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Orthopedic
Treatment of the Knee
 Knee arthritis is a progressive condition in which the cartilage in the
knee wears away. This allows the underlying bones to come in contact, which
causes pain, swelling, heat, and deformity. There are several forms of
arthritis of the knee because there are three separate compartments that can
wear out.
Arthritis
can involve the patellofemoral joint (between the kneecap and the
thigh-bone), the medial tibiofemoral joint (the inside of the knee), the
lateral tibiofemoral joint, or any combination.
Arthritis of the knee should first be treated conservatively with
anti-inflammatory medications, physical therapy, injections of steroids,
injections of hyaluronic acid (Synvisc™, Hyalgan™, Supartz™), or
arthroscopic surgery. Traditional surgery, known as total knee replacement
(TKR) replaces all three compartments of the knee. The latest techniques
allow selective replacement of each specific compartment. This is called
uni-compartmental replacement. The MIS (minimally invasive surgery)
technique is utilized, decreasing post-operative pain and speeding recovery
time.
Knee Arthroscopy/ACL Repair
Knee arthroscopy is a very common and minimally invasive outpatient
procedure. It can be used for the injured non-arthritic knee or for the
conservative treatment of the arthritic knee. Arthroscopy is a one day
out-patient procedure performed under local anesthesia with
micro-incisions. |
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UNI-COMPARTMENTAL KNEE REPLACEMENT. ONLY THE MEDIAL COMPARTMENT HAS BEEN
REPLACED. |
The patient generally uses crutches for two to three days after the
surgery and returns to non-impact work in short order. Small,
self-contained, articular (joint surface) cartilage defects can be repaired
by this technique, but when there is more extensive damage to the joint
surface then total joint replacement surgery or uni-compartmental surgery may be more appropriate. |
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 Knee Replacement Surgery
TKR is very successful in patients with severely arthritic knees who have
not responded well to conservative (non-operative) or arthroscopic surgical
treatment. The patient enters the hospital on the morning of surgery after
a thorough examination has confirmed fitness for surgery. The operative
side is verified and the anesthesiologist performs another evaluation.
The damaged areas are removed and the prosthetic knee parts, made of
titanium and plastic,
are carefully fit for size and positioned according to
the patient’s anatomy. Holes are drilled and the parts are cemented into
place or press-fit, which is a newer technique.
TOTAL KNEE REPLACEMENT
The surgery itself, which takes
approximately one hour, is
done under spinal
anesthesia and sedation unless
there are contra-indications. This surgery utilizes the MIS technique which
allows for quick recovery of range of motion.
The patient then goes to the recovery room
until the anesthesia wears off. The patient is walking and performing
strengthening exercises by the next day. TKR normally requires two to four
days in the hospital. Walking aids (canes) and physical therapy are
required for six to eight weeks. Possible complications, which are rare,
include bleeding, infection, stiffness, wound healing problems, wear, or
blood clots. TKR is a very successful procedure with a high degree of
patient satisfaction.
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Copyright © 2006
Brian Peck. All Rights Reserved. |
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