Our Summary

This research paper discusses a common orthopedic surgery in the U.S., called total knee arthroplasty. The main goals of this surgery are to restore alignment and balance to the leg and knee. Traditionally, surgeons have aimed to achieve a neutral alignment, but recently there’s been a shift towards focusing on the natural movement (kinematic alignment) of the knee instead. Alongside these new ideas, new technologies have been introduced to help surgeons more accurately achieve the best possible alignment and balance for the knee.

FAQs

  1. What is total knee arthroplasty and how common is it in the United States?
  2. What are the primary concepts in the surgical technique of knee replacement?
  3. What new technologies have been introduced to improve the accuracy of optimal limb alignment and soft-tissue balance in knee replacement surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about knee replacement surgery is to diligently follow the post-operative rehabilitation program prescribed by their healthcare team. This typically includes physical therapy exercises to strengthen the surrounding muscles, improve range of motion, and aid in the recovery process. Consistency and dedication to the rehabilitation program can greatly impact the success of the knee replacement surgery and help the patient regain mobility and function in their knee.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits their daily activities and quality of life. These patients may have conditions such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis that have not responded to conservative treatments such as medication, physical therapy, or injections. Patients who have significant deformities in their knee joint, such as bowleggedness or knock-knees, may also be candidates for knee replacement surgery.

It is important for patients considering knee replacement surgery to undergo a thorough evaluation by a healthcare provider to determine if they are a good candidate for the procedure. Factors such as age, overall health, and the severity of the knee joint damage will be taken into consideration when determining if knee replacement surgery is the best treatment option. In addition, patients who are willing to commit to post-operative rehabilitation and follow-up care are more likely to have successful outcomes after knee replacement surgery.

Timeline

Before knee replacement:

  1. Patient meets with orthopedic surgeon to discuss symptoms and potential treatment options.
  2. Patient undergoes pre-operative testing and preparation, including blood tests, X-rays, and physical therapy.
  3. Patient receives education on the surgery, recovery process, and potential risks and complications.
  4. Patient may be advised to make lifestyle changes, such as losing weight or quitting smoking, to improve surgical outcomes.

After knee replacement:

  1. Patient undergoes total knee arthroplasty surgery to replace the damaged knee joint with an artificial implant.
  2. Patient typically stays in the hospital for a few days for post-operative care and physical therapy.
  3. Patient begins a rehabilitation program to regain strength, flexibility, and range of motion in the knee.
  4. Patient may experience some pain, swelling, and stiffness in the knee in the weeks following surgery.
  5. Over time, patient gradually resumes normal activities and experiences improved mobility and reduced pain in the replaced knee.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with knee replacement surgery?
  2. How long is the recovery process and what can I expect in terms of pain management?
  3. Will I need physical therapy after surgery and for how long?
  4. What type of implant will be used in the surgery and why