Total Knee Replacement (Arthroplasty)

Knee osteoarthritis (OA)

Osteoarthritis is a condition in which articular cartilage is destroyed due to aging, injury to the knee joint, rheumatoid arthritis, or other causes causing inflammation of the joint walls. It results in knee joint swelling and pain. When the joint surface is further destroyed, This results in common knee deformity. Limit the range of knee flexion and walk deformed

Osteoarthritis is a disease that cannot be cured and returned to normal. Therefore, the primary treatment is to delay the deterioration of the joint surface for as long as possible. To avoid joint replacement surgery, However, the knee joint is severely deformed in some patients. Joint replacement surgery is a very effective treatment.

Non-Surgical Treatment Options for Osteoarthritis

Managing osteoarthritis effectively often starts with non-surgical approaches to alleviate symptoms and delay the need for surgical intervention. These methods include:

1. Weight Management
Maintaining a healthy body weight is essential to reduce stress on the knee joints. For individuals whose BMI exceeds 25 kg/m², losing weight can significantly decrease joint pressure, improving mobility and reducing pain.

2. Knee Muscle Strengthening Exercises
Strengthening the muscles around the knee helps improve joint support and stability. Here’s a simple exercise you can try at home:

• Sit in a chair with your back supported.
• Lift your legs slightly off the ground.
• Tighten your thigh muscles while wiggling your ankles.
• Hold the position for 5-10 seconds and repeat 15-30 times for each leg.
  Aim to perform this exercise at least three times a day.

3. Medications for Osteoarthritis

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These are used to manage inflammatory pain. However, they should only be taken under medical supervision and for short durations to minimize risks such as high blood pressure, kidney issues, or stomach ulcers.
• Long-Term Medications: Options like glucosamine, diacerein, or chondroitin may help slow the progression of osteoarthritis. These medications generally show effectiveness after 3-4 weeks of consistent use and are often prescribed for 3-6 months.

4. Joint Fluid Injections (Visco-Supplementation)
This treatment involves injecting artificial joint fluid directly into the knee. The injection helps replace the reduced natural joint fluid, minimizing friction and inflammation within the joint. The effects typically last for several months, offering pain relief and improved mobility.

Indications for Knee Replacement Surgery

• Severe pain in the knee joint that does not improve with rest or medication, often accompanied by grinding or clicking sounds during movement.
• Discomfort or pain when bearing weight, such as walking, climbing stairs, or standing for extended periods, that interferes with daily activities.
• Reduced range of motion in the knee, including difficulty bending or straightening the leg fully. Tasks like squatting or kneeling become impossible or highly uncomfortable.
• A feeling of instability or weakness in the knee, often described as the knee “giving way” during movement.
• Structural changes in the knee, such as bow-legged (varus) or knock-kneed (valgus) deformities, which may worsen over time and affect alignment and function.

Knee Replacement Surgery Techniques

The doctor will perform surgery on the damaged joint surface entirely and insert a new joint surface made from special medical materials which is strong, durable, and able to blend well with body tissues. The surgeon must set the correct position for placing the artificial joint surface. Adjusts the tightness or looseness of the tissue surrounding the knee joint appropriately. Currently, the shape of the artificial knee can be bent approximately 100 -145 degrees.

The material of the artificial knee surface is made from metal and polymer. It is solid and safe for the body and meets international certification standards from the United States (FDA); the artificial knee surface is attached to the bone with cement (Bone cement) to increase the adhesion strength between the metal joint surface and the bone.

Post-Surgery Recovery & Long-Term Care

Following knee replacement surgery, patients are encouraged to start moving as soon as possible. They can typically sit up and move their legs and ankles immediately after the procedure. Within 24 hours, under the guidance of a physical therapist, patients begin walking exercises. The primary recovery goal at this stage is to achieve a knee range of motion that allows at least 90 degrees of bending and almost full extension. Meeting these milestones enables patients to transition to home-based care and continue their rehabilitation journey.

Recovery Timeline for Knee Replacement Surgery

The recovery timeline after knee replacement surgery varies but typically follows these stages:

• First Month: During the initial weeks, patients are advised to use a four-legged walking aid for stability and to minimize pain while weight-bearing. This allows gradual adaptation to the new joint while promoting healing.
• Progression: As strength and confidence improve, patients can transition to crutches or a cane.
• Three Months: By the three-month mark, most patients regain their ability to walk unassisted and resume daily activities with significantly reduced pain and improved mobility.

Importance of Physical Therapy After Knee Replacement

Physical therapy is a crucial component of knee replacement recovery. Patients should engage in a consistent exercise routine, either on their own or with the assistance of a physical therapist, to restore the knee’s range of motion. Targeted exercises improve flexibility, increase the ability to bend and straighten the knee, and prevent scar tissue (fascia) from forming and limiting joint movement. Commitment to physical therapy ensures better outcomes and long-term joint health.

How Long Do Artificial Knee Joints Last?

Prosthetic knee joints are designed to last approximately 20 years when the procedure is performed by an experienced orthopedic surgeon using high-quality materials. To extend the lifespan of an artificial knee, patients should maintain a healthy weight, avoid activities that place excessive stress on the joint, and refrain from deep bending positions. Proper care and lifestyle adjustments are essential for maximizing the durability of a knee replacement and ensuring a long-lasting improvement in mobility and quality of life.