Knee replacement surgery is a surgery designed to replace the bones that make up the knee joint with artificial parts, in order to relieve pain in the joint and restore its function.
The procedure involves removing the diseased and damaged parts of the joint, bone and cartilage, and replacing them with an artificial joint made of metal and durable complex materials.
When can a knee replacement be performed?
Knee replacement surgery is usually necessary when the joint is worn out or injured in a way that restricts its movement, and when there is severe pain that is not relieved even at rest.
The most common reason for performing a knee replacement is osteoarthritis, a condition in which inflammation and damage to the bones develop due to abrasion and degeneration of the articular cartilage, which can cause severe pain.
There are other conditions that may lead to the need for knee replacement such as rheumatoid arthritis, gout, damage to bone development, necrosis of the joint bones due to damage to the blood supply, and mechanical damage or deformity of the joint leading to cartilage damage and pain.
When can I apply for knee replacement surgery?
Knee replacement is usually recommended after other and more conservative treatments, such as physical therapy and steroids injection into the joint have failed to relieve pain or improve joint range of motion.
Surgery may be recommended for those suffering from severe pain with swelling and stiffness of the knee which in turn causes limitation in movement, or when the pain interferes with daily routine and sleep. Additionally, if the pain experienced limits daily activity and affects mental state, knee treatment via surgery can be a solution to the difficulties that accompany the impairment of function and pain.
In any case in which a knee replacement is considered, the decision will be made in consultation with the surgeon after weighing in the risks and the degree of benefit expected from the surgery.
How is the surgery performed?
Knee replacement surgery requires anesthesia that can be regional (using an epidural injection in the back) or general, depending on the patient's joint decision along with the medical staff.
During the surgery, which usually lasts around two hours, the knee bends in a way that allows the entire surface area of the joint to be exposed. After cutting the skin along the knee, the surgeon will expose the joint, move the patella aside and remove the damaged parts of the joint.
The surgical team will connect the artificial joint parts to the femur and tibia after their preparation and abrasion. Before the operation is completed and the incision is closed, the surgeons straighten and rotate the knee in all directions to ensure satisfactory function of the new knee.
Recovery and return to routine after knee replacement
Returning to movement and even walking on foot is often possible shortly after surgery, and in many cases the medical staff will encourage patients to move their legs in order to increase blood flow to the foot and speed recovery.
Simultaneously with the treatment of blood thinners and antibiotics to prevent clots or infection, physiotherapy treatment will begin, designed to train the patient to use the new knee correctly, a treatment that will continue even after discharge from the home medical center or to a rehabilitation setting.
Adherence to movement and physical therapy is essential for the success of knee treatment, and for most patients this treatment provides significant pain relief and improvement in the range of motion of the knee for years.
What are the possible complications?
Knee replacement surgery is a fairly common surgery and the vast majority of patients undergo the procedure without complications. However as with any surgery there are risks and complications which can arise.
The main possible complications in this surgery include stiffness of the joint, infection of the surgical site and sometimes of the implants - this condition requires re-surgery.
Unexpected bleeding can sometimes develop into the joint cavity and may also result in damage to the ligaments, blood vessels or nerves connected around the knee. Deep vein thrombosis (DVT) can form, which requires anticoagulant treatment, and joint pain may develop after surgery.
In some cases the replaced knee will not reach the desired stability and will need further surgery to correct implant stability.
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