Frequently Asked Questions
Primary Knee Replacement
Primary knee replacement, also known as total knee arthroplasty, is a surgical procedure whereby an injured or arthritic knee joint is replaced with an artificial implant. The intention of the surgery is to alleviate pain, enhance mobility, and restore function in patients with severe knee arthritis or injury.
Candidates usually include any person with chronic knee pain, stiffness, or limited mobility that interferes with daily activities and conservative treatments such as physical therapy, medication, or lifestyle changes. Besides this, physicians will consider the patient’s general health, age, and activity level in determining whether surgery is indicated.
Though generally safe, possible risks of knee replacement include infection, blood clots, loosening of the implant, joint stiffness, and nerve or blood vessel damage in very extreme cases. Advances in surgical technique and post-operative care have tended to reduce these risks, but patients are closely monitored to handle complications.
The recovery time is unique to each individual, but most patients begin walking with support just a few days after surgery and continue their physical therapy program to gradually regain strength and flexibility. Most people return to light daily activities in 4 to 6 weeks while complete recovery may take 3 to 6 months. Optimum recovery is greatly improved when the rehabilitation program outlined by your physician is carefully followed.
For implanted knees, it could last for 15 to 20 years or more, depending on particular weight, activity level, or type of implant. Though most patients will need only one knee replacement in a lifetime, some younger or more active ones may be faced with revision surgery if an implant is worn out.
Partial Knee Replacement
A partial knee replacement, sometimes called unicompartmental knee arthroplasty, is surgery wherein only the part of the knee joint that is worn out is replaced, and not the entirety of the joint. This applies when there is arthritis or damage in only one compartment or section of the knee.
The ideal candidates for partial knee replacement usually have arthritis or damage affecting only one part of the knee, reasonably good overall functioning of the knee, and minimal deformity. There should be sufficient knee stability, with intact ligaments, since partial replacement is not quite indicated when several compartments are involved.
It is less invasive compared to the total knee replacement: smaller incisions, less bone removed, and generally quicker recovery. Patients often describe that the knee feels more natural after surgery and, because the healthy parts of the knee are preserved, the procedure may well involve less pain and a shorter rehabilitation period.
Recovery after partial knee replacement is generally shorter compared to total knee replacement. Most patients can resume light activities in 2-4 weeks and more strenuous activities after a few months. Patients often have less stiffness and may achieve motion more quickly, although physical therapy remains very important.
Partial knee replacements are durable and can last for 10 to 15 years or more. However, some patients with arthritis progression in other parts of the knee may eventually need to undergo full knee replacement. Regular follow-up with your orthopedic surgeon will help assess the condition of the knee and any additional signs of wear and/or arthritis.
Revision Knee Replacement
A revision knee replacement is a surgical procedure to replace or repair a previously implanted knee prosthesis that has failed or is no longer functioning properly. This will help in addressing the problems of pain, loosening of the implant, infection, or mechanical failure of the implant.
Chronic Pain: The patient has persistent pain or soreness with conservative treatment.
Loosening of Implant: The implant is loose/unstable as indicated by an imaging study.
Infection: Deep infection in the knee joint.
Mechanical Failure: The prosthesis has failed or is showing a wear and tear pattern.
Limited Function: There is inability to carry out activities of daily living because of knee dysfunction.
Revision knee replacement consists of the removal of the existing implant and its replacement with a new one. The surgery may include:
Bone preparation: cleaning off old cement or pieces of implant for preparing the bone for a new implant.
Tailor made Implant placement: correctly positioning and aligning the new prosthesis, which may be specifically tailored in its positioning and alignment to meet particular needs of the patient.
Repairing surrounding tissues: repairing damaged tissue or ligaments.
It takes around 2-3 hours to perform and is done under general or spinal anesthesia.
Revision knee replacement needs more time for recovery compared to primary knee replacement. Most patients are able to walk with support within one or two days of surgery. The full recovery and resumption of normal activities take around 6 months along with additional physical therapy to get good strength and mobility.
Risks include chances of infection, blood clots, implant failure, stiffness, and prolonged recovery since the revision procedure is often more complex.
