joint region is surrounded by soft tissue called cartilage, a flexible material that serves as a covering to protect bone endings. Other soft tissues like ligaments and tendons join bones and joints.
Description
As you age or engage in repetitive movements, your knee joint can naturally weaken. Various injuries and illnesses sometimes speed up this process. Over time, the knee joint and neighboring tissues can be weakened by a relatively common inflammation-causing illness called osteoarthritis. If this condition progresses unchecked, it can result in significant and potentially life-limiting joint damage.
Knee Damage Causes
Doctors attribute many cases of knee replacement-inducing damage to a condition called arthritis. Though this joint-inflaming disease has several forms, the three leading to most knee replacements are:
- Rheumatoid Arthritis – This immune system disorder causes gradual cartilage damage. When left unchecked, cartilage loss is possible. Such events may also bring forth deterioration of surrounding structures such as bones, muscles, and other soft tissues.
- Post-Traumatic Arthritis – This condition appears after a traumatic event like a car accident or a fall. They often cause serious injuries like bone fractures and acute soft tissue tears, and then cause inflammation which can lead to weakening cartilage.
- Osteoarthritis – This form of arthritis is called a wear-and-tear illness. Cartilage gradually weakens with age. This problem frequently occurs in individuals over 50 and is the most common reason people seek total knee replacement. Osteoarthritis is often labelled a wear and tear disease.
Risk Factors
Your chances of developing knee arthritis increase if you have any underlying risk factors such as:
- Obesity – The joints of obese or grossly overweight individuals face additional stress and strain. Excess fatty tissue produces proteins known to increase bodily inflammation.
- Age – Your risk significantly increases as you age, and relatively common in elderly individuals.
- Genetic Predisposition – Certain people hold genetic flaws capable of causing joint damage. Osteoarthritis sometimes runs in families.
- Gender – Women stand at a higher risk than men. Researchers cannot pinpoint the exact reason why.
- Developmental Defects – If you were born with a developmental defect impacting bone or tissue growth, your risk of osteoarthritis is greater.
- Previous Joint Injuries – If you sustained an injury to the knee joint or surrounding areas, your probability of contracting osteoarthritis is higher.
- Underlying Illnesses – Underlying medical conditions like metabolic diseases have been known to produce joint damage-inducing inflammation.
- Repeated Stress – Your risk heightens if you participate in sports or work in a profession that places continual or acute stress on your knees.
Symptoms
Pain is arthritis’s most obvious and potentially debilitating sign. This discomfort often intensifies when you walk, stand, or remain idle for extended timeframes. Furthermore, pain typically worsens as the condition progresses.
Osteoarthritis is divided into several stages, with zero being the mildest and four considered the most serious. Your symptoms will vary depending on the specific stage of the condition.
You might experience common symptoms, including:
- Varying degrees of pain.
- Discomfort that worsens when you move or remain still for prolonged periods.
- Swelling in and around the knee.
- Redness.
- Warm knee skin.
- Knee stiffness.
- Joint stiffness.
- Grating or locking sensations when moving your knee.
- Knee swelling.
- Tenderness to the touch.
Severer cases might result in knee-locking and creaking, cracking, or grinding noises when you stand or walk. If your case is serious enough, you may experience knee instability and mobility problems.
Complications
If not treated during its early stages, arthritis can limit your ability to engage in routine activities and move. This can result in more notable injuries like bone fractures and those caused by the gradual breakdown of other knee structures.
Diagnosing Knee Arthritis
Arthritis is usually diagnosed following a complete orthopedic evaluation involving several key steps, including:
- Physical Examination – During this stage, your medical history is documented, and questions are asked about your lifestyle, occupation, injury history, or involvement in any recent traumatic events. Your doctor will examine your knee, looking for apparent abnormalities and other red-flag symptoms like redness or swelling.
- Motion Tests – You perform various motion tests designed to determine how far your knee extends and its stability level, strength, and overall positioning.
- Internal Imaging – Internal imaging tools such as X-rays, MRI machines, and CT scanners capture images of knee components like bones and soft tissues. These diagnostic tools can view internal images of your knees and determine arthritis’s presence, its severity, and if any associated bone damage has occurred
- Blood Tests – Sometimes, physicians order blood tests to rule out conditions producing arthritis-like symptoms.
Partial Knee Replacement
If your knee’s joint or surrounding bones and tissues have sustained damage, you might need to undergo partial knee replacement. During this procedure, surgeons remove a part of the damaged knee joint, cartilage, or bone affected by arthritis and resurface the area using artificial components.
