Total Knee Arthroplasty
Knee joint anatomy
The knee is the largest joint in the body. This joint is made up of three bones. The lower part of the femur, the upper part of the tibia and the patella. The lower end of the thigh has hinged movements on the leg, and the patella can move up and down in a groove-like depression in front of the lower end of the thigh.
In the parts where these three bones are in contact with each other, their surface is covered with cartilage and this slippery surface makes these three bones move easily on each other. There is also a thick, viscous fluid inside the knee joint called the synovial fluid, or synovial fluid, which lubricates the cartilage and facilitates joint movement.
When is a knee replacement (knee arthroplasty) needed?
When this joint is damaged due to knee injuries, it causes severe pain that may distract the person from even simple activities such as climbing stairs or walking. The pain may even be present when sitting and sleeping.
If taking medication, changing the level of daily activities of life and using a cane can not help reduce the patient's problems, it is usually the last resort to replace the knee joint.
Gradual wear of the knee joint and destruction of its articular cartilage for any reason (aging, diseases and injuries caused by trauma, etc.) causes painful movement, dryness and limited mobility of the knee joint. In this situation, by changing the joint surfaces, joint movements can be improved and pain can be eliminated.
Knee replacement surgery is one of the most common and successful orthopedic surgeries, provided that the standard prostheses of the world are used, performed by a skilled surgeon who is aware of this particular surgery and the patient has a proper rehabilitation period.
In this surgery, the damaged cartilage and bone are removed from the knee joint and replaced with an artificial joint.
The most important goal of knee replacement is to eliminate the pain that is caused in the knee due to wear and tear and arthritis, rheumatism or destruction of the joint surface. Obtaining the desired range of motion in the knee joint and correcting the deformations created in the knee are other cases of using the artificial knee joint.
Life of knee prostheses
The lifespan of knee prostheses is ideally between 15 and 20 years. Unlike in previous years, when knee replacement surgery was performed more in the elderly and middle-aged people, today, with the use of better prostheses and newer surgical techniques, this operation can be performed at a young age and even in adolescence. Although it may seem that performing knee replacement surgery at a young age forces a person to replace the joint again at an older age, studies have shown that the sooner this surgery is performed, the better the outcome. It relieves joint pain and dryness and helps people of all ages to reach their maximum health capacity.
The patient's age, weight or gender is not a determining factor in deciding to have surgery, and the most important factor in deciding is the severity of the patient's pain and the disability caused by this pain for the patient's life. Of course, it should be borne in mind that obese people are 3 times more likely to get an infection after surgery and 1.5 times more likely to lose a joint.
The most important diseases that destroy the knee joint to such an extent that it is necessary to replace the joint are:
- Osteoarthritis and wear and tear of the knee joint, which usually develops and spreads in old age (knee osteoarthritis begins with the destruction of cartilage in the joint and eventually causes bone loss).
- Rheumatoid arthritis, which also destroys the cartilage of the knee joint and ultimately damages the joint bone.
- Poorly welded or non-welded intra-articular fractures that cause wear and tear on the joint after a few years
What is needed for knee replacement surgery:
*Joint replacement surgery can be helpful when other treatments have not worked or if you have any of the following symptoms:
*Pain intensity and limited mobility reduce the patient's ability to perform daily tasks such as walking, climbing stairs, getting in the car, and sitting in a chair.
*Moderate to severe pain at rest
*Do not eliminate swelling and knee pain with medication or intolerance of medication by the patient
*Deformity and arching of the knee inward or outward
How is knee replacement surgery performed:
Knee replacement surgery usually takes one to two hours. To perform this surgery, the surgeon removes the remnants of articular cartilage and a small amount of bone from these areas with incisions made in the lower surface of the femur and the upper surface of the tibia (tibia), then replaces them with metal implants. It strengthens them to the bone bed with a special substance called bone cement. He then places a strong piece of polyethylene plastic between the two metal pieces. In this way, the femurs and tibia can move together easily and painlessly.
The surgeon makes bone incisions while replacing the knee joint in a way that also corrects the deformity and deviation of the knee.If both legs need this surgery, the second leg can be operated on three months apart.