Ouch, I Have a Charley Horse!
By Chris Leahy, PA-C Orthopedic and Reconstructive Surgery Chances are, you’ve had a sudden muscle cramp, often referred to as a...
If you are experiencing chronic pain and limited mobility in your knee, you may be a candidate for knee replacement surgery. Advancements in knee implant design and surgery techniques have made knee implant surgery more successful than ever before. With over 300,000 knee replacements performed last year in America, knee replacement surgery has become an important way to enhance the quality of life for many people.
Osteoarthritis is the most common reason to perform knee replacement surgery. As we get older, many people experience a reduction or wearing away of cartilage inside the knee. This causes pain due to bone rubbing on bone. Fractures of the knee, torn cartilage and damage to ligaments can also cause excessive wear of the knee joint, even many years after an injury. The following are common signs of severe arthritis in the knee:
Your orthopedic specialist will be able to give you a detailed diagnosis of your condition. A diagnosis usually starts with a complete history and physical examination, including X-rays of the knee. Once your doctor has all the information needed, he or she will discuss whether a knee replacement is right for you. With younger patients, a non-surgical treatment program is sometimes recommended. This is because patients under 50 years old are more likely to wear out their new knee prematurely, resulting in the need for a second knee surgery (also known as revision knee replacement).
Although the knee works much like a hinge, it is a very complex joint with surfaces that roll and glide in different directions as it undergoes movement. The latest knee implant designs replicate the natural movement of the knee joint more closely than ever before and take advantage of the posterior cruciate ligament (PCL) and collateral ligaments for support. Components are designed so that metal always articulates against plastic, allowing smoother movement and minimal wear of the joint.
During your knee replacement, your orthopedic surgeon will resurface the knee joint, replacing the worn or damaged surfaces with an implant made of metal alloys, ceramic material or high-density plastic. Most implants are usually cemented into place. However, some implants feature a cementless design, which relies on bone growth into the surface of the implant for fixation. These require a longer healing time than cementless designs. Your surgeon will help you decide which one is best for you.
Although there are over a hundred different prosthetic knee replacement designs, all fall into two categories – a fixed-bearing or a mobile-bearing design. Fixed bearing knee implants are usually highly successful for older patients. If you are a younger, more active patient your surgeon may recommend a mobile-bearing design since it may potentially offer greater performance with less wear. Reliant Medical Group orthopedic surgeon Dr. William Balcom has designed an innovative new mobile bearing knee implant called the Rotating Bearing Knee, which offers patients a greater range of motion while also minimizing wear. Before recommending a specific knee replacement design, your surgeon will carefully consider your age, gender, lifestyle, and occupation.
After completing knee replacement surgery, you will stay in the hospital for a few days while you recover. Starting the day after surgery, a physical therapist will show you how to exercise your new knee joint. It’s important to perform the required physical therapy to gain strength and keep the joint flexible. For several weeks after surgery, you may need the assistance of crutches or a walker. You will be able to gradually increase your mobility during the first 3 to 6 weeks after surgery until you are able to walk up and down stairs and resume most normal daily activities such as shopping and light housekeeping. Driving a car is also possible for most patients 4 to 6 weeks after their operation. After your recovery, you may engage in low-impact activities such as walking, swimming, biking or playing golf. Be sure to talk to your doctor before performing any higher impact activities such as jogging or skiing to make sure they are safe for you.
Today most knee replacements are designed to last approximately 20 years. However, a replacement knee joint is subject to wear just like your natural knee joint. For this reason, it is sometimes necessary to perform a second (revision) surgery in some older patients. The good news is that knee replacement surgery has been proven highly successful and more than 95% of people who undergo a total knee replacement enjoy significant pain relief and enhanced mobility. In fact, a total knee replacement offers one of the greatest quality of life improvements of any operation.