Types of Knee Replacement Surgery
Most of us have probably experienced some form of knee pain or injury at some point in our lives. The resulting pain in the knee will depend on the severity of the injury and can range from a mild discomfort to extreme debilitation. The knee is an important joint that impacts a person’s ability to perform basic tasks such as walking and climbing up a flight of stairs. Any injury or discomfort to the knee can thus impact one’s quality of life tremendously.
Studies show that the knee is one of the easiest to injure joints in the human body. It is also the largest joint humans have. Given its extreme importance in our day-to-day activities, any pain or impact causing an injury in the knee can have a profound effect on us. Fractures and dislocations are common examples of injuries that can occur to the knees.
The process of aging can also lead to injury due to wear and tear in the parts of the knee. If knee injuries do not get treated successfully by medication, doctors recommend knee replacement surgery. In this blog, we will take a look at the main types of knee replacement surgery available today for patients suffering from knee joint problems.
What is knee replacement surgery?
Knee replacement surgery is a medical procedure that is carried out to treat extreme pain in the knees. This surgery helps restore normalcy of movement in the knee joint. Knee replacement surgery is commonly performed to treat osteoarthritis.
There are two main types of knee replacement surgery. They are:
- Total knee replacement
- Partial knee replacement
Between these two types, total knee replacement is the more commonly performed procedure.
Knee replacement surgeries are generally performed after other methods of treatment have failed to yield any significant results. Prior to a knee replacement surgery, the patient would have been recommended certain anti-inflammatory medications, cortisone injections, and physiotherapy.
Total knee replacement
In a total knee replacement surgery, the surgeon will remove all the damaged portions of the patient’s knee and replace these with prosthetic parts. Damaged knee parts that get replaced include the cartilage, bone, and connective tissue.
Upon removal of the damaged parts, the surgeon will go on to shape the remaining portion of the knee so that it fits perfectly with the prosthetic.
The total knee replacement procedure will require the patient to be hospitalised for a few days so that the doctor can monitor post-surgery recovery.
A patient undergoing a total knee replacement will also have to sit for sessions of physiotherapy. They will usually also require support while walking, at least for the first few days. This support can be provided in the form of crutches, a walking stick, or a walker.
Upon successful completion of the surgery and physiotherapy, the patient is usually able to resume normal activities. However, they may be advised to avoid activities such as running which can increase the risk of damage to the newly operated knee and its prosthetic parts. It helps to follow the doctor’s instructions to a tee in order to increase the longevity of the inserted prosthetics.
The total knee replacement surgery does have a few risks. Doctors generally make it a point to discuss the possibility of these risks with their patients prior to the procedure. One of the major risks associated with a total knee replacement surgery is the possibility of blood clots that can result in the patient suffering a stroke. The implants too can possibly get infected in which case they will be removed.
Additionally, the knee patient and discomfort sometimes does not go away even after the surgery. In rare cases, misalignment can cause the prosthetic to become loose. If this happens, the surgery can be carried out again in order to rectify the problem.
Do bear in mind that the results and risks of the total knee replacement surgery can vary from case to case. It is advisable to always follow the doctor’s instructions for maximum efficacy of the treatment done. Patients must have very realistic expectations of the results of their knee replacement surgery.
Partial knee replacement
True to its name, a partial knee replacement surgery only sees a portion of the knee get replaced by prosthetics. This surgery is also known as a unicompartmental knee replacement.
Patients who suffer from arthritis in only one section of their knee qualify for a partial knee replacement surgery. If there is arthritic damage in more than one section of the knee, a partial knee replacement is not a good solution. The patient may then be advised to opt for a total knee replacement surgery.
As may be expected, a partial knee replacement surgery has a shorter healing time than a total knee replacement. However, the doctor will advise the patient for follow-ups as there is always a risk of arthritis occurring in the parts of the knee that did not get removed in the surgery. So, patients may find themselves needing a second surgery to treat newly damaged compartments of the knee.
Doctors generally evaluate which patients are suitable for a partial knee replacement as this form of treatment may not be the best course of action for everyone. This is primarily because a partial knee replacement is generally more suitable for those who have healthy bone and ligament in a major portion of their knees which guarantee a successful recovery.
Patients who undergo a partial knee replacement will also have to use the support of crutches for a few weeks after their surgery before they can walk independently again.
Like with the total knee replacement surgery, the partial knee replacement surgery’s results too can vary between patients.
Robotic partial knee replacement surgery
As the name suggests, a robotic partial knee replacement surgery is a medical procedure performed with the assistance of a robot. Prior to the actual surgery, a computed tomography (CT) scan is carried out in order to determine the exact structure of the patient’s knee. The actual surgery sees the use of a robotic arm that helps correctly fit the prosthetics which have been tailor-made as per the patient’s unique measurements. Given the extreme precision involved in this operation, there is a higher degree of accuracy seen.
Techniques used in knee replacement surgery
Now that we have seen the main types of knee replacement surgery, let’s quickly take a look at the techniques employed by surgeons. There are two main types of techniques used for a knee replacement surgery. The first is the traditional approach which involves a large incision and a greater recovery time. The second technique is known as MIS or minimally invasive surgery. In the minimally invasive surgery, the surgeon makes a relatively smaller cut – around 3 inches – for the procedure.
