Knee Joint Replacement
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Definition
Knee joint replacement is surgery to replace a knee joint with a man-made (artificial) joint. The artificial joint is called a prosthesis.
See also: Unicompartmental knee arthroplasty
Alternative Names
Total knee replacement; Knee arthroplasty; Knee replacement - total; Tricompartmental knee replacement; Subvastus knee replacement; Knee replacement - minimally invasive; Knee arthroplasty - minimally invasive
Description
During knee joint replacement surgery, damaged cartilage and bone are removed from the knee joint. Man-made (artificial) pieces, called prostheses, are then placed in the knee. These pieces may be placed in up to three surfaces in the knee joint:
Lower end of the thigh bone. This bone is called the femur. The replacement part is usually made of metal.
Upper end of the shin bone--the large bone in your lower leg. This bone is called the tibia. The replacement part is usually made from metal and a strong plastic.
Back side of your kneecap. Your kneecap is called the patella. The replacement part is usually made from a strong plastic.
You will not feel any pain during the surgery because you will have one of these two types of anesthesia:
Regional (
spinal or epidural) anesthesia. Medicine is put into your back to make you numb below your waist. You will also get medicine to make you sleepy. And you may get medicine that will make you forget about the procedure, even though you are not fully asleep.
After you receive anesthesia, your surgeon will make a cut over your knee to open it up. This cut is often 8 to 10 inches long. Then your surgeon will:
Move your kneecap (patella) out of the way, then cut the ends of your thigh bone and shin (lower leg) bone to fit the replacement part.
Cut the underside of your kneecap to prepare it for the new pieces that will be attached there.
Fasten the two parts of the prosthesis to your bones. One part will be attached to the end of your thigh bone and the other part will be attached to your shin bone.
Attach both parts to the underside of your kneecap. A special bone cement is used to attach these parts.
Repair your muscles and tendons around the new joint and close the surgical cut.
The surgery usually takes around 2 hours.
Usually, artificial knees have both metal and plastic parts. Some surgeons now use different materials, including metal on metal, ceramic on ceramic, or ceramic on plastic.
References
Crockarell JR, Guyton JL. Arthroplasty of the knee. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 6.
Jones CA, Beaupre LA, Johnston DW, Suarez-Almazor ME. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007; 33(1): 71-86.
Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009;360:1749-1758.
Review Date: 9/22/2011
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Total knee replacement; Knee arthroplasty; Knee replacement - total; Tricompartmental knee replacement; Subvastus knee replacement; Knee replacement - minimally invasive; Knee arthroplasty - minimally invasive
Why the Procedure Is Performed
The most common reason to have a knee joint replaced is to relieve severe arthritis pain. Your doctor may recommend knee joint replacement if:
Knee joint replacement is usually done in people ages 60 and older. Younger people who have a knee joint replaced may put extra stress on the artificial knee and cause it to wear out early.
See also: Deciding to have knee or hip replacement
After the Procedure
You will stay in the hospital for 3 to 5 days. During that time you will recover from your anesthesia and from the surgery itself. You will be asked to start moving and walking as soon as the first day after surgery.
Full recovery will take 3 months to a year.
Some people need a short stay in a rehabilitation center after they leave the hospital and before they go home. At a rehab center, you will learn how to safely do your daily activities on your own.
For more information, see also:
Outlook (Prognosis)
The results of a total knee replacement are often excellent. The operation relieves pain for most people. Most people do not need help walking after they fully recover.
Most artificial knee joints last 10 to 15 years. Some last as long as 20 years before they loosen and need to be replaced again.
References
Crockarell JR, Guyton JL. Arthroplasty of the knee. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 6.
Jones CA, Beaupre LA, Johnston DW, Suarez-Almazor ME. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007; 33(1): 71-86.
Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009;360:1749-1758.
Review Date: 9/22/2011
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Total knee replacement; Knee arthroplasty; Knee replacement - total; Tricompartmental knee replacement; Subvastus knee replacement; Knee replacement - minimally invasive; Knee arthroplasty - minimally invasive
Risks
Risks of any surgery are:
For more information about joint replacement, see also: Risks of hip and knee replacement
References
Crockarell JR, Guyton JL. Arthroplasty of the knee. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 6.
Jones CA, Beaupre LA, Johnston DW, Suarez-Almazor ME. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007; 33(1): 71-86.
Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009;360:1749-1758.
Review Date: 9/22/2011
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 9/22/2011
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.