Total Knee Replacement

Knee Anatomy

The knee is one of the most complex joints in the body. Strong and stable, It is also the largest joint in the body and is commonly referred to as a “hinge” joint because it allows the knee to flex and extend. It supports much of our weight. The knee joint is formed by the shin bone (tibia), the thigh bone (femur) and the kneecap (patella). The joint is embedded with synovial liquid to lubricate the joint. The end of each bone is covered with a layer of cartilage, which cushions and protects the bone while allowing smooth movement. If damaged, the cartilage cannot repair itself.

Arthritis of the Knee

The most frequent cause of discomfort and chronic knee pain is arthritis, which is the leading cause of disability in India. Of the more than 100 types of arthritis, the following three are the most common causes of joint damage:

  • Osteoarthritis is a disease which involves the wearing away of the normal smooth joint surfaces. This results in bone-on-bone contact, producing pain and stiffness.

  • Rheumatoid Arthritis is an autoimmune disease (auto means self). With rheumatoid arthritis, the body’s immune system produces a chemical that attacks and destroys the synovial lining covering the joint capsule, the protective cartilage and the joint surface, causing pain, swelling, joint damage and loss of mobility. It affects women more often than men and can strike young and old alike.

  • Trauma-related arthritis, which results when the joint is injured, is the third most common form of arthritis. It also causes joint damage, pain and loss of mobility.

  • Knee Replacement

    When debilitating pain, accompanied by stiffness, swelling and limited motion in your knee keep you from your daily activities, it may be time to consider total knee replacement . Total knee replacements have been used to treat joint disease since the 1970s and it is one of the most successful ortopaedic procedures.

    When debilitating pain, accompanied by stiffness, swelling and limited motion in your knee keep you from your daily activities and medications, physical therapy and other conservative methods of treatment no longer relieve pain, it may be time to consider total knee replacement. Total knee replacements have been used to treat joint disease since the 1970s and it is one of the most successful ortopaedic procedures.

    Knee Replacement

    In total knee replacement, your surgeon will make a cut down the front of the knee to expose your kneecap. This is then moved to the side to reach the damaged joint's surfaces, and the knee is flexed. The damaged ends of the femur.....and tibia are carefully cut away. The end of your tibia is replaced by a flat metal plate and a plastic spacer, which reduces friction when your joint moves. The end of your femur is replaced by a curved piece of metal. Together they create an artificial joint. Your artificial joint may last 10-15 years, sometimes longer, after which another replacement may be needed. In most people, total knee replacement and physiotherapy will significantly improve your quality of life.

    Dr. (Prof.) C.S. Yadav uses the Midvatus (MV) approach to total knee replacement. Some investigators report a better outcome in the early postoperative period in patients compared to other standard approaches. The midvastus approach was found to offer early advantage in terms of less pain and earlier return to function.

    Revision (Repeat) Knee Joint Replacement Surgery

    If for any reason knee replacement surgery fails, revision surgery may be necessary. In revision surgery, the original knee joint replacement components are removed and replaced with new ones. Revision surgeries are more complex and the implants may not last as long as first time or primary joint replacements. Failure can occur for a variety of reasons including:

  • repeated dislocations

  • loosening and wear of the new joint

  • bone loss

  • infection

  • Sometimes the joint fails when too much stress is placed on it over time. It is extremely important to follow the long term precautions to protect your joint.