Knee Replacement in Portland, OR

The knee is one of the most common joints affected by osteoarthritis. Osteoarthritis, also known as “wear and tear” arthritis is the most common type (inflammation of a joint).

In the United States, the prevalence of symptomatic knee osteoarthritis in patients age 45 and older has been estimated between:

• 9 and 13.5 percent in men and
• 2 and 18.7 percent in women

Osteoarthritis affects the articular cartilage in the knee. Articular cartilage is the smooth coating that covers the surface of the bones inside the knee. Articular cartilage also cushions and helps lubricate the joint surfaces. In osteoarthritis, the articular cartilage begins to degrade. Over time, the articular cartilage can thin or form cracks. Pieces of cartilage may come loose and float inside the knee, further irritating the joint. After a long period of time, the cartilage can become completely “worn away,” and the bones begin to rub together.

Osteoarthritis usually comes on slowly and results in knee pain, stiffness and/or swelling. Sometimes a grating sound can be heard when the knee is bent – such as when climbing up and down stairs or crouching. Bumps or nodes may appear around the knee joint. Sometimes a knee can have a mild amount of osteoarthritis and feel perfectly fine.

Most types of treatment for osteoarthritis of the knee work best when started early before there is a lot of “wear and tear” in the knee. For this reason, establishing a correct diagnosis is very important. In some cases, osteoarthritis of the knee can be diagnosed based on the medical history and physical examination of the affected joint(s). An x-ray may be ordered to determine how much joint damage there is. Sometimes blood tests or joint fluid tests are ordered to confirm the diagnosis or to distinguish between different types of arthritis.

No one knows for sure what causes osteoarthritis in the knee but some risk factors include:

• Previous knee injury, e.g., meniscal tear, ligament injury
• Family history of osteoarthritis
• Being overweight
• Damage to the knee from another type of arthritis
• Aging

A lot can be done to help people who have osteoarthritis in their knee(s). The goal of treatment is to reduce pain, control swelling and maintain or improve mobility of the knee but unfortunately, there is no known cure for osteoarthritis.

Every osteoarthritic knee is different, and there should be a team approach to treatment. Some available treatments include exercises, medications, education on activity modification, weight loss, heat and cold therapy, techniques for joint protection, injections and in some cases partial or total knee replacement. Total Joint replacement eliminates or reduces joint pain, increases mobility and improves quality of life. Doctors and physical therapists who deal with people who have osteoarthritis can help outline a treatment program.

Knee arthritis is a common problem that many patients face. It is a degenerative condition that can be very painful and may limit your daily activities.

The knee joint is formed by the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). C-shaped wedges of tissue called menisci act as shock absorbers in the knee, and ligaments hold the joint together. The bones in the joint are covered with articular cartilage, a tissue that protects the bones and allows the joint to glide smoothly with movement.

Arthritis can damage the articular cartilage in the knee, either with wear and tear over time or due to inflammatory conditions like rheumatoid arthritis. Eventually, the cartilage can wear away completely in places, causing the bones to rub together. This condition can be very painful and may limit knee function, making even simple movements like walking or bending difficult.

Eventually, arthritis damage can progress to the point that nonsurgical treatments are not effective in relieving pain. In these cases, our surgeon, Dr. Amer Mirza, may recommend knee replacement surgery.

Most knee replacement procedures will require a hospital stay of 1-3 days. Patients start physical therapy as soon as possible after surgery, as this is a critical part of recovery to strengthen the knee and restore motion.

Most patients are able to resume their normal activities within 3 weeks of surgery, and full recovery is generally about 6 weeks.

The risks associated with knee replacement surgery include:

• Infection in the Joint
• Blood Clots
• Implant Problems (e.g., loosening)
• Wear
• Nerve Injuries

If you experience any of these problems after surgery, be sure to contact your surgeon immediately.

Infections and blood clots are two serious risks. We use antibiotics and blood thinners to avoid these complications. We also take special precautions in the operating room to reduce the risk of infections. Your surgeon will discuss ways to reduce your risk of infection including, losing weight, quitting smoking, and controlling your blood sugar. If you need help in any of these areas, just ask. We have resources to help you.

According to the American Academy of Orthopaedic Surgeons, more than 90% of patients who undergo knee replacement surgery experience dramatic relief of knee pain and a significant improvement in the ability to perform common activities of daily living.

Patients should also be aware that total knee replacement will not allow you to do more than you could before you developed arthritis. Your surgeon will advise against high-impact activities such as running, jogging, jumping or other high-impact sports, as excessive activity may speed up the normal wear of the implants .

The duration of your knee replacement surgery will vary from patient to patient. On average, the procedure takes between one to three hours. However, if you are only in need of one joint replacement, this duration could be shorter.

Unfortunately, no. There are a number of contraindications or health conditions in which this knee replacement surgery is not recommended as it can put the patient at an increased level of risk. Dr. Mirza will help determine if you are a candidate for the procedure. However, if you are someone who has the following underlying health conditions, you may not qualify for a knee replacement:

• Uncontrolled diabetes
• Severe cardiovascular issues
• Infection concerns or any immune issues
• Overall health and activity levels
• Allergies to implant materials

While we may not be in the future of full robotic or bionic body replacements, there have been some very exciting advancements in the arena of knee replacement surgical techniques and products. Such advancements include:

• Minimally invasive surgery: Today's knee surgery often involves smaller incisions that greatly minimize trauma to the patient's surrounding tissues. This helps to reduce pain and inflammation following the procedure and leads to an overall faster recovery time.
• Precision placement via robotics: We didn't say all robotics were a dream of the future! Today, robotics are used in the surgical process for weighted precision with the placement of knee implants.
• Customized 3D implants: Gone are the days of a one-size-fits-most knee implant. Today, 3D implants can be printed to replicate a patient's anatomy exactly. This improves the longevity and function of the replacement implant.

There are three key stages that will help you prepare for this important surgery:

• Consult with an orthopedic surgeon. First, you need to schedule a consult with our team at Summit Orthopaedics. Here, we can discuss your medical history, medications, lifestyle, and expectations you might have for the surgery.
• Follow guidelines for the preoperative assessment. A preoperative assessment may feel invasive as it involves a lot of medical tests like imaging scans, blood tests, and a full physical examination. Be aware that all of these are necessary to ensure the very best outcome.
• Adhere to suggested lifestyle adjustments. Your orthopedic team may recommend lifestyle adjustments to ensure the best outcome. Be sure to follow both the pre-surgery and post-surgery recommendations for the best effects.

During your consultation, you will meet with Dr. Mirza to discuss your current health condition, concerns about your current knee pain, and how a knee replacement may help you achieve long-term relief. A knee replacement surgery consultation may involve preoperative X-rays, an analysis of your past medical history, and a list of any medications you are taking. Dr. Mirza will also take this time to examine your knee and knee pain to help determine if you are an eligible candidate for knee replacement. Your consultation is the perfect time to ask Dr. Mirza any questions you may have regarding the procedure and recovery.