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Stories for Reprint
Total Knee Replacement:
What You Need to Know
By Ferdous Al-Faruque, MARRTC Staff
Most people don't think about their knees much until a knee becomes injured or painful from arthritis. Often medication and exercise can help, but in some cases health care professionals may suggest total knee replacement surgery or TKR.
"Most of the time with patients with arthritis you don't go to knee replacement as a first option," says Dr. Russell Windsor, an orthopedic surgeon at the Hospital for Special Surgery in New York. "The thought is you put off the operation for as long as you reasonably can.
"But if people want to remain active and find their activities severely limited by arthritis (and nothing else has worked, then they can consider having the surgery)."
In a healthy knee the cartilage that covers the end of the bones allows a person to bend their joint smoothly and without pain. If the cartilage between two bones wears down or is damaged from an injury, the bones can begin to rub against each other and lead to pain and sometimes disability.
Total knee replacement surgery involves replacing the worn end of the bones with metal or plastic implant caps so the bones glide smoothly against each other.
Windsor, who is also a professor of orthopedic surgery at Cornell University, says, "The newer designs of implants have made it more and more appealing to younger and younger patients." He also adds that there is a trend in recent years to open up the area around the knee as little as possible so patients recover faster from their surgery.
According to the most recent data from the Centers for Disease Control and Prevention, over half a million total knee replacement surgeries took place in 2005 alone. Windsor says the Hospital for Special Surgery does between 4000 and 5000 of those surgeries a year.
Although total knee replacement is the most common type of knee replacement surgery, some people may have the option to do a partial knee replacement, where only the damaged part of their knee is replaced with an implant.
People considering knee replacement need to talk to their healthcare professional to fully understand the risks and benefits, and their responsibility after the surgery to do rehabilitation therapy, says Windsor. He also states improvements in rehabilitation therapy now make it possible for patients to get back on their feet faster and increase their mobility. But if a person chooses not to complete their rehabilitation, it could impact their ability to fully recover after surgery.
Windsor says people need to be realistic about what the surgery can do for them, "(The replacement knee) is not a 20-year-old's knee; you're going to have to have reasonable expectations." That being said, some of Windsor's patients have been able to get back to playing low impact sports. "I think in the end most of the patients are very, very happy they did it; it changes their life," he said.
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