Orthopaedic Conditons & Treatments

Knee Replacement Surgery

Knee Replacement Surgery is a surgical treatment that replaces a severely damaged knee joint with an artificial prosthesis. This type of surgery is often recommended to people with painful conditions of the knee that have not responded to more conservative nonsurgical treatments. Osteoarthritis, also known as wear-and-tear arthritis, is the most common reason for knee replacement surgery.

Other conditions successfully treated include rheumatoid arthritis, post-injury arthritis, fractures, torn cartilage and ligaments, as well as other rare, destructive joint diseases.  All of these problems can lead to irreversible damage to the knee joint that can only be repaired with surgery. The American Academy of Orthopaedic Surgeons reports that more than 542,000 people undergo knee replacement surgery (known as arthroplasty) each year.

Types of Knee Replacement Surgery

Depending on the severity and extent of degeneration of the knee joint, the orthopaedic surgeon may perform total or partial (unicompartmental) knee replacement. Total knee replacement surgery replaces the whole knee joint. Partial knee replacement surgery replaces either the inside (medial) or outside (lateral) parts of the knee.

The surgeon may perform open surgery or arthroscopic surgery. Open surgery is the traditional approach of making one 8-to-10-inch incision. Arthroscopic surgery is a minimally invasive approach that makes two or more small incisions (each 4 to 6 inches long). Into one of the incisions, the surgeon inserts a pencil-thin instrument that contains a light, a system of lenses and a video camera. The camera sends clear images to a display monitor by the operating table to guide the surgeon's actions. Special thin surgical instruments are inserted into one or more of the other incisions. The benefits of a minimally invasive procedure for the patient are less bleeding, shorter hospital stay, faster recovery and a better-looking scar.

After removing damaged bone and tissue, the surgeon implants the metal and plastic prosthesis which consists of three components:
 

  • The tibial component resurfaces the top of the tibia (shinbone).
  • The femoral component resurfaces the top of the femur (thighbone).
  • The patellar component resurfaces the bottom of the kneecap that rubs against the thighbone.

Technological Advances in Knee Replacement Surgery

Innovations in the prosthetic devices or implants have led to recent breakthroughs including:

  • Gender-specific prostheses that recognize the anatomically differences between the male and female knee
  • Greater mobility prostheses that provide a wider range of motion so that you can walk up and down stairs as well as easily get up from a seated position or kneel.

Conditions Treated with Knee Replacement Surgery
 

  • Osteoarthritis – The most common arthritis that affects the knee, osteoarthritis is caused by the slow and steady degeneration and thinning of the smooth articulate cartilage that covers the ends of bones in the knee joint. Healthy cartilage makes it possible for joints to have a normal, pain-free range of motion and function that allows them to glide smoothly in their sockets. When osteoarthritis develops, it breaks down the cartilage and narrows the space in which the joint moves and causes pain, inflammation and limited range of motion.

    Osteoarthritis can interfere with your ability to work, as well as limit your daily activities and quality of life. The knee and the hip are the joints most affected by osteoarthritis because they help carry our body weight. As a result, they are prime candidates for the slow and steady wear and tear of this potentially debilitating joint disease.
  • Rheumatoid arthritis – This type of arthritis is one of over 100 rheumatic diseases (diseases that affect the joints and their connective tissues such as muscles, tendons and ligaments). It is a chronic autoimmune, systemic disease that can cause inflammation of multiple joints in your body. Autoimmune diseases occur when your body is attacked by its own immune system. Inflammation from rheumatoid arthritis can become so severe that knee joint is swollen and deformed, making it difficult to move your leg.
  • Post-traumatic arthritis – This type of arthritis can develop after a knee injury even though you received the proper treatment for the injury and fully recovered from it. Post-traumatic arthritis may develop years after a fracture, ligament injury or meniscus tear (a tear in the connective tissue of the knee).

Knee Replacement Surgery Recovery

According to the National Institutes of Health (NIH), many patients are able to walk without a cane or walker within 3-4 weeks after surgery. You will need physical therapy for 4-6 months. Most forms of exercise are okay after surgery, including walking, swimming and biking. High-impact activities such as jogging should be avoided.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Joint Replacement Services in New York performs knee replacement surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the joints and connective tissues.

Rehabilitation Services

The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.