Our Summary

This paper discusses the treatment of severe joint disease with a procedure known as total knee arthroplasty (TKA), or knee replacement surgery. While typical designs and surgical methods have been successful, some patients are not completely satisfied with the results. To improve this, new surgical techniques and tools have been developed, such as the use of accelerometers for navigation, custom-made surgical tools for each patient, and robotic assistance in the surgery. The authors hope these innovations will increase the precision of the surgery, which may lead to better results for patients in terms of function and longevity of the implant. The paper reviews the current state of these new technologies as seen in recent orthopedic research papers.

FAQs

  1. What is total knee arthroplasty and what conditions does it treat?
  2. What are some of the surgical innovations developed to improve the accuracy and precision of total knee arthroplasty surgery?
  3. How can these surgical innovations potentially improve functional outcomes and implant survivorship in total knee arthroplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement is to follow a comprehensive rehabilitation program after surgery. This program typically includes physical therapy exercises to help improve strength, flexibility, and range of motion in the knee. By actively participating in rehabilitation, patients can speed up their recovery process and achieve better outcomes in terms of mobility and function. It is important to follow the guidance of healthcare professionals and adhere to the prescribed exercises to ensure a successful knee replacement surgery.

Suitable For

Patients who are typically recommended for knee replacement surgery are those suffering from advanced degenerative joint disease, also known as osteoarthritis. These patients often experience severe knee pain, stiffness, swelling, and limited range of motion that significantly impacts their quality of life and ability to perform daily activities. Candidates for knee replacement surgery are usually those who have not obtained relief from conservative treatments such as medication, physical therapy, and injections. Additionally, patients who have significant joint damage as seen on imaging studies such as X-rays or MRIs may also be recommended for knee replacement surgery.

Timeline

  • Before knee replacement:
  1. Patient experiences chronic knee pain, stiffness, and swelling that does not improve with conservative treatments such as medications, physical therapy, and injections.
  2. Patient undergoes a thorough evaluation by a orthopedic surgeon, including imaging studies such as X-rays and MRIs, to determine the extent of joint damage and candidacy for surgery.
  3. Patient discusses the risks and benefits of knee replacement surgery with their surgeon, and decides to proceed with the procedure.
  4. Patient undergoes preoperative testing and preparation, including blood work, physical therapy, and possibly weight loss to optimize surgical outcomes.
  • After knee replacement:
  1. Patient undergoes total knee arthroplasty surgery, which involves removing damaged bone and cartilage from the knee joint and replacing it with artificial components made of metal and plastic.
  2. Patient stays in the hospital for a few days after surgery for monitoring and rehabilitation, including physical therapy to regain strength and mobility in the knee.
  3. Patient continues with outpatient physical therapy and exercises to improve range of motion and build muscle strength in the knee.
  4. Over the following weeks and months, patient gradually resumes normal activities and experiences reduced pain and improved function in the replaced knee.
  5. Patient follows up with their surgeon for regular check-ups and monitoring of the replaced knee, and may need to avoid high-impact activities to prolong the lifespan of the artificial joint.

What to Ask Your Doctor

  1. What are the risks and benefits of total knee arthroplasty surgery?
  2. How long is the recovery process after knee replacement surgery?
  3. What type of implant will be used in the surgery and why?
  4. Will I need physical therapy after the surgery, and for how long?
  5. What activities should I avoid after knee replacement surgery?
  6. How long can I expect the knee replacement to last?
  7. Are there any alternative treatments to knee replacement that I should consider?
  8. What type of anesthesia will be used during the surgery?
  9. How many knee replacement surgeries have you performed, and what is your success rate?
  10. Will I need any additional tests or evaluations before the surgery?

Reference

Authors: Keeney JA. Journal: Orthopedics. 2016 Jul 1;39(4):217-20. doi: 10.3928/01477447-20160628-03. PMID: 27434889