The knee is one of the most complex joints in the human body. It needs to accommodate a wide variety of movements, provide stability, and support the weight of the body.
In order for the knee to properly function, it has a layer of cartilage covering the outer surfaces of the bones that forms the knee joint. This tight but smooth tissue is a shock absorber that helps to protect and cushion the adjacent bone surfaces, and provides a smooth and low friction range of motion of the joint without pain.
However, overexertion, damage from repetitive motions or an injury, and certain conditions (such as osteoarthritis or rheumatoid arthritis) may cause the cartilage itself to wear down over time – causing pain and limited function of the joint. As the damage to the cartilage surface in the knee becomes more severe, it causes problems with knee movement such as stiffness, swelling, and pain.
Do I Need a Knee Replacement?
If all of the normal cartilage cushions in the knee is worn away, causing painful bone-against-bone arthritis, then knee pain and knee disability can be quite severe. Initial treatment options involve anti-inflammatory medications, knee injections (steroid injections, lubricant injections, and PRP injections), physical therapy and activity modification, and bracing.
If you have failed conservative treatments and have end-stage knee arthritis, the way to fix the knee may involve either a partial knee replacement or a total knee replacement (also called a full knee replacement or a total knee arthroplasty). After careful evaluation of your x-ray findings and a physical examination of your knee, you and your orthopedic surgeon will work together to determine your individual goals and treatment options.
A partial knee replacement involves resurfacing just one area of the knee that is worn away from arthritis, and keeping the other healthy areas in the knee. Since there is less modification of the structure of the knee, there is typically less surgical dissection of tissues around the knee, and less blood loss related to surgery. Healing and rehabilitation also usually proceeds faster, because there are fewer tissues that need to heal after the procedure. Since a partial knee replacement preserves more of the original joint than a total knee replacement, the final mobility of the knee is frequently better, and patients tend to feel the knee is more natural or normal.
However, a partial knee replacement is not always enough if the damage to the knee is more diffuse. Depending on the extent and location of the cartilage damage in the knee, and the how healthy the ligaments in the knee have remained, a total knee replacement might be the best option for treating your knee arthritis.
What Parts of the Knee Need Replacing?
In many patients with knee arthritis, the damaged part of the knee is the medial compartment, or the inner part of the knee. This is the side that is closest to the other knee. For others the arthritis is located in the front of the knee beneath the knee cap (the patellofemoral joint), or on the outer aspect of the knee (the lateral compartment). Most commonly, patients develop arthritis throughout the entire knee, but one spot can be more involved than another.
When the damage is localized, a partial knee replacement becomes more attractive, as repair is only necessary for certain areas. If there is significant damage throughout all parts of the knee, such as with severe arthritis or ligament damage, a total knee replacement may be in order.
For all types of knee replacement, metal and plastic-based prosthetic materials are used to replace the damaged sections by resurfacing areas in the knee, similar to placing a crown on a tooth. With proper rehabilitation after the operation, patients work to improve their knee range of motion initially. Over time, as healing progresses and strength improves, improved function without the pain and swelling of arthritis can be achieved.
Board-Certified Orthopedic Knee Replacement Surgeon
If you have knee problems, an orthopedic surgeon will be able to give you a proper diagnosis and discuss all of the options available to you, starting with nonsurgical treatments and sometimes offering a surgical cure. Act now to prevent further knee pain and improve your physical function.
Dr. Brett Gilbert caters to patients in Raleigh, Durham, Apex, and throughout the Triangle area. With state-of-the-art equipment and top-notch training, he aims to combine technical expertise with a compassionate approach to patient caregiving his patients the personalized treatment they deserve.
Call our office today at (919) 788-8797 and schedule an appointment with Dr. Gilbert, a board-certified orthopedic surgeon specializing in the treatment of hip and knee arthritis. You may also easily request an appointment through our online form. We look forward to hearing from you!