Our Summary

This research paper is about a procedure called total knee arthroplasty (TKA), which is basically a total knee replacement surgery. This type of surgery is becoming more popular among younger, active people. Traditionally, a material called cement has been used to fix the new knee in place. However, there is growing interest in using a method that doesn’t use cement, because it may last longer.

Advances in how these knee replacements are made could make this cementless method even better in the long run. Current studies show that the results of these newer, cementless knee replacements are about the same as the traditional, cemented ones.

However, it’s important to choose the right patients for this cementless method, as it may not work for everyone. More high-quality research is needed to understand the differences between the two methods and the benefits of each.

FAQs

  1. Who are the typical candidates for total knee arthroplasty (TKA)?
  2. What are the differences between cemented and cementless fixation techniques in TKA?
  3. What are the potential benefits of using cementless TKA systems?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow a personalized rehabilitation plan to ensure a successful recovery. This may include physical therapy exercises, walking aids, and lifestyle modifications to protect the new knee joint. It is important to communicate any concerns or difficulties with the healthcare team to address them promptly and optimize the outcome of the surgery.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who are experiencing severe knee pain and disability that is not alleviated by other treatments such as medication, physical therapy, or injections. These patients may have conditions such as osteoarthritis, rheumatoid arthritis, or traumatic injury that have caused extensive damage to the knee joint.

In recent years, there has been a trend towards recommending knee replacement surgery for younger and more active individuals who are looking to maintain an active lifestyle. These patients may have more specific demands and expectations for their knee function post-surgery, making the choice of implant and fixation method particularly important.

For patients considering a cementless knee replacement, it is important that they have good bone quality and are at a lower risk for infection, as these factors can impact the success of the procedure. Additionally, patients should have realistic expectations about the potential benefits and risks of cementless fixation compared to traditional cemented fixation.

Ultimately, the decision to recommend knee replacement surgery and the choice of implant and fixation method should be made in consultation with a skilled orthopedic surgeon who can assess the individual patient’s needs and goals.

Timeline

Before knee replacement surgery:

  • Patient experiences chronic knee pain, stiffness, swelling, and limited mobility
  • Patient undergoes a thorough evaluation by a healthcare provider, including physical examination, imaging tests, and possibly a trial of conservative treatments such as physical therapy or medications
  • Patient and healthcare provider discuss the risks and benefits of knee replacement surgery, as well as the expected outcomes and recovery process
  • Patient undergoes pre-operative preparations, including medical clearance, pre-surgical consultations, and education on post-operative care and rehabilitation

After knee replacement surgery:

  • Patient undergoes the surgical procedure, which involves removing damaged bone and cartilage and replacing it with a prosthetic implant
  • Patient typically stays in the hospital for a few days for monitoring and initial rehabilitation
  • Patient begins a comprehensive rehabilitation program, which includes physical therapy, exercise, and pain management to regain strength, flexibility, and function in the knee
  • Patient follows up with their healthcare provider for monitoring of the surgical site, management of any complications, and ongoing assessment of the knee function
  • Over time, the patient experiences improvements in pain, mobility, and quality of life, with the goal of returning to normal activities and enjoying a more active lifestyle without the limitations of knee pain.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with knee replacement surgery?
  2. What is the expected recovery time and rehabilitation process after knee replacement surgery?
  3. How long can I expect the knee replacement to last and what factors can affect its longevity?
  4. What type of knee replacement implant will be used in my surgery and why was this specific implant chosen for me?
  5. What are the differences between cemented and cementless fixation techniques for knee replacement and why would one be recommended over the other for me?
  6. How many knee replacement surgeries have you performed using cementless fixation techniques and what has been the success rate?
  7. What can I do to optimize the success of my knee replacement surgery and improve long-term outcomes?
  8. Are there any lifestyle changes or precautions I should take after knee replacement surgery to prevent complications or implant failure?
  9. What are the potential signs of complications or implant failure that I should watch for after surgery?
  10. Are there any alternative treatments or interventions that could be considered before resorting to knee replacement surgery?

Reference

Authors: AlShehri Y, Megaloikonomos PD, Neufeld ME, Howard LC, Greidanus NV, Garbuz DS, Masri BA. Journal: JBJS Rev. 2024 Jul 5;12(7). doi: 10.2106/JBJS.RVW.24.00064. eCollection 2024 Jul 1. PMID: 38968372