Every time you walk or move, you use your knee joint. Since your knee is a vital part of your mobility, a damaged knee joint can be very painful and cause great frustration. Because of this injury to your knee, everyday activities such as walking in the grocery store or getting into your car may be difficult and painful. Fortunately, there are different methods to treat a damaged knee joint. Total knee arthroplasty is one of the most common ones used for severe arthritis of the knee.

These X-rays depict the difference between a normal knee (left) and an arthritic knee.

Surgery is safe and the results are excellent. A total knee replacement can make it easier for you to use your knee joint, and can help bring you back to your pre-symptomatic life. The knee joint can be damaged at any age, and it may keep you from performing activities that you used to previously enjoy. Often, the pain and stiffness may even limit the daily tasks that you can do.

Benefits of Knee Replacement

A total knee replacement can allow you to move more freely and easily. The primary benefits of total knee arthroplasty are listed below:

• It can decrease or completely stop your knee pain. Once the pain from surgery goes away, many patients are painfree
• Having your knee replaced will increase your leg strength. The absence of pain will allow you to exercise and this will build up muscles
• Having your knee replaced will also improve the quality of your life because you will now be able to perform your daily activities without much pain.
  

Components used for knee replacement

Knee Anatomy

The knee joint is a hinge joint that bears the weight of the body and allows the lower limb to have movement between the thigh and lower part of the leg. The joint moves smoothly allowing you to walk, run, bend, and move without any discomfort. When the knee is damaged, the joint may lose its ability to shock absorb and glide smoothly. A damaged knee may lead to severe pain and a decrease in movement. The components of the knee joint include:
Bones: The knee joint is formed where the femur (or thigh bone) meets the tibia (or shinbone) and the patella (also known as the kneecap).
Cartilage: This is a covering of smooth, slippery tissue. It lines the ends of the femur and tibia as well as the under-surface of the patella. Cartilage functions as a shock absorber and also as a lubricated surface that allows the joint to glide smoothly during movement. The medial and lateral menisci are two semilunar pieces of cartilage within the knee joint.
Ligaments: These are a supportive soft tissue. They connect the bones of the joints and maintain strength and stability of the joint. The main ligaments of the knee are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and the medial and lateral collateral ligaments.
Muscles: The main muscles that move the knee joint are the hamstrings and the quadriceps, also known as the quads.
Tendons: Tendons are soft tissues that attach the muscles to the bones.

Pathology of a Damaged Knee

Damage to the knee joint can lead to severe pain and restriction of movement. Throughout your life, cartilage eventually wears away. Cartilage does not completely regenerate, so over time, the damage may progress. Signs and symptoms of this may be joint swelling, pain, decreased range of motion, and stiffness. As the cartilage continues to wear away, the bones will begin to rub together or eburnate. This can be a cause of severe pain and limit your daily activities.

Osteoarthritis: Osteoarthritis is caused by wear and tear of the joint over time. This basically occurs because of years and years of usage. As the cartilage is rubbed off, and the bones are exposed, the bones rub together. This can cause joint space narrowing, osteophyte (bone spur) formation, and sclerosis. The grinding of the bones against each other can cause severe pain. This is commonly seen in overweight patients and patients who have participated in sports where there has been a constant jarring of the knee joint. For example, jogging on asphalt or pavement may speed up deterioration of the joint.

Inflammatory Arthritis: Systemic disease, such as rheumatoid arthritis or gout, can lead to inflammation of the joint lining. This inflammatory reaction can lead to severe pain and swelling. There will be progressive destruction of the joint and arthritic change.

Injury: A fracture or injury to the knee can disrupt the surface of the joint. If the joint surface is not smooth, it can lead to friction. These roughened surfaces can cause the can cause the cartilage to wear away. This is referred to as traumatic arthritis.

Avascular Necrosis: This is due to a derangement in blood supply to the bone cells. In this disease the bone cells actually die and this can cause destruction of the joint. This can lead to secondary arthritis and severe pain. This is also known as osteonecrosis.

X-Rays

X-rays will be taken to depict the bony anatomy of your knee joint. An x-ray may show changes in the structure and alignment of the joint. The x-ray may show osteophytes (bone spurs), which are a build up of bone in areas where there is arthritis. It may also show cyst formation or sclerosis in the bone.
 

Repaired knee joint

Repaired Knee Joint
 
These features are commonly seen when the cartilage wears away and the bones grind against each other. X-rays are also used to help the surgeon plan the knee replacement surgery.

The Surgical Procedure

Once you are taken into the operating room, you will be given anesthesia. If it is general anesthesia, you will sleep through the surgery. If it is spinal anesthesia, however, you will be insensitive to pain from the waist down. You will also receive some type of sedation with the spinal anesthesia. Then an incision about 8 inches long is made on the front of your knee. The damaged bone is then removed. The lower end of the femur (thigh bone) and upper end of the tibia (shinbone) are shaped to fit the prosthesis. The prosthetic components are then inserted into the proper position. Then the surgeon articulates (joins) the new surfaces of the joint and tests mobility and alignment. 

Complications

As with any type of surgical procedure, there are certain risks or complications associated with a total knee replacement. We are continually striving to provide the optimum environment for your surgery and recovery, minimizing any potential complications. Possible problems include, but are not limited to, reactions to anesthesia, blood clots, injury to a nerve or blood vessel, fracture, infection, swelling, and dislocation of the kneecap. It is our primary goal to help you through your total joint replacement procedure with minimal complications and maximum recovery. Therefore, we will instruct you in measures that will aid you in having a rapid recovery.