Knee replacement is a highly skilled surgery done to replace/resurface the bones of knee joint damaged by arthritis. Metal and plastic parts are used to cap the ends of bones that form the knee joint including the knee cap. Goal of knee replacement surgery is to relieve pain and restore function of the knee joint and normally done when all conservative measures like weight reduction and activity modification, medication, physical therapy and joint injections are no longer effective in relieving the severe pain related to arthritis.
Knee replacement is usually done in severely damaged knee joint because of various forms of arthritis like Osteoarthritis (Most common cause and related to advancing age), Rheumatoid arthritis, Gout and arthritis secondary to previous severe injury of knee joint etc. When such arthritis either causes severe pain that restricts ADLs (Activities of daily living like eating, walking, bathing, personal hygiene, toileting and dressing) or it causes severe Rest pain or Instability (feeling of losing balance while walking or standing), this surgery is advisable.
Arthroplasty of Knee (Replacement) is a highly successful procedure that provides dramatic pain relief in more than 90% patients. After surgery how much knee will bend (Flexion) will depend on three major factors:
• How much is the range of motion before operation (How much knee is bending before operation).
• Type of Implant used (Modern high flexion knee implants up to 150-160 degree flexion)
• How effectively patients follow post-operative exercise program of initial few months
Replacement of knee is broadly of two types:
• Partial Knee replacement (Unicondylar) in which only one part of knee is replaced, it is done when only one part of knee joint is predominantly damaged.
• Total knee replacement where all parts of knee are replaced done when whole of the knee joint is damaged by arthritis.
After surgery patients are usually discharged on 3rd or 4th day and walking is started normally on 1st or 2nd postoperative day. Patient has to follow a good exercise and physiotherapy program for 3 months after surgery.
As Knee replacement is a major surgery so complications can occur in few patients during or after surgery although incidence is low. Common complications include Infection, Bleeding, Blood clots in blood vessels, loosening of implants etc.
In conclusion, Knee Replacement is a highly effective surgery if done in appropriately selected patients of severe forms of Knee Arthritis causing severe pain affecting the activities of daily living.
Dr. Sanjay Kumar
Orthopedic Surgery Specialist
Bahrain Specialist Hospital
Email: sanjay.kumar@bsh.com.bh