Knee Joint Replacement

What Is Joint Replacement Surgery?

Joint Replacement Surgery

Arthritis of the joints can result in pain and functional difficulty. In some severe cases, patients are unable to walk even short distances. Often, medication, injections, and joint cleaning procedures such as arthroscopy do not provide an optimal function or adequate pain relief. Joint Replacement surgery has become the standard of care for this group of conditions.

Why Is Total Joint Replacement Necessary?

Arthritis of the joints can result in pain and functional difficulty. In some severe cases, patients are unable to walk even short distances. Often, medication, injections, and joint cleaning procedures such as arthroscopy do not provide an optimal function or adequate pain relief. Joint Replacement surgery has become the standard of care for this group of conditions.

Knee Replacement
A Total Knee Replacement

How Is A Total Knee Joint Replacement Performed?

You will be given an anaesthetic and the surgeon will replace the damaged parts of the joint. In an arthritic knee the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function.

The materials used in a total joint replacement are designed to enable the joint to move just like your normal joint. The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Several metals are used, including stainless steel, alloys of cobalt and chrome, and titanium. The plastic material is durable and wear resistant (polyethylene).

At OrthoSports, our surgeons are well versed in the latest techniques in joint replacement surgery, including Computer-aided Navigation, Minimally-invasive Surgery (MIS) and partial joint replacements like Unicondylar Knee Replacements (“Uni”) and Hip Resurfacing operations. In MIS, specially designed jigs are used to guide the insertion of the hip and knee joint replacement parts. The result is a smaller incision which may be less painful and may allow earlier return to walking. Normal Hip and Knee Replacement scars can be about twenty centimeters long, MIS techniques allow the scar to be less than ten centimeters

If your condition is not very severe, you might be a candidate for a “half knee”.This is known as a Unicondylar knee replacement. The recovery for this operation is faster than for a Total Knee Replacement but it is only suitable for patients with milder symptoms. These are patients with knee arthritis in which only half the joint is involved. This does not occur as often as when the whole joint is involved, but when indicated, allows for a smaller incision and earlier return to function. The figure on the right shows a “Uni” knee in position.

Half Knee
A “half knee” or Unicondylar knee

What Happens After Surgery

Your surgeon will encourage you to use your “new” joint shortly after your operation. After knee replacement, you will often stand and begin walking the day after surgery. Initially, you will use a frame for assistance but quickly progress to using a cane or walking stick.

Some patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues are healing, but it will end in a few weeks or months.

Exercise is an important part of the recovery process. Your orthopaedic surgeon or the staff will discuss an exercise program for you after surgery.

After your surgery, you may be permitted to play golf, walk and dance. However, more strenuous sports, such as tennis or running, may be discouraged.

The motion of your joint will generally improve after surgery. The extent of improvement will depend on how stiff your joint was before the surgery.

After Surgery

Computer-Aided Surgery

Joint replacement surgery has evolved over the last 30 years to become one of the most common and predictable procedures in an Orthopaedic surgeons repertoire. Nonetheless, problems with malalignment, loosening, longevity and survivability still arise.

Implant survival is multifactorial but proper alignment and orientation of the prosthetic components is an important issue. This is even more important when there is a severe deformity or bone loss. The use of computer-aided surgery enables surgeons to plan their surgery and optimise the placement of implants.

Computer-aided or computer “navigated” surgery has become very popular in recent years. It utilizes a tracking system and preprogrammed software to provide a “map” of the operative field.

Greater precision is possible compared to conventional surgery and accuracy is improved to 1 mm or 1 degree with current navigation systems. This is especially useful when operating on organs that are difficult to access or where there is a risk of injury to important structures.

In the last few years, Minimally Invasive Surgery (MIS) in Orthopaedics has taken off tremendously. While many joint operations are now performed arthroscopically, some operations such as joint replacement still require an open incision.

By using MIS techniques, our surgeons are able to give patients smaller, more cosmetic incisions that allow faster recovery and rehabilitation after surgery. Navigation surgery helps the surgeon to “see” even when using very small incisions. The combination of Computer-aided Navigation with Minimally Invasive Surgical techniques promises to open up a whole new way of thinking about the definitions of “major” joint replacement surgery.

Orthosports doctors are actively involved in performing computer guided joint replacement surgery.
 
Your surgeon will encourage you to use your “new” joint shortly after your operation. After knee replacement, you will often stand and begin walking the day after surgery. Initially, you will use a frame for assistance but quickly progress to using a cane or walking stick.

Some patients have some temporary pain in the replaced joint because the surrounding muscles are weak from inactivity and the tissues are healing, but it will end in a few weeks or months.

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