Knee disease can make your life a painful and frustrating experience. Even something as simple as squatting down to pick something up can cause you a lot of pain. In many cases, an orthopedic surgeon can help you replace your knee with a safe and effective procedure.
Many people who don’t know much about artificial joints think that the joint will be completely removed and a stainless steel joint will be installed, making the limb look like a robot and unnatural. In fact, artificial joint replacement is simply the removal of the worn and damaged joint surface and the implantation of an artificial joint to restore a normal smooth joint surface, just like a dental brace.
Total knee arthroplasty?
Total knee replacement surgery is one of the greatest achievements in modern orthopaedics and one of the best treatments for knee disorders, a great success in the field of medicine in the 20th century. Artificial total knee arthroplasty is considered one of the most effective and successful procedures for the treatment of end-stage or severe knee arthritis.
Total knee arthroplasty is a surgical procedure in which the cartilage on the surface of the knee that has been damaged by the disease is removed and replaced with a simulated prosthetic joint made of metal and high molecular polyethylene. This procedure is also known as “surface replacement”, which means that an artificially smooth joint surface is used to replace an already uneven joint surface. It also corrects the gravitational line of the joint (joint deformity) and improves joint mobility.
The procedure originated in the mid-1960s and has matured with improvements in surgical techniques and prosthetic materials. Modern joint designs have accumulated more than thirty years of experience with highly satisfactory results. Advances in medical science have led to a success rate of over 90% in ten years of joint replacement, and patients can use the implanted prosthesis normally for 15 to 20 years, or even for the rest of their lives. Once the initial habituation period is over, most prostheses behave like normal body organs in life. The number of total knee replacements each year in developed countries has even surpassed that of total hip replacements.
What is the knee joint?
The knee joint is one of the most loaded joints in the human body for various activities. It is used for walking, walking, sitting, lying, running and jumping in daily life. As a compound joint, it consists of the distal femur (femoral condyle) and the proximal tibia (superior tibial articular surface) and the patella. Ligaments hold the bones together and stabilize the joint, while the surrounding muscles and tendons also stabilize the joint and allow it to move. The femoral condyles glide smoothly over the superior tibial articular surface, allowing the lower leg to move smoothly and painlessly.
The inner surface of the joint is covered with cartilage, which is often destroyed by arthritis, such as degenerative osteoarthritis and rheumatoid arthritis. Bone spur formation is common in patients with degenerative osteoarthritis, as well as other signs such as joint pain, swelling, increased local temperature, joint stiffness, deformity, and decreased mobility.
In a normal knee, the cartilage is smooth and flat; in osteoarthritis of the knee, the cartilage is worn and peeled away and the subchondral bone is exposed.
What are the indications for surgery?
Almost all serious joint diseases can be solved by joint replacement. Examples include osteoarthritis and rheumatoid arthritis. The most common of these is osteoarthrosis of the knee, a degenerative disease of the knee bones that causes roughness and unevenness of the knee surface and pain during movement of the knee joint.
The following criteria also need to be met.
① Imaging changes of bone and cartilage destruction on the joint surface.
② the presence of moderate to severe persistent pain.
③ Failure to improve function and pain after at least six months of conservative treatment.
④Patients are able to actively cooperate with the physician and have good compliance with treatment.
Age is no longer a decisive factor for artificial joint replacement. Initially, due to the limitations of early artificial joint prosthesis design and material wear properties, as well as the immaturity of the surgical technique, artificial joint replacement was once thought to be only suitable for people over 65 years of age. However, as more new wear-resistant materials became widely used in artificial joints, surgical techniques, especially revision techniques, improved the design of various revision prostheses, and people’s quality of life requirements continued to improve, more and more senior citizens and young people underwent artificial joint replacement due to severe joint disease.
What is the procedure?
The surgery is performed under anesthesia. The surgeon makes an incision in the affected knee and scrapes away the rough top part of the femur and tibia in order to insert the replacement device. The two parts of the replacement device are implanted into the femur and tibia with a special bone cement.
Advantages / Disadvantages
A total knee replacement can keep you pain-free for years to come. This procedure replaces your injured joint with an artificial knee. The surgery will not give you back your old age, but it will give you many substantial benefits.
Benefits
1. Complete disappearance or significant reduction in joint pain, even from the surgery, within a few weeks. Increased strength in the legs, as your knee joint if no longer painful, increased opportunity to use your legs and muscles are exercised.
2. restoration of stability and flexibility of the knee joint.
3. Knee replacement allows you to manage daily tasks and low physical activities more comfortably and with a significantly improved quality of life. You are able to go through daily life with ease and can participate in some sports
4. The conventional effects of knee replacement can last 15 to 20 years, and it will allow you to move more easily during that time.
The artificial knee joint is not shaped like our body’s knee joint, but it is just as functional. The artificial knee fits snugly into the bone, and its smooth surface allows you to move freely.
Disadvantages
1. It is very difficult to treat infections in artificial joints. 1% of people have infections after surgery, which can lead to prolonged treatment, or even to the removal of the artificial joint and its replacement after the infection is controlled. The infection rate of the re-replaced joint is higher than that of the first operation.
2.Mechanical problems:These types of problems are not common, but sometimes require re-surgery to fix them, such as loose, sunken, worn out prosthesis, or stiff joints.
3.It is more expensive.
Service life and efficacy?
The longevity of the artificial knee is determined by two main issues: the wear and tear of the joint, and the loosening of the prosthesis due to wear particles. The strength and wear resistance of the artificial knee material can generally satisfy patients for 15-20 years, or even longer. Of course, the service life of the artificial joint is also related to many factors, such as the patient’s exercise level, the choice of artificial prosthesis, the surgeon’s surgical technique, and his or her own condition.
What determines the success of joint replacement surgery?
First, the patient’s indications must meet the needs of the surgery, the patient must be in good general condition and good mental status, have no contraindications to surgery, and have reasonable expectations for the artificial joint replacement.
Second, the surgeon’s surgical plan, intraoperative operation, and postoperative management also affect the success rate of the surgery. Dr. Wang Yansong, the chief surgeon, has extensive experience in knee arthroplasty during his long clinical work and is able to handle various joint replacement operations.
In addition, the choice of artificial joint is also important. Not all expensive, new artificial joints are good and appropriate. Patients and families should discuss with their doctors and make a decision after a reasonable analysis of the future use of the joint. Do not blindly chase after the expensive and new ones.
What about post-operative protection?
After arthroplasty, you need to develop good habits of life and activities to maintain the stability of the joint, and learn some important rehabilitation knowledge to perform joint rehabilitation exercises. It is important to pay attention to the prevention and control of infections, and to actively treat any infections such as skin infections. After arthroplasty, patients can resume normal work life after the initial adaptation period. In addition to strenuous antagonistic activities, patients can properly perform simple activities such as walking, jogging, swimming and cycling.