Knee replacement is a procedure to treat severe knee pain that limits every day activities – and it can be unilateral (one knee) or bilateral (two knees).
According to the Australia’s National Joint Registry, there has been an 88 per cent increase in knee replacement surgeries between 2003 and 2014 – with more than 54,000 Australians undertaking the procedure in 2014.
Symptoms commonly associated with osteoarthritis of the knee that typically requires this surgery include:
- Severe knee pain that limits your everyday activities
- Pain that increases when you are active, but gets a little better with rest
- Swelling and feeling of warmth in the joint
- Some patients complain of increased symptoms as weather gets colder
- Stiffness in the knee, especially in the morning or when you have been sitting for a while
- Long-lasting knee inflammation and swelling that doesn't get better with rest or medications
- In advanced cases, moderate or severe knee pain while resting, day or night
- A bowing in or out of your leg
- Knock knees
- Knee stiffness
How does joint replacement surgery work?
Knee replacement is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability.
It is usually performed for osteoarthritis but also for other kinds of knee disease such as rheumatoid arthritis and psoriatic arthritis.
A torn meniscus, cartilage defects and ligament tears are other reasons your doctor may suggest a total knee replacement.
Knee replacement surgery can be performed as a partial or a total knee.
What is the difference between total and partial knee replacement?
Osteoarthritis of the knee most commonly affects the medial compartment (inside the knee), and can also affect the lateral compartment (outside of the knee) and the patellofemoral compartment (in front of the knee).
Total knee replacement involves surgery to all three components of the knee and today the bulk of surgical knee surgeries in Australia (83 per cent) are total replacements. (the rest are partial revision surgeries).
Total knee replacement has the
Partial knee replacement is generally recommended when only one compartment of the knee is affected rather than all three.
The upside for a partial knee reconstruction is that just one compartment is replaced during surgery, and anterior and posterior cruciate ligaments are preserved; more of your own body structure remains intact and there is a faster recovery.
The downsides however are a higher revision (repeat or re-do) rate; and potentially worse function after revision than with total knee replacement.
It is estimated though that only about 6 per cent of candidates are suitable for partial replacement surgery, with the ideal patient typically older, less active, with minimal deformity.
Patients with inflammatory types of arthritis, such as rheumatoid arthritis are not regarded as good candidates for partial knee replacement.
What happens during knee replacement surgery?
In general, knee replacement surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
The operation typically involves substantial postoperative pain, and includes vigorous physical rehabilitation.
The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility.
Hospital stay is generally about a week.
Most patients can safely drive at 6 weeks and gradually increase walking distances in 6 weeks.