Total Knee Arthroplasty

July 25, 2019

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities of daily living, such as walking or climbing stairs.  You may even begin to feel pain while you are sitting or lying down.  If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery.  

Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure to resurface a knee damaged by arthritis.  Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the underside of the kneecap.  This surgery may be considered for someone who has severe arthritis or a severe knee injury.  

Knee replacement surgery was first performed in 1968.  Since then, improvements in surgical materials and techniques have greatly increased its effectiveness.  Total knee replacements are one of the most successful procedures in all of medicine.  Studies show that more than 600,000 knee replacements are performed each year in the United States.  

The knee is the largest joint in the body and having healthy knees is required to perform most everyday activities.  The knee is made up of the lower end of the thighbone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). The ends of these three bones where they touch are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily.  The menisci are located between the femur and the tibia.  These C-shaped wedges act as “shock absorbers” that cushion the joint.  Large ligaments hold the femur and tibia together and provide stability. The long thigh muscles give the knee strength. All remaining structures of the knee are covered by a thin lining call the synovial membrane.  This membrane releases a fluid that lubricates the cartilage, reducing the friction to nearly zero in a healthy knee.  Normally, all of these components work in harmony.  But disease or injury can disrupt this harmony, resulting in pain, muscle weakness, instability, and reduced function. 

Various types of arthritis may affect the knee joint.  Osteoarthritis, a degenerative joint disease that affects mostly middle-aged or older adults may cause the breakdown of joint cartilage and adjacent bone in the knees.  Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, may cause damage to the cartilage of the knee.  

The decision to have total knee replacement surgery should be a cooperative one between you, your family, your family physician, and your orthopedic surgeon. Your physician may refer you to an orthopedic surgeon for a thorough evaluation to determine if you might benefit from the surgery. 

There are several reasons why your doctor may recommend knee replacement surgery.  People who benefit from total knee replacement often have:

• Severe knee pain or stiffness that limits your everyday activities including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain  and you may need to use assistive devices to aid your ambulation such as a cane or walker.

• Moderate or severe knee pain while resting, either day or night.

• Chronic knee inflammation and swelling that does not improve with rest or medication.

• Knee deformity – a bowing in or out of your knee.

• Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries. 

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and cannot do.  More than 90% of people who have knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living; but total knee replacement will not allow you to do more than you could before you developed arthritis. Realistic activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports.  With appropriate activity modification, knee replacements can last for many years.  

If you feel you might be a candidate for or are interested in discussing total knee replacement surgery, any of our orthopedic surgeons would be happy to evaluate you and discuss this with you.  No referral is necessary to see one of our orthopedic surgeons.  At Iowa Specialty Hospital/Orthopedic Specialists, our approach to total joint replacements is a team approach which includes, you, the patient, as a key player.  Prior to your surgery, you will attend out joint day which will include visiting with therapy departments who will gather additional information from you to better care for you after surgery.  You also will have joint class, which will educate you about the surgery, how to prepare and how to be successful once you return home.  

If you are having knee pain and difficulty, we would be happy to do an evaluation and see what treatment would be the best to help provide you relief.   Call 515-955-6767 in Fort Dodge or 515-532-9310.  

« Back