Knee

Knee Replacement (Partial and Total Knee Replacement)

Every year in the U.S., almost 700,000 people have a hip or knee replacement. Most are done in people older than 60. But many people have this surgery at a younger age.

Total knee replacement (TKR) is one of the most successful procedures in all of medicine. Knee replacement surgery is safe and very effective to relieve pain, correct leg deformity, and restore function, and quality of life.

What causes chronic knee pain and disability?

Osteoarthritis is the main reason for knee replacement operations in the U.S. But knee replacement may be recommended when rheumatoid arthritis damages cartilage, and causes knee pain and stiffness; or when post-traumatic arthritis following a serious knee injury damages the cartilage on the surfaces the knee bones.

What is a knee replacement?

A partial knee replacement involves replacing one part of the damaged knee, either the inside or the outside of the knee. A partial knee replacement preserves the healthy part of the knee, and provides good long-term results.

A total knee replacement resurfaces the bones of the knee joint and is recommended for people with severe knee damage that causes significant disability. It involves removal of the damaged cartilage and bone from the knee joint, and replacing them with implants.

The goal of both procedures is to relieve pain and improve function and mobility, so you can return to the daily activities of your life and improve your quality of life.

How long does a knee replacement last?

Partial knee replacements last up to ten years. But the part of the knee that was not replaced will degenerate with time and more arthritis. One in ten people need a repeat operation. Total knee replacement lasts about 20 years.

When will a knee replacement be recommended?

When the patient has:

  • Severe destruction of the knee joint with progressive pain and stiffness that limits their everyday activity
  • Moderate or severe knee pain that occurs while resting day or night, and keeps you awake at night, and is not improved with medications and exercise
  • Chronic knee inflammation and swelling that does not improve with rest or medications
  • Knee deformity

Who is a good candidate?

You are a good candidate for partial knee when:

  • You have arthritis in only one part of the knee, and not the other side, under the kneecap, or in the entire knee joint
  • You are older, thin and not very active
  • There is only a minor deformity in the knee
  • You have good range of motion
  • The ligaments are stable

For total knee: There are no age or weight limits. Recommendation is based on the patient’s level of pain and disability.

The procedure

The surgical procedure chosen depends on the patient’s needs, and condition and the surgeon’s preferences.

Both total knee and partial knee surgery are done under regional anesthesia or general anesthesia. Partial knee replacement is minimally invasive surgery called arthroscopy. Dr. Stark will use an arthroscope to assess the damage, and insert tools to remove the damage and resurface the area with implants. Minimally invasive surgery requires only small incisions, and reduces risk and recovery time. Most people go home the same day.

Total knee surgery may be performed with minimally invasive arthroscopy, or with open surgery and an 8-10” incision made down the center of the knee. During surgery, the damaged knee tissue and bone are removed, and replaced with man-made implants or prosthetics. The wound is closed with stitches.

Recovery

Amazingly, recovery from knee replacement surgery takes just weeks. Most people are up and walking the day of surgery with crutches or a walker. Physical therapy will begin within 48 hours after surgery, with knee stabilizers to steady the knee.

Recovery from partial knee surgery takes three to four weeks, and within six weeks for total knee surgery. Outpatient physical therapy for four to six months will boost the odds of a good outcome.

Knee arthritis makes it difficult for you to perform simple every day activities like walking and climbing stairs, and the pain follows you even when you are sitting or lying down. Today joint replacement surgery is safe and effective to relieve pain and restore quality of life. Dr. Stark has offices in Oceanside, Carlsbad and San Diego, California.


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