Knee Arthritis

Arthritis is a condition that causes pain, stiffness and swelling in the joints. Osteoarthritis is the most common form of arthritis and it commonly affects the knees. Arthritis of the knee may develop as the cartilage protecting the bones of the knee joint wears down over time. Over the years, as stress is put on the joints, cartilage wears thin and sometimes even erodes completely, resulting in stiffness and pain. Arthritis of the knee occurs more frequently in older individuals, however it sometimes develops in athletes from overuse of the knee joint or after an injury.

Symptoms of arthritis of the knee may include pain, swelling and stiffness within the joint. Some individuals also experience a feeling of weakness in the knee that results in the knee locking or buckling. These symptoms tend to worsen after increased physical activity and as the condition progresses. Over time, as arthritis of the knee progresses, the knee joint becomes increasingly stiff and inflamed, difficult to move, and very painful, even when at rest.

To diagnose arthritis of the knee, a doctor will review all symptoms and perform a physical examination. X-rays and other imaging tests are often used to assess the amount of damage to the joint. Treatment for arthritis of the knee initially focuses on relieving pain and addressing symptoms and is commonly treated with a combination of methods. Avoiding certain physical activities that place stress on the knee may be helpful. Medication may also be used to treat pain and may include:

  • Anti-inflammatory medication such as aspirin, ibuprofen or acetaminophen
  • Prescription pain relievers
  • Corticosteroid injections

Physical therapy may be a successful form of treatment for some patients. Severe cases of osteoarthritis of the knee may require surgery to reposition the bones or replace the joint. Most procedures can be performed through arthroscopy, which significantly reduces bleeding, scarring and recovery times.

Partial Knee Replacement

Total Knee Arthroplasty

Patients with severe pain and stiffness that does not respond to conservative treatments or more moderate surgery may require total knee arthroplasty, commonly known as knee replacement, to relieve pain and restore function. Whereas in a healthy knee smooth cartilage cushions the connecting bone ends, when osteoarthritis develops, the resulting pain and stiffness that may require surgical intervention.

In a total knee arthroplasty, the damaged ends of the bones are removed and replaced with a prosthesis made of metal and plastic. These artificial parts allow the joint to move smoothly so the patient experiences pain relief and a better quality of life.

Total Knee Replacement

Total Knee Arthroplasty Procedure

The total knee replacement procedure is performed in a hospital under general anesthesia. During the procedure, an incision is made in the knee to access the joint so the damaged bone and cartilage can be removed. Once the damaged tissue is removed, the prosthetic device is inserted and may be either cemented or pressed into place. Cemented knee replacements are most commonly used, and are fixed into the joint for immediate support. Press-fit knee replacements are designed to have the surrounding bone grow into the implant for long-term joint stability.

Recent advances in surgical technology make it possible to perform minimally invasive joint replacements. Various minimally invasive techniques allow the joint to be replaced with less cutting and manipulation of muscles, tendons and ligaments around the joint. There are other potential advantages to minimally invasive surgery, including smaller incisions, less bleeding, less scarring, less pain and a speedier recovery.

Recovery From Total Knee Arthroplasty

A short hospital stay is likely, varying a bit depending on the type of procedure performed and the overall health of the patient. Patients usually experience immediate relief from the joint pain suffered before the replacement. However, there will be some post-operative discomfort that can be managed with prescribed pain medication.

Physical therapy starts in the hospital, as soon as possible after surgery, usually the next day, to ensure rapid healing and restoration of full function. Most patients either proceed to inpatient rehabilitative treatment for approximately a week, or return home and begin outpatient rehabilitation sessions a few times a week.

Patients in physical therapy progress from taking steps with a walker or crutches to walking without assistive devices on stairs and slopes. Continuous passive motion (CPM) machines are commonly used to reduce recovery time and prevent muscle contracture without straining the joint. Patients are also given exercises to perform at home to reinforce the rehabilitative process.

Risks Of Total Knee Arthroplasty

Although considered a safe procedure for most patients, there are certain risks associated with all surgery. These risks include: infection, excessive bleeding, blood clots, buildup of excessive scar tissue, limited range of motion, nerve damage, and implant rejection. For the great majority of patients, total knee arthroplasty is successful and uneventful, providing effective pain relief and greatly improved quality of life.

High Tibial Osteotomy