There are various treatment possibilities for knee arthritis. Some will respond to certain treatments better than others as each patient is unique. It is generally best to start with the most conventional treatments. Total knee replacement may be an option if conservative treatments for arthritis pain do not yield and simple activities such as walking or climbing stairs might become difficult or unbearable. In this methods, the cartilage and bone surface is removed and resurfaced with a metal and plastic implant.
New marginally invasive and minor incision surgical procedures are being used for total joint replacement. Because less tissue is cut, these methods may allow for quicker, less painful recovery and a quick coming back to activities.
Computer-assisted surgery is the latest generation of technology accessible in joint replacement. With the aid of an extremely precise computer-imaging system, the surgeon produces a visual map of the knee that lets him see past what is possible with the naked eye. Every part of the operation is tracked by a computer including the surgical instrumentation and the positioning of the implant, empowering the surgeon to attain extremely accurate implant alignment.
Conventional open surgery for a total joint replacement used to involve a six to ten-inch incision. Marginally invasive, or negligible incision surgery (MIS) is usually much smaller.
Knee replacement surgery is a major operation and necessitates a substantial amount of consideration. It is a major decision, also a large commitment, since rehabilitation will be needed to achieve maximum function. Below are some signs and symptoms to help you determine whether you need to undergo a total knee replacement.
1. Knee pain that disturbs your sleep.
2. If your participation in your favorite recreational activities is prevented by the pain in your knee.
3. Your ability to conduct necessary and daily functions, such as climbing stairs or standing up is limited by the knee pain.
4. You have tried more conventional treatments, but they have not been much effective
Surgical techniques vary based on the patient’s requirements and the doctor’s approach, but largely the steps are as below:
1. The vital signs of the patient are examined to ensure blood pressure, heart rate, body temperature, and oxygenation levels are stable and operation can be performed. A mark is placed on the knee which is to be operated.
2. Anesthesia is administered. The patient may be given general anesthesia or be given a sectional anesthesia to prevent sensation in the lower half of the body also with a relaxant. It is decided well ahead of time on what type of anesthesia a patient is given.
3. Check Anesthesia for Orthopedic Surgery
4. The doctor does an incision down the middle of the knee about 8 to 10 inches, and then cuts through deeper tissue, comprising of the quadriceps tendon, and flips over the kneecap to reach the femur and tibia. Otherwise, some doctors make minor incisions and use nominally invasive procedures for this.
5. To better the doctor’s ability to reach the joint, the knee is bent to 90 degrees.
6. The doctor uses a bone saw to take away the arthritically injured areas at bottom of the femur and the top of the tibia. Every bone is restructured to precisely fit its new prosthesis. Since these cuts must be accurate, the doctor makes use of either a metal jig or computer assistance to line up the cuts.
7. A doctor may resurface the back of the kneecap, or patella, and assign an implant. A polyethylene component may be assigned to enable the patella’s gliding against the new joint. Studies have not shown a substantial change in results for patients who underwent patella resurfacing and those who did not.
8. Components are attached to the femur and tibia and patella if required. What type of component is used determines in what manner these components are attached to the bone In most knee replacement operations, they use cemented components that are affixed using bone cement. Cemented and cementless components come with different benefits.
9. An elastic polyethylene cushion is placed above the new tibia surfaces. This spacer works as a shock absorber between the two new prosthetic surfaces.
10. The leg is flexed and protracted to examine the suitability of the components and the new knee’s range of motion.
11. The doctor straightens out the knee to let the components, cement, and bone to bond together. Since the bone cement is fast acting, which may take only about 10 minutes.
12. The doctor will restore any deep tissue that was cut during operation and then stitches the skin at the incision.