Knee Replacement 101

Knee Replacement (from side)

Knee Replacement (from front)

Total Knee Repaclement X-Ray (from side)

Total Knee Repaclement X-Ray (from front)

The knee is the largest joint in the body. The knees are essential to performing many routine everyday activities. The knee is made up of the lower end of the thigh bone (femur), which rotates on the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Large ligaments attach to the femur and tibia to provide stability. The long thigh muscles give the knee strength. The joint surfaces where these three bones touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to move easily. All remaining surfaces of the knee are covered by a thin, smooth tissue liner called the synovial membrane. This membrane releases a special fluid that lubricates the knee, reducing friction to nearly zero in a healthy knee.

Joint Replacement: New Life for Worn Knees

Disease or injury can disrupt this free-flowing movement resulting in pain, muscle weakness and less function. Most patients who undergo total knee replacement are age 60 to 80. Recommendations for surgery are based on a patient's pain and disability. If the knee is severely damaged by arthritis or injury, it may be difficult to perform simple activities such as walking or climbing stairs. Eventually, it may become painful to even sit or lie down. If medications, changing your activity level, and using the aid of walking devices are no longer helpful to ease the pain, total knee replacement surgery may be an option. By resurfacing the knee and the damaged and worn surfaces, total knee replacement surgery can relieve pain, correct leg deformity, and provide a quicker return to daily activities.

Is Total Knee Replacement Right for Me?

The decision whether to have total knee replacement surgery should be a unanimous agreement between you, your family, your family physician and your orthopedic surgeon. Your physician may refer you to an orthopedic surgeon for a thorough evaluation to determine if you could benefit from this type of surgery.

Reasons that you may benefit from total knee replacement include:

  • Severe knee pain that limits everyday activities, including walking, going up and down stairs, and getting in and out of chairs. It may be difficult to walk more than a few blocks without significant pain.
  • Moderate or severe knee pain while resting, either day or night
  • Chronic knee inflammation and swelling that doesn't improve with rest or medications
  • Knee deformity--a bowing in or out of the knee
  • Knee stiffness--inability to bend and straighten the knee
  • Failure to obtain pain relief from non-steroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, which are more effective in the early stages of arthritis.
  • Inability to tolerate or failure to improve with treatments such as cortisone injections and physical therapy.

The orthopedic evaluation consists of several components:

  • Medical history - Your orthopedic surgeon will gather information about your general health and asks you about the extent of your knee pain and your ability to function
  • Physical Exam - This will include an assessment of knee motion, stability, strength, and overall leg alignment
  • X-rays - X-rays will determine the extent of damage and deformity in the knee

Your orthopedic surgeon will review the results of your evaluation and discuss whether total knee replacement would be the best option to relieve pain and improve mobility. Other treatment options - including medications, injections, physical therapy, or other types of surgery - also will be discussed and considered. Your orthopedic surgeon also will explain the potential risks and complications of total knee replacement, including those related to the surgery itself and those that can occur over time following surgery. Learn more about total knee replacement surgery...