How Would You Know If You Need a Knee Replacement?
Consisting of the femur, tibia and patella, stabilised by soft tissues and bathed in synovial fluid, damage to this joint often requires a knee replacement. The knee is a hinge joint, so rather like a cat flap, it can only move backwards and forwards. This restricted motion is in contrast to that of the hip, a ball and socket joint that also enables a limited degree of rotation between the femur and acetabulum. The knee is designed to support most of our body weight when standing, walking, running, and even squatting. However, even a relatively minor injury could make these typical human activities difficult and sometimes impossible.
Many of those reading this article who love to play sports have, at some time, accidentally twisted their knee while playing. In most cases, treatments to reduce swelling and relieve pain, combined with a spot of rest and appropriate physiotherapy, would have been enough to do the trick. However, a partial or total joint replacement will sometimes be the only option where the damage to the joint is too extensive for a palliative approach.
Some Typical Reasons to Perform a Knee Replacement
In addition to traumatic injuries to the joint, several medical conditions could also lead to the need for this type of surgery, more often known by orthopaedic specialists as arthroplasty. The following is a list of the five more common ones:
- Osteoarthritis: This is often described as a “wear and tear” disease and affects more than 32,5 million American adults alone. It is typified by the progressive loss of protective collagen on the articulating surfaces.
- Rheumatoid Arthritis: This is a chronic inflammatory disorder of autoimmune origin that, in addition to causing painful, swollen joints, can cause damage to the lungs, heart and blood vessels.
- Gout: The severe joint pain and swelling in this condition is caused by the formation of tiny uric acid crystals. If untreated or resistant to treatment, gout can cause permanent joint damage and might even require a knee replacement when this joint is badly affected.
- Bone Dysplasias: This is a general term for abnormal bone growth conditions, including deformities and loss of cartilage. They are often present from birth and may require surgery if they are excessively painful or severely limit a patient’s mobility.
- Avascular Necrosis: If the blood supply to a bone in the knee is compromised, the affected bone can become necrotic (it can die). Arthroplasty will eventually be the only option to relieve the symptoms and improve the joint’s movement.
About Knee Replacement Surgery
Once a diagnosis is confirmed, in most cases, the attending physician will start with a conservative routine, relying on painkillers to relieve the pain and swelling. Only if and when these are no longer effective can you expect a referral to an orthopaedic surgeon.
Today, most surgeons adopt a minimally invasive technique, accessing the joint through tiny incisions, removing the damaged parts and replacing them with metal and plastic prostheses. The procedure limits blood loss and infection risks and reduces recovery times.
Dr Jan De Vos performs hip, shoulder and knee replacement surgery at Pretoria’s Wilgers Life Hospital. He is always happy for patients to contact him to discuss arthroplasty and other orthopaedic procedures they might be considering.