Our Summary

The research paper explores the risk of needing a second knee surgery after undergoing a partial knee replacement, known as a unicompartmental knee replacement (UKR). This type of knee surgery is often considered a precursor to a total knee replacement (TKR), especially in younger patients. The study used data from 1,000 patients who had a UKR to calculate the chances of needing a revision surgery in their lifetime. The results showed that the risk of needing a second surgery decreases as the patient’s age at the time of the first surgery increases. With a 15% risk at age 55, 11% at 65, 7% at 75, and 4% at 85. The findings suggest that UKRs are a valid option as a definitive knee replacement, not just a precursor to a TKR. This information, along with the known benefits of UKR like faster recovery and lower morbidity and mortality, can be helpful for patients when deciding between a UKR and a TKR.

FAQs

  1. What is a unicompartmental knee replacement (UKR) and how does it differ from a total knee replacement (TKR)?
  2. Based on the study, how does the risk of needing a second knee surgery change with the patient’s age at the time of the first surgery?
  3. What are some of the benefits of a UKR compared to a TKR as mentioned in the research paper?

Doctor’s Tip

A helpful tip a doctor might tell a patient about knee replacement is to follow a proper rehabilitation and physical therapy program after surgery. This will help improve strength, flexibility, and range of motion in the knee, leading to better long-term outcomes and reducing the risk of needing a revision surgery in the future. It is important to be diligent with exercises and follow the guidance of healthcare professionals to ensure a successful recovery.

Suitable For

Patients who are typically recommended for knee replacement surgery include those with severe knee pain that limits daily activities, knee stiffness, swelling, and instability. Other factors that may indicate the need for knee replacement surgery include:

  • Advanced arthritis or degenerative joint disease in the knee
  • Failure to respond to non-surgical treatments such as medications, physical therapy, or injections
  • Significant joint damage or deformity
  • Inability to participate in desired activities or sports due to knee pain or limitations
  • Previous knee injuries or surgeries that have not provided adequate relief

Overall, the decision to undergo knee replacement surgery is based on a combination of factors including the severity of symptoms, the patient’s overall health, age, and lifestyle goals. It is important for patients to discuss their options with a qualified orthopedic surgeon to determine the most appropriate treatment plan for their individual needs.

Timeline

Before knee replacement:

  1. Patient experiences chronic knee pain, stiffness, and swelling.
  2. Patient undergoes various conservative treatments such as physical therapy, medications, and injections to manage symptoms.
  3. Patient consults with an orthopedic surgeon who recommends knee replacement surgery as a last resort option.

After knee replacement:

  1. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.
  2. Patient undergoes knee replacement surgery, either partial or total, which involves replacing the damaged knee joint with an artificial implant.
  3. Patient stays in the hospital for a few days for post-operative care, including pain management and physical therapy.
  4. Patient transitions to outpatient physical therapy to regain strength, flexibility, and range of motion in the knee.
  5. Patient gradually resumes daily activities and experiences reduced pain and improved mobility in the knee.
  6. Patient follows up with their orthopedic surgeon for routine check-ups to monitor the success of the knee replacement and address any concerns or complications.

What to Ask Your Doctor

  1. What are the risks associated with undergoing a knee replacement surgery, specifically a unicompartmental knee replacement (UKR)?

  2. How long can I expect the recovery process to take after a knee replacement surgery?

  3. What are the potential long-term complications or side effects of a knee replacement surgery?

  4. How will a knee replacement surgery impact my daily activities and quality of life?

  5. What are the expected outcomes of a knee replacement surgery, in terms of pain relief and improved mobility?

  6. What are the alternatives to knee replacement surgery, and how do they compare in terms of effectiveness and risks?

  7. How many knee replacement surgeries have you performed, and what is your success rate?

  8. What type of rehabilitation or physical therapy will be necessary after a knee replacement surgery?

  9. What are the factors that could increase my risk of needing a second knee surgery after a UKR?

  10. How long can I expect the artificial knee joint to last, and what factors can affect its longevity?

Reference

Authors: Kennedy JA, Burn E, Mohammad HR, Mellon SJ, Judge A, Murray DW. Journal: Knee Surg Sports Traumatol Arthrosc. 2020 Dec;28(12):3935-3941. doi: 10.1007/s00167-020-05863-3. Epub 2020 Feb 12. PMID: 32052120