Doctors usually recommend that you undergo this procedure, known as unicompartmental knee replacement, if you have extensive damage affecting only one part of your knee. The presence of widespread damage typically indicates the need for total knee replacement.
Total Knee Replacement
Your doctor might recommend that you consider undergoing total knee replacement if:
- Pain either interferes with your ability to perform or prevents you from completing routine actions such as climbing stairs, walking, or standing up.
- Discomfort does not ease when you rest or while sleeping.
- Obvious knee or leg deformities appear.
- Inflammation and swelling worsen or fail to improve following treatment.
Above all, total knee replacement should serve as a last resort undertaken only when less aggressive therapies prove unsuccessful.
Underlying illnesses like infections, cancer, or immune system diseases might increase your risk of post-surgical complications. But people of various ages and body types have successfully undergone this procedure.
Preparation
Before undergoing surgery, you must disclose what medications you regularly use to your doctor. Certain drugs could cause potentially dangerous complications, and you might be asked to stop using or alter dosage until after your operation. Additionally, you will be advised not to smoke or consume alcohol in the days or weeks preceding surgery.
You must also either postpone or schedule dental appointments well before your operation. Certain dental procedures cause small amounts of bacteria to enter your bloodstream. These pathogens could travel to your replaced knee components, increasing your risk of infection.
If you are having a total knee replacement, you should consider securing a professional health aid’s services. You will likely require help executing basic household chores until the replaced knee heals enough to perform such actions on your own.
You will also likely be restricted from eating or drinking anything in the hours leading up to surgery.
Partial Knee Procedure
Before surgery, you will be given anesthesia. The specific type will depend on several underlying factors. Common forms include general and spinal anesthesia and peripheral nerve blockers.
The surgery’s first stage involves joint inspection. Surgeons make an incision in your knee and exam its insides to confirm that damage is limited to one area and can be corrected with a partial knee replacement. If the surgical team deems all systems go, the procedure begins. It is divided into three operating stages.
The first phase is bone preparation. Doctors use special tools to remove damaged tissues. The next stage involves material insertion. Damaged tissues are replaced with artificial coverings designed to recreate the missing joint components. Partial knee replacement’s final stage is spacer insertion. Spacing devices are placed between the inserted artificial components.
The entire operation typically lasts anywhere from one to two hours. Following the procedure, you will be taken to a recovery room until the anesthesia wears off. Once awake and alert, you will either be discharged or taken to a room for further evaluation.
Total Knee Procedure
Before surgery, you will be given the appropriate anesthetic medication to ensure you feel no pain.
Once anesthesia sets in, surgeons will make incisions into your knee and access the damaged tissues. Once any damaged bone and cartilage are removed, the surgical team inserts and properly positions a new knee joint built out of artificial components. The procedure lasts anywhere from one to two hours.
Intended Advantages
The advantages of partial or total knee replacement include reduced pain and improved mobility.
The Recovery Process
Most partial and total knee replacements are usually performed on an outpatient basis. If not, you will spend a day or two in the hospital for post-operative evaluation.
It is normal to feel a certain degree of pain following your operation. It should be temporary and respond to treatments like over-the-counter or prescription pain relievers.
You should be able to place weight on your repaired knee. You may need to use assistive devices such as crutches, walkers, or canes for several days or weeks.
You will also need to undergo a course of physical therapy to help your knee regain any lost strength or mobility. Arthritis often adversely impacts your knee’s strength, mobility, and stability. Physical therapy is a course of individually tailored exercises designed to help your repaired knee restore any lost attributes.
You should be able to return to normal activities in four to six weeks. It is important to stress that these numbers are averages, and everyone heals at their own rate.
Possible Complications
When performed by experienced surgeons inside reputable facilities, most operations go on without a hitch. Complications are uncommon. The surgery does come with certain risks, such as:
- Blood clots.
- Wound infections.
- The dislodging of artificial knee replacement components.
- Post-operative pain.
- Injury to surrounding blood vessels and other physical components.
You might reduce your risk of these post-surgical complications by practicing blood clot-prevention measures like using blood thinning drugs or wearing compression clothing, cleaning and protecting surgical wounds as directed by your doctor, and being vigilant in avoiding dangerous environments capable of increasing your chances of sustaining falls.
Extending A Knee Replacement’s Shelf Life
Your artificially constructed knee can last for many years if you take necessary safeguarding measures, such as always following your doctor’s instructions, protecting your knee, and maintaining a healthy weight through activities like consuming a healthy diet and exercising.
Next Steps
If you have knee pain and are looking for help, call for an appointment with Dr. Peter Howard to have it checked out.