SOMA Orthopedics

Total knee replacement

What is a total knee replacement?
A total knee replacement (video), also known as a knee arthroplasty, is the most common joint replacement surgery performed in the United States. Since it’s advent in the late 1960's, millions of patients with osteoarthritis, rheumatoid arthritis, and post traumatic arthritis have benefited from knee replacements. Historically, knee replacements were only indicated in patients older than 65 years with end stage osteoarthritis. Technological advances and procedural improvements have expanded these indications to include younger patients with a variety of diseases involving the knee. Many patients with night pain, pain at rest, difficulty performing ADL’s or the inability to enjoy their customary hobbies and sporting activities are excellent candidates for a total knee replacement.

What is involved in total knee replacement?
Total knee arthroplasty is a surgical procedure (video) designed to remove the diseased portions of the femur, tibia and patella. The procedure is also a powerful method to correct any alignment abnormalities giving patients a more symmetrical, normal gait. Prior to the surgery, the orthopaedic surgeon will carefully evaluate the patient and his/her radiographs for conditions that should be addressed during the procedure. Whereas conventional incisions for this procedure have been quite extensile, minimally invasive techniques help reduce the surgical dissection required.. These techniques are not only important for aesthetics, but also for better post-operative pain control and immediate post-operative rehabilitation. During the procedure, the orthopaedic surgeon removes the diseased portions of the tibia and femur. The articular surfaces are replaced with metallic components which are designed to mimic the anatomic and physiologic features of the native knee. A plastic liner is secured to the tibial component. The new “joint” is the articulation between the liner and the femoral component. The patella may or may not be resurfaced depending on the etiology and extensive nature of the disease.

New advancements in knee replacement surgery has incorporated the use of modified plastics and metals such as ceramics for better wear characteristics and longer survival of implants.


What to expect after Total Knee Replacement surgery ?
An important factor for patients in deciding whether to have a hip replacement is understanding what the procedure can and can"t do. For most types of knee replacements, the patient is highly encouraged to walk the day after surgery. Hospitalization is approximately 3-6 days and is tailored to the individual capabilities and needs of each patient. Extensive participation with physical therapy is required for an optimal result. As far out as 10 years, greater than 97% of patients will experience a dramatic reduction of hip pain and a significant improvement in their ability to perform common activities of daily living. Patients will be asked to refrain from high impact activities but will be able to perform many other types of sporting activist such as brisk walking, golfing, doubles tennis and even skiing on appropriate terrain.