Knee Replacement

If you have ongoing knee pain even with ongoing nonsurgical treatment, knee replacement surgery may be an option for you. At Summit Orthopaedics, our board-certified surgeon, Dr. Amer Mirza, and expert staff will guide you through the treatment process and help you decide what is right for you.

For some patients, nonsurgical treatments like anti-inflammatory medications, injections, and walking supports may be sufficient for managing pain due to arthritis. At Summit Orthopaedics, we do everything possible to help patients with knee pain, using less invasive options and joint preservation techniques to help patients with knee arthritis avoid or delay the need for surgery.

What is knee arthritis?

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.

What are the risk factors for knee 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.

How does arthritis cause knee pain?

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.

Are there different surgical options for knee replacement surgery?

Depending on the location and severity of knee arthritis, there are different surgical options available for knee replacement. At Summit Orthopaedics, Dr. Mirza has expertise in total knee replacement and partial knee replacement procedures.

Partial Knee Replacement

If your arthritis is limited to only one side of the knee, partial knee replacement may be an option. During a partial knee replacement, only the damaged side of the knee is replaced with prosthetics, and the healthy bone remains. For these patients, Dr. Mirza may recommend a partial knee replacement because it feels more like a “normal” knee than a total knee replacement. Partial knee replacement also allows for quicker recovery times and less pain in recovery when compared to a total knee replacement.

Total Knee Replacement

If arthritis damage is not limited to only one part of the knee, total knee replacement is likely the best option to improve knee function.

Knee replacement surgery involves removing the damaged portions of the knee and replacing them with prosthetic components. The damaged bone is replaced with metal implants, and a medical-grade plastic spacer is inserted between the metal implants to allow the new knee to glide with movement.

For many patients with severe knee arthritis, this is a very successful procedure that is effective in reducing knee pain and improving function.

What is recovery like for 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.

What are the risks associated with knee replacement surgery?

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.

What results can you expect from knee replacement surgery?

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 .