Knee Replacement: Types, Risks, and Outcomes

Knee pain and joint degeneration can have a significant impact on a person’s quality of life, making even simple tasks such as walking or climbing stairs painful. Knee replacement surgery may be recommended if basic treatments fail to provide relief. This article will give you all the information you need to know before deciding on knee replacement surgery.

What is knee replacement?

The femur (thigh bone), tibia (shin bone), and patella (kneecap) are the three main components of the knee joint. These bones are covered in a smooth cartilage layer that allows them to glide and move smoothly against one another. However, the cartilage in the knee joint can deteriorate due to a variety of factors such as arthritis, injury, or general wear and tear, resulting in pain, stiffness, and limited mobility. 

In this case, knee replacement, also known as knee arthroplasty, is a surgical procedure that replaces injured or worn-out components of knee joints with parts made of metal or other synthetic materials that last for decades. As a result, knee replacement can help patients relieve pain, stiffness, and limited mobility caused by arthritis – joint inflammation or swelling – and thus improve mobility and patients’ quality of life.

Partial Replacement vs Total Replacement

There are two main types of knee replacement surgeries 

Partial Knee Replacement (PKR): Partial knee replacement involves replacing only the affected part of the knee joint. This procedure is appropriate for patients who have arthritis or damage to only one knee. Partial knee replacement has several advantages over total knee replacement, including smaller incisions, a shorter recovery time, and the preservation of healthy bone and tissue.

Total Knee Replacement (TKR): In contrast, total knee replacement entails replacing the entire knee joint, including the lower thigh bone, upper shin bone, and back side of the kneecap. This procedure is commonly used for patients who have severe arthritis or significant knee joint damage. For patients with extensive joint damage, total knee replacement can provide significant pain relief and improvement in knee function. As a result, it necessitates a hospital stay and a longer recovery period.

Do you really need a replacement?

Knee replacement surgeries have proven to be highly successful in relieving pain and improving the function of the knee. Meanwhile, the replacement itself is not without risks. Some of the potential risks associated with knee replacement include

Infection: Infections are among the most serious complications that can occur after knee replacement surgery. Despite stringent infection control measures, there is still a small risk of developing an infection in the knee joint during the procedure. Antibiotics are frequently administered before and after surgery to reduce this risk, and thorough sterilization techniques are used in the operating room. Increased pain, swelling, warmth, redness, and fever are all symptoms of infection. If an infection is suspected, it is critical to seek medical attention as soon as possible to avoid further complications.

Blood Clots: Blood clots, or Deep Vein Thrombosis (DVT), can form in the veins of the legs following knee replacement surgery. If these clots travel to the lungs and cause a pulmonary embolism, they can be fatal. Patients are frequently given blood thinners, encouraged to move their legs on a regular basis, and advised to wear compression stockings during the recovery period to avoid this. Patients should be aware of the symptoms of DVT, such as leg pain, swelling, and warmth, and seek medical attention if these symptoms occur.

Nerve Damage: Nerve damage is a rare but potential side effect of knee replacement surgery. During the procedure, nerves around the knee may be injured, resulting in numbness, weakness, or even paralysis. Surgeons take great care to avoid nerve damage, but patients must be aware of the possibility. Most cases of nerve damage are temporary and resolve with time, but permanent nerve injury can occur in rare cases.

Implant Problems: Loosening, dislocation, and wear and tear of implants can occur over time. Modern knee implants are built to last, but they are not immune to mechanical problems. Regular follow-up appointments with the surgeon, as well as adhering to postoperative guidelines, can assist in identifying and addressing any potential issues early on. Revision surgery may be required in some cases to replace or readjust the implants.

Despite the risks, if non-surgical procedures such as walking aids, specialized insoles, pain-relief medicine, hydrocortisone injections, or alternative operations such as arthroscopy, osteotomy, or microfracture are not improving your knee conditions or relieving pains, doctors may recommend a knee replacement as a long-term effective treatment plan.

How is knee replacement being done?

Before performing a knee replacement, doctors will conduct an evaluation that includes a review of your medical history, a physical examination, and imaging tests such as X-rays or MRI scans to assess the condition of your knee, plan for the surgical approach, and ensure that patients are fit for the procedure. If you are a candidate for the procedure, we recommend that you plan ahead of time for when you return home after the procedure, as you will have limited mobility and will require rehabilitation for at least a few weeks.

Once on an operating day, the procedure begins with the administration of anesthesia. Anesthesia can be chosen in a variety of ways, and it is usually discussed and decided upon during preoperative consultations. General anesthesia, which puts the patient to sleep, or regional anesthesia, such as spinal or epidural anesthesia, which numbs the lower body while the patient remains awake.

The incision will then be made as a general open cut or a minimally invasive cut using surgical instruments. Following that, using specialized surgical tools, the damaged cartilage and bone are carefully removed. The femur (thigh bone) and tibia (shin bone) are prepared for prosthetic components by reshaping the bone surfaces. 

The artificial knee components, also known as prostheses, are inserted into the prepared bone surfaces after the replacement area has been prepared. A metal alloy implant for the femur, a metal and plastic implant for the tibia, and sometimes a plastic implant for the patella (kneecap) comprise the prostheses. The implants are secured using bone cement or a cementless technique that allows natural bone growth to anchor the implants. Then, between the metal implants, a plastic spacer is inserted to create a smooth gliding surface within the knee joint. The spacer aids in the replication of the knee joint’s natural movement and function.

The surgeon then tests the range of motion and stability of the knee joint, making any necessary adjustments to ensure proper alignment and function of the components. This step is critical for optimizing the surgical outcome. If the replacement joints work properly and there are no complications, the incision is closed to complete the surgery. Following surgery, the patient is taken to a recovery area where they are closely monitored. To alleviate postoperative discomfort, pain medication may be administered. 

Depending on the circumstances, the patient is then transferred to a hospital room or a specialized rehabilitation facility. A comprehensive rehabilitation program that includes physical therapy exercises, mobility training, and pain management is required for recovery. The patient gradually resumes activities while working to regain knee strength, flexibility, and function.

Knee Replacement at Phyathai 1 International

Musculoskeletal Center of Phyathai 1 International is highly experienced in dealing with pains and abnormalities in your knees. Our team of board-certified physicians in orthopedics can provide you with a comprehensive treatment from physical therapy in condolence with Physical Therapy & Rehabilitation Center to minimally invasive knee replacement surgery for both partial and total knee replacement. 

If you are currently suffering from knee pains or limited movement, we recommend consulting with our specialist at the Musculoskeletal Center of Phyathai 1 International, both open daily from 8 am to 8 pm. To ensure the fastest procedure time, We recommend taking a reservation by phone at number (+66)2-201-4600 ext.3220 and 3222 or by E-mail at [email protected].