With newer implant technologies and improved surgical techniques we use , revision knee replacements have the potential now to last 20 years, and even longer in certain cases. The longevity of the implant will, however, depend on various factors such as the activity level of the patient, weight of the patient, and general health of the patient.
It might involve further non-surgical treatment-avoiding surgery-with medicines, physiotherapy, or injections. If these fail to work and symptoms persist, then revision surgery is done.
Yes, but being overweight may raise the complications and could make the surgery more difficult. Even modest preoperative weight loss might result in improved outcomes and fewer risks.
Preparation includes:
Preoperative Testing: These include tests to check overall health and find out whether one is fit for undergoing this type of surgery.
Weight Control: Loss of weight, if recommended.
Physiotherapy: Pre-operative exercises to help strengthen the knee along with the surrounding muscles.
Life Style Changes: Whatever change one needs to bring about for easy recovery-planning a post-operative care and support and making necessary adjustments at home.
Yes, physical therapy is critical to a successful recovery. It helps restore strength, flexibility, and function to the knee. Your therapy program will be tailored by our team for your particular needs and may continue for several months depending upon your mobility recovery.
High Tibial Osteotomy (HTO)
HTO is a surgical procedure, in which an incision is made on the top part of the tibia to re-align the knee joint. Weight-bearing is transferred from the damaged part of the knee in order to decrease pain and halt the onset of arthritis in patients with knee osteoarthritis or one-sided malalignment.
Generally, HTO is indicated for young and active patients with unilateral knee osteoarthritis, often involving the medial compartment of the knee, and in cases of malalignment or misalignment of the knee, often with a “bow-legged” deformity. Candidates for HTO often need to have good stability in the knee, healthy cartilage in other parts of the knee, and not have advanced arthritis.
HTO can alleviate pain and enhance function by preserving the natural knee joint, which is great for younger, active patients who want to maintain a high level of activity. Other than knee replacement, HTO allows patients to continue high-impact activities and may delay the need for a knee replacement in the future.
Recovery after HTO takes several months. Patients can walk with the support of crutches or with a knee brace to limit their weight-bearing on the operated leg for a time. Physical therapy is necessary for retraining the muscles and restoring mobility. Most people are able to resume their normal activities in three to six months, but complete recovery may take up to a year.
Results of an HTO may last 10-15 years or longer depending on variables such as age activity level, and the progression of arthritis. Although the HTO is able to delay the need for a knee replacement, patients may require further surgery if the arthritis progresses in other parts of the knee.
Fracture Around Knee Replacement
A fracture around the knee replacement means a break in the bone near or around the area where a knee implant has been fitted. These fractures can occur in the femur, tibia, or patella and generally result from trauma or a fall; they can also arise as a result of insidious symptoms related to bone weakness around the implant, often because of osteopenia or osteoporosis.
The symptoms of a fracture around a knee replacement are sharp pain in the knee or thigh area, inability to bear weight through the affected limb, and possibly deformity or swelling. The patients will also show poor mobility or inability to move the knee joint properly, which may interfere with the stability of the implant.
Treatment of fractures around a knee replacement depends on the severity and location of the fracture, as well as on the condition of the knee implant. The less serious are treated by immobilization with limited weight-bearing, while serious ones are usually treated with surgery. Surgery may include screw and plate fixation or even partial implant replacement in cases of loosening or damage to implanted material.
The treatment typically involves rest, limited weight-bearing, and physical therapy to restore strength and function. Recovery times may differ due to the severity of the fracture and surgery. It would take many patients several months for the bone to heal; meanwhile, some needed rehabilitation to work their way back to mobile and strong knees. In extreme situations, walking devices are used during recovery.
Fractures can be prevented by avoiding falls, maintaining bone strength, and ensuring the stability of knee implants. This one can achieve through regular exercise for strength, balance, and flexibility, plus a diet containing calcium and vitamin D. General advice also includes the avoidance of high-impact activities and treatment of any bone health conditions, such as osteoporosis, to minimize the risk of a fracture occurring around a knee replacement.
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