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One of the most common causes of severe knee pain requiring replacement is osteoarthritis. Osteoarthritis occurs when the cartilage cushioning the bones wears down over time. This allows bone surfaces to rub together, causing pain, stiffness and loss of movement. Other causes can include previous knee injuries like torn ligaments or cartilage, joint infections, or birth defects affecting knee alignment. Genetics also play a role, as certain people are more prone to arthritis due to inherited factors.
The Replacement Procedure
A knee replacement starts with making an incision in the knee area. The surgeon then removes damaged bone and cartilage and makes the surfaces smooth. Artificial components are implanted to replace the knee joint. These usually consist of metal alloy and high-grade plastic parts. The tibia and femur bones are reshaped to accommodate metal plates that are fixed with screws or bone cement. Spacers are inserted between the components. The patella, or kneecap, may also be reshaped and have a plastic button added. Incisions are closed with sutures or surgical staples.
Recovery and Rehabilitation
After surgery, patients usually stay in the hospital for a few days and then move to a rehabilitation facility or home. Crutches or a walker are used initially to avoid putting weight on the new joint. Physical therapy starts with leg-strengthening and range-of-motion exercises. As recovery progresses, activities are gradually increased. Most people can walk independently within a few weeks and return to regular low-impact activities within a few months. High-impact sports may not be possible depending on the person’s age and surgical outcome. Pain typically improves dramatically right after surgery and continues to lessen over subsequent months.
Long-Term Results and Lifespan
With proper postoperative rehabilitation, most people see great improvements in knee pain and mobility following replacement. While artificial joints don’t last forever, they can provide 15-30 years of service depending on factors like a person’s size and activity level. If the knee replacement wears out over time, revision surgery may be necessary to replace the artificial parts. Advances in components and surgical techniques continue to improve longevity. When replacement is no longer effective, options include further revision surgery if possible or relying on pain management approaches.
New Advancements
In recent years, new materials and designs have enhanced knee replacements. Some innovations include highly cross-linked polyethylene for increased wear resistance, different bearing surfaces between tibia and femur components, improved fixation methods, and customized implant sizing using imaging scans. Robotic-assisted surgery may provide more accurate placement and alignment. “Minimally invasive” approaches use smaller incisions that may speed healing. “Bicompartmental” replacements affect only the areas most damaged by arthritis and preserve more native knee structures. These advancements offer benefits like increased activity levels, improved longevity and greater patient satisfaction.
Who Is a Candidate?
The ideal candidate for knee replacement is generally a patient over 60 years of age with severe, end-stage knee arthritis not adequately managed by nonsurgical methods. Factors like joint damage extent and distribution, body weight, activity level, medical status and expectations guide decisions. Younger, active patients may choose replacement to restore function earlier. Those with inflammatory arthritis, prior knee injuries or damage to multiple joints are also candidates. When pain severely limits daily living despite medications and lifestyle modifications, replacement provides effective relief for improved quality of life.
Preparing for Replacement Surgery
To prepare, patients work with their surgeon and primary care physician to optimize overall health before a major procedure. Any medical issues like heart disease or diabetes require management and clearance. A nutritional consultation addresses excess weight which reduces postoperative stress. Patients stop blood thinners per medical guidelines, arrange help at home and preplan transportation. In pre-op education, expectations are set regarding surgery details, recovery process and outcomes. Any concerns about risks, limitations or costs are discussed. Pre-habilitation with a physical therapist improves strength and mobility before immobilization. Addressing preparations boosts confidence and smooths the transition to recovery.
Future Outlook
Overall, knee replacement has become a remarkably successful surgery thanks to improved materials, techniques and understanding of the rehabilitation process. While longevity may still be an issue for some younger, heavier patients, refinements aim to address this challenge and continue enhancing outcomes. Exciting areas of research include biologic joint replacements that could repair rather than replace damaged cartilage, computer-simulated customized implants, resurface procedures and the potential for stem cell therapy for arthritis. As medical advances accumulate, knee replacement will remain an invaluable option for restoring mobility in those suffering from the debilitating effects of advanced joint degeneration.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
