Knee Joint Replacement
Knee joint replacement helps patients in the treatment for severely diseased knee joints. A joint replacement procedure is designed to:
- Relieve pain
- Reduce symptoms
- Restore mobility
- Regain function and
The knee joint can become worn-out most commonly as a result of osteoarthritis but may also result from other causes such as trauma or injuries, meniscal tears and overuse.
Symptoms of Osteoarthritis
Patients complain of the following symptoms
- Severe pain in the knee felt deep inside, the front, sides or back of the knee.
- Swelling around the knee
- Sensation of ‘grating’ or ‘locking’ in the knee
- Pain at night
The pain is often made worse with walking or performing normal activities such as putting on shoes and socks, going up and down stairs or getting up from chairs,
Dr Biggs will need to diagnose the specific nature and extent of damage present and which surgical approach will best serve you
Often, osteoarthritis can be identified during a physical exam by a medical professional. By manipulating the knee and leg bones the cause of symptoms can be pinpointed.
During this consultation Dr Biggs will:
- Take a medical history
- Perform a physical examination
- Assess the joint’s range of motion
While there are is no blood test for osteoarthritis, other diagnostic methods are:
In order to clearly understand the nature of any loss of the joint space or bone spur formation imaging scans are required:
- X-rays do not show cartlidge but are often normal as they can help rule out other problems with the knee that may have similar symptoms like fractures (broken bone) or ACL injury.
- MRI can create detailed images of both hard and soft tissues within your knee. An MRI can produce cross-sectional images of internal structures required if the diagnosis is unclear or if other soft tissue injuries are suspected such ligament injuries or articular cartilage injuries.
While not all of these tests are required to confirm the diagnosis, this diagnostic process will also allow Dr Biggs to review any possible risks or existing conditions that could interfere with the surgery or its outcome.
Joint Replacement Surgery of the Knee
Knee replacement surgery is also referred to as knee arthroplasty.
During knee replacement, Dr Biggs removes damaged bone and cartilage and can replace it with an artificial joint made of metal alloys, high-grade plastics and polymers.
There are three common approaches to damaged joints. Dr Biggs offers:
- Knee cap replacement
- Partial joint replacement
- Total joint replacement
Each procedure apply minimally invasive surgical techniques and Dr Biggs may also employ computer assisted technologies. This allow for optimised patient outcomes.
Knee Cap Replacement
Knee cap is also referred to patellofemoral replacement arthroplasty.
This procedure is suitable for patients when arthritis only affects under the surface of the knee cap and involves the replacement of the under-surface of the kneecap and its groove
The outcome of knee cap replacement can be good if the arthritis doesn’t progress has less procedural trauma offering speedier recovery times than a larger operation.
The procedure results can be less predictable when compared to total knee replacement as the arthritis has progressed to other parts of the knee.
Some surgeons advise a total knee replacement as the results are more predictable. Others feel that it’s better to preserve the rest of the knee joint if it isn’t affected by arthritis.
The operation is only suitable for 2-3% of patients with osteoarthritis.
Partial Knee Replacement
Partial Knee Replacement or Unicondylar Knee Replacement simply means that only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.
Unicondylar Knee Replacements have been performed for decades and developments in implant design, instrumentation and surgical techniques have resulted in this approach being considered as the procedure of choice for unicompartmental arthritis.
Unicondylar Knee Replacement Approach
Your knee is divided into three major compartments:
- The medial compartment (ie. the inside part of the knee),
- The lateral compartment (ie. the outside part), and
- The patellofemoral compartment (ie. the front of the knee between the kneecap and thighbone).
In a uni-compartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the remainder of the knee is left alone.
Advantages of Partial Knee Replacement
The benefits of a Unicondylar Knee Replacement over a total knee replacement (TKR) are:
- The smaller incision
- Less bone removal
- Less blood loss
- Faster recovery
- Better range of movement and
- A more “natural” feeling knee
Candidates for Partial Knee Replacement
Patients suitable for Partial Knee Replacement are those who are:
- Suffering pain
- Restricted mobility interferes with your lifestyle
- Clinically proven to have only one diseased compartment
- Not suffering with severe angular deformity
- Nott suffering inflammatory arthritis e.g. rheumatoid arthritis
- Not suffering an unstable knee
- Not previous osteotomy patients
- Not involved in heavy work or contact sports
While a partial knee replacement can be considered at any age, the outcome of the surgery tends to depends on the type of arthritis, rather than your age.
- Younger patients would benefit from bone preservation which is helpful if you need revision surgery at a later stage
- Older patients would benefit from a less stressful operation with less pain and less risk of bleeding
Partial Knee Replacement Procedure
The procedure is designed to be performed with minimal local trauma
- a small incision around 7cm is made to expose the knee joint
- The bone ends of the femur and tibia are prepared
- Components are then inserted to make sure they fit properly
- The final components are placed with or without cement
- The knee is then carefully closed and drains usually inserted, and
- The knee dressed and bandaged.