Knee transplant, often referred to as knee replacement surgery, is a medical procedure in which a damaged or diseased knee joint is replaced with an artificial implant. Here are some key points about knee replacement surgery:
Types of Knee Replacement :
Knee replacement surgery, also known as knee arthroplasty, can be classified into several types
based on the extent of the surgery and the specific parts of the knee being replaced. Here are the
primary types:
1. Total Knee Replacement (TKR) : Involves replacing the entire knee joint.
2. Partial Knee Replacement (PKR) : Only the damaged part of the knee is replaced.
3. Revision Knee Replacement : Replacement of a previously implanted knee prosthesis.
Total Knee Replacement (TKR) :
During this process, prosthetic components replace the knee joint entirely. It is the most common type of knee replacement surgery and is typically recommended for patients with severe arthritis or significant knee damage.
Components :
Femoral component : This part replaces the femur which is the tip of the thigh bone.
Tibial component : Replaces the top of the shin bone (tibia).
Patellar component : May be used to replace the kneecap (patella).
Partial (Unicompartmental) Knee Replacement (PKR) :
This surgery is performed when damage is limited to a single compartment of the knee, typically either the medial (inside) or lateral (outside) compartment. It preserves more of the patient’s natural
knee compared to a total knee replacement.
Benefits :
» Less invasive than TKR.
» Faster recovery.
» Preservation of healthy bone and ligaments.
Kneecap (Patellofemoral) Replacement
This type of knee replacement focuses on replacing only the undersurface of the kneecap and the groove at the end of the thigh bone where the kneecap sits. It is suitable for patients with arthritis
confined to the patellofemoral compartment.
Advantages :
» Minimally invasive. Retains most of the knee’s natural structure.
Complex (Revision) Knee Replacement
A revision knee replacement is performed when a previous knee replacement has failed due to wear,
loosening, infection, or other complications. Specialized implants are needed for this more intricate
procedure.
Components :
Custom or specialized prosthetics. Additional components to ensure stability and
alignment.
Minimally Invasive Knee Replacement
This technique uses smaller incisions compared to traditional knee replacement surgery, which can
lead to quicker recovery times, less pain, and reduced scarring. Both total and partial knee
replacements can be performed using minimally invasive techniques.
Benefits :
Reduced muscle and tissue damage. Faster rehabilitation.
Indications for Knee Surgery :
Knee surgery may be indicated for a variety of reasons, depending on the underlying condition,
severity of symptoms, and the patient's overall health and activity level. The decision to proceed with
surgery should be made collaboratively by the patient and their healthcare team, considering the
potential benefits, risks, and the patient's individual needs and goals.
Common indications for knee surgery include:
Osteoarthritis : Severe pain that limits everyday activities Chronic inflammation and swelling
that doesn't improve with rest or medications. Significant stiffness and reduced range of
motion. abnormality, such as a knee bend or release.
Rheumatoid Arthritis : Persistent pain and swelling. Joint damage visible on X-rays or other
imaging studies. Failure to react to standard therapies including medicine and physical therapy
Meniscal Tears : Pain, particularly when twisting or rotating the knee. Swelling and stiffness.
Catching or locking of the knee. Inability to fully move the knee
Ligament Injuries (e.g., ACL, PCL) : Instability in the knee joint. Pain and swelling. Difficulty
bearing weight on the affected leg. Active individuals or athletes who wish to return to sports or
activities.
Fractures : Severe pain and inability to move the knee. Bone fragments that may interfere with
joint function. Failure of conservative treatments like casting or bracing.
Patellar (Kneecap) Issues : Dislocation or subluxation of the patella. Chronic patellar pain not
responsive to conservative treatments. Malalignment or instability of the patella.
Cartilage Injuries : Persistent knee pain. Swelling. Mechanical symptoms like catching or
locking.
Tumors : Presence of benign or malignant tumors affecting the knee joint.
Infection : Severe infection within the knee joint that doesn't respond to antibiotics.
Procedure of Knee Replacement :
Knee replacement surgery, also known as knee arthroplasty, involves replacing a damaged or worn-
out knee joint with an artificial joint (prosthesis).
Preoperative Preparation :
Evaluation : A thorough medical evaluation including medical history, physical examination,
and imaging tests (X-rays, MRI) to assess the knee's condition.
Preoperative Testing : Blood tests, EKG, and other tests to ensure the patient is fit for surgery.
Patient Education : Information on the procedure, postoperative care, and rehabilitation.
Surgical Procedure:
Anesthesia is administered either as general anesthesia (patient is unconscious) or regional
anesthesia (spinal or epidural, where the lower body is numbed). A surgical cut is made on the front
of the knee to access the joint. Removal of damaged bone and cartilage from the thighbone (femur),
shinbone (tibia), and kneecap (patella). The removed bone and cartilage are replaced with metal
components that recreate the surface of the joint. A plastic spacer is placed between the metal
components to ensure smooth movement. The implants are fixed to the bone using either cemented
or cementless techniques. The incision is closed with stitches or staples, and a sterile bandage is
applied.
Postoperative Care :
1. The patient is monitored in the recovery room until the anesthesia wears off.
2. Medications are administered to manage pain.
3. Physical Therapy begins within 24 hours post-surgery, focusing on knee movement and
walking with assistance.
4. Hospital Stay typically lasts a few days, depending on the patient’s progress and overall
health.
5. Continued physical therapy at home or in a rehab center. Activities to strengthen the knee and
improve mobility.
6. Regular check-ups with the surgeon to monitor recovery and address any concerns.
Recovery :
Most patients experience significant pain relief, improved mobility, and better quality of life after knee
replacement surgery. Full recovery can take several months, and the longevity of the implant typically
ranges from 15 to 20 years, depending on factors like activity level and overall health.
Knee replacement surgery can significantly improve the quality of life for individuals with severe knee
damage, leading to reduced pain and improved mobility.
Activity Modifications : Avoiding high-impact activities that may damage the new knee.
Regular Exercise : To maintain strength and mobility.
Periodic Check-ups : To ensure the implant is functioning well.