Our Summary

This research paper discusses the challenges and potential solutions regarding knee replacement surgery. Despite the success of total knee replacement surgery, there are over 20,000 cases each year where the surgery needs to be redone. In the past, a method called cementless fixation was suggested to decrease the number of failures caused by the knee replacement loosening. However, initial results of this method were disappointing, as it was linked to the early loosening of the knee replacement without infection. As a result, the method using cement to fix the knee replacement has remained the most reliable technique. However, due to changes in the average patient’s health and circumstances, some doctors are considering the cementless method again.

FAQs

  1. What is total knee arthroplasty (TKA)?
  2. What are the common issues associated with total knee arthroplasty (TKA)?
  3. What is the difference between cemented and cementless fixation in total knee arthroplasty (TKA)?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow a proper rehabilitation and exercise program after surgery. This can help improve strength, flexibility, and range of motion in the knee, leading to better outcomes and a quicker recovery. It is important to work closely with a physical therapist to ensure proper technique and progress at a safe pace.

Suitable For

Patients who are typically recommended for knee replacement surgery include those who have severe knee pain that limits daily activities, have significant knee stiffness, have failed conservative treatments such as medication or physical therapy, have knee deformities, or have advanced arthritis in the knee joint. Additionally, patients who are relatively young and active may also be recommended for knee replacement surgery, as they may benefit from improved function and quality of life following the procedure.

Timeline

Before knee replacement:

  • Patient experiences chronic knee pain, stiffness, swelling, and limited mobility
  • Patient may have tried conservative treatments such as physical therapy, medications, and injections without success
  • Patient consults with an orthopedic surgeon who recommends knee replacement surgery
  • Pre-operative evaluations including imaging tests and medical history review are conducted
  • Patient undergoes pre-operative education and preparation for surgery

After knee replacement:

  • Patient undergoes knee replacement surgery, which typically takes 1-2 hours
  • Patient stays in the hospital for 1-3 days for recovery and rehabilitation
  • Physical therapy begins immediately to help regain strength and mobility in the knee
  • Patient may experience some pain and discomfort initially but it gradually improves with medication and therapy
  • Follow-up appointments with the surgeon are scheduled to monitor healing and progress
  • Patient gradually resumes normal activities and experiences improved mobility and reduced pain in the knee
  • Full recovery can take several months, with continued physical therapy and exercise recommended for optimal outcomes

What to Ask Your Doctor

  1. What are the risks and benefits associated with cementless knee replacement compared to cemented knee replacement?
  2. How long does the recovery process typically take for a cementless knee replacement?
  3. What is the expected lifespan of a cementless knee replacement compared to a cemented knee replacement?
  4. What factors make a patient a good candidate for cementless knee replacement?
  5. What is the success rate of cementless knee replacement in terms of reducing pain and improving function?
  6. Are there any specific restrictions or limitations on activities following a cementless knee replacement?
  7. What is the likelihood of needing a revision surgery with a cementless knee replacement compared to a cemented knee replacement?
  8. Will I need any special post-operative care or monitoring with a cementless knee replacement?
  9. How does the cost of a cementless knee replacement compare to a cemented knee replacement?
  10. What additional information or research should I consider before deciding on cementless knee replacement surgery?

Reference

Authors: Papas PV, Congiusta D, Cushner FD. Journal: J Knee Surg. 2019 Jul;32(7):596-599. doi: 10.1055/s-0039-1678687. Epub 2019 Mar 1. PMID: 30822792