Due to advancements in medical technology, the patient can generally expect similar results from both these approaches to knee surgery. The only major difference to note would be the size of the incision done to carry out the operation.
Preparation prior to the knee replacement surgery
Before the patient undergoes a knee replacement surgery, the doctor will take them through a few things that need to be done in order to prepare for the treatment. Here is a quick look at how to prepare prior to the procedure.
- Extensive diagnostic tests (such as blood tests, magnetic resonance imaging, and X-rays) will be conducted in order to evaluate the exact nature of knee damage and the type of treatment required
- The patient will be advised to stop the consumption of certain medicines before the surgery
- Patients will also be advised to avoid eating any food for a few hours prior to the surgery
- The doctor will sometimes discuss options of anaesthesia (general anaesthesia and spinal anaesthesia) and help the patient reach a decision as to which one is preferable
Looking at recovery after the knee replacement surgery
The doctor will also discuss prognosis prior to the actual surgery. The patient will be advised on the steps they may need to take to make recovery a smoother process.
The duration of a patient’s stay in the hospital after the knee replacement surgery will usually depend on the type of surgery they have undergone, their own health condition, and whether they have any kind of assistance at home. If the patient lives alone, they may need to stay hospitalised for longer in order to get good support and care for better recovery.
- Physiotherapy sessions
Physical therapy sessions form an important part of the recovery process after a knee replacement surgery. These sessions will begin once the doctor feels the patient is able to perform the exercises required. Physiotherapy sessions will take place in the hospital while the patient is admitted and even continue after discharge. While the exercises may cause initial discomfort, the long-term benefits are certain noteworthy.
- Avoid putting pressure on the knee
Patients must be very careful and avoid putting pressure on their knees soon after their surgery. They must avoid high-intensity exercises such as running and not life heavy objects. Following these instructions can aid in maintaining the fitted prosthetics in good condition for a longer span of time.
- Follow prescription
Patients must take all prescribed medicines as instructed by their doctor. This will aid in proper recovery and also help minimise any discomfort. Patients may also be prescribed certain supplements which may help bring strength back to muscles in the treated areas of the knee.
- Take due precaution
Patients need to take extreme care to ensure that they do not fall down after a knee replacement surgery. Falling down can lead to a severe impact on the treated areas of the body. To avoid such accidents, patients may continue using crutches or walkers to move around. They should avoid walking fast and be careful of slippery surfaces. Support bars and rugs can be placed in the washroom so that patients do not slip and fall.
- Know what activities are allowed post-surgery
Upon recovery, the patient may engage in exercises that do not impact the knee too hard. Swimming and walking are generally allowed. Jogging, running, and playing tennis are best avoided.
Questions to ask the doctor before a knee replacement surgery
It is extremely important for the patient to get answers to any questions they may have before undergoing a major operation such as a knee replacement surgery. Talking openly will help the patient truly understand their condition and prognosis. This, in turn, gives real peace of mind. To that effect, here is a list of important questions that a patient may want to consider asking their doctor:
- Why is this surgery being performed and how will it help me?
- Are there any other treatment options available to me?
- How do I prepare for my surgery?
- Are there any kinds of activities that are not allowed post the knee replacement surgery?
- How often do I need to return for a follow-up consultation and examination?
- How long will the procedure take?
- Can I come alone or do I need to bring a friend/family member along?
- How long is the recovery period and what can I expect?
- Are there any medications or foods that I need to avoid before the surgery and during my recovery period?
- What kind of experience do you have with this type of surgery?
- Will my health insurance cover my surgery costs?
It is always advisable to be as honest and direct in asking questions. This way, a patient can be sure of going into the procedure room at ease.
It is also advisable to take a second opinion from another doctor in case the first one did not provide satisfactory responses. In case of a conflicting diagnosis, do explore more options and speak with more specialists prior to agreeing to treatment. A medical operation is an expensive process; it is also one that tires the patient out physically and mentally. Therefore, a good and steady decision should be taken. The patient should only opt to get treated by a physician with whom they feel comfortable.
When is a knee replacement surgery required?
A knee replacement surgery is generally recommended to patients who are diagnosed with osteoarthritis. However, this procedure may also be advised in cases of rheumatoid arthritis, injuries to the knee, and unusual growth of the bone. The type of knee replacement surgery that is recommended will be decided on a case-to-case basis.
Arthritis can severely impact a person’s ability to perform daily tasks and live a normal life. The joint pain can become unbearable and often worsen with changes in the weather. It is advisable to seek professional medical help as soon as possible to improve one’s quality of life.
Who may not qualify for a knee replacement surgery?
If knee pain is treatable with regular medication, doctors would avoid recommending a knee replacement surgery. Other patients who may not qualify for this form of treatment include people who are obese. Excess body fat can weigh on the newly fitted prosthetics and cause them to move out of place. Patients who have weak muscles in the thigh are also discouraged from undergoing a knee replacement surgery.
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As medical technology keeps progressing, we may see newer breakthroughs and inventions. Medical procedures for treating knee problems will be far more evolved in the future. Until then, Meril’s FREEDOM ® Total Knee System and OPULENT BIONIK GOLD KNEE offer real value and hope to patients suffering from knee problems.