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Total Knee Replacement

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel joint pain while you are sitting or lying down.

If medications, changing your activity level and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Another alternative is resurfacing, which allows damaged and worn surfaces of your knee to be repaired to relieve joint and muscle pain, correct leg deformity and help you to resume normal activities.

Recommendations for surgery are based on a patient's pain and disability, not age. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

Total Knee Replacement Surgery
A total knee replacement is a surgical procedure in which a diseased knee joint is replaced with artificial material. The knee is a hinge joint that provides motion at the point where the thigh meets the lower leg.

During a total knee replacement, the end of the femur is removed and replaced with a metal shell. The end of the lower leg is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic “button” may be added under the kneecap surface.

Who Undergoes Total Knee Replacement and Why?
The first knee replacement—one of the most important orthopedic surgical advances of the 20th century—was performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased the surgery’s effectiveness.

Most people undergo knee replacement because of knee arthritis. Arthritis causes inflammation around the joint. This inflammation can lead to cartilage loss and exposed bone instead of the normal, smooth joint surface around the knee.

Today, approximately 581,000 knee replacements are performed each year in the United States.

The following are some symptoms that knee replacement candidates suffer from:

  • Severe knee pain that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs
  • Moderate or severe knee pain while resting, either day or night
  • Chronic knee inflammation and swelling that does not improve with rest or medications
  • Knee deformity such as a bowing in or out of your knee
  • An inability to bend and straighten your knee completely
  • Lack of pain relief from nonsteroidal anti-inflammatory drugs (NSAIDs)—these medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis
  • Inability to tolerate complications from pain medications
  • Failure to substantially improve with other treatments, such as cortisone injections, physical therapy or other surgeries

Anatomy of a Healthy Knee
The knee is the largest joint in the body. Normal knee function is required to perform most everyday activities. The knee is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shinbone (tibia) and the kneecap (patella), which slides in a groove on the end of the femur. Large ligaments attach to the femur and tibia to provide stability. The long thigh muscles give the knee strength.

When Joint Pain Symptoms Start to Appear
The joint surfaces where these three bones touch are covered with articular cartilage—a smooth substance that cushions the bones and enables them to move easily. All remaining surfaces of the knee are covered by a thin, smooth tissue liner called the synovial membrane. This membrane releases a special fluid that lubricates the knee, reducing friction to nearly zero in a healthy knee.

Normally, all of these components work in harmony. But joint disease or injury can disrupt this harmony, resulting in joint pain and swelling, muscle weakness, and reduced function.

Is Total Knee Replacement for You?
Whether to have knee replacement surgery should be a cooperative decision made by you, your family and your orthopedic surgeon. The process of making this decision typically begins with a referral by your primary care doctor to an orthopedic surgeon for an initial evaluation.

Alternatives to Total Knee Replacement Surgery
At Gwinnett Medical Center, we offer a range of alternatives to total knee replacement procedures. Your orthopedic surgeon may discuss unicompartmental knee replacement or resurfacing, or a bicompartmental resurfacing procedure.

To learn more about other procedures we perform, go to Procedures or call 678-312-5000.