Knee replacement is a highly skilled surgery done to replace/resurface the bones of the 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.
The goal of knee replacement surgery is to relieve pain and restore function of the knee joint and is 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 joints because of various forms of arthritis like Osteoarthritis (the most common cause, which is related to advancing age), Rheumatoid arthritis, Gout and arthritis secondary to a previous severe injury of the knee joint etc. When such arthritis either causes severe pain that restricts Activities of Daily Living (ADLs) like eating, walking, bathing, personal hygiene and dressing, or it causes severe rest pain or instability (the feeling of loosing 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% of patients. After surgery, how much the knee will bend (flexion) will depend on three major factors:
● The range of motion before operation (how much the knee could bend before the operation).
● Type of implant used (modern high flexion knee implants give upto 150- 160 degree flexion)
● How effectively patients follow post operative exercise programme for the initial few months
Replacement of
knee is broadly of two types:
● Partial Knee replacement (Unicondylar) in which only one part of the knee is replaced; it is done when only one part of the knee joint is predominantly damaged.
● Total knee replacement, where all parts of knee are replaced; it is done when the whole knee joint is
damaged by arthritis. After surgery patients are usually discharged on the third or fourth day and walking is started normally on first or second postoperative day. The patient has to follow a good exercise and physiotherapy programme for 3 months after surgery.
As Knee Replacement is a major surgery, complications can occur in a few patients during or after surgery, although the 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 when done for appropriate patients who suffer from severe forms of Knee Arthritis causing severe pain that affects the activities of daily living.
Dr. Sanjay Kumar
Orthopedic Surgery Specialist
Bahrain Specialist Hospital
Email: sanjay.kumar@bsh.com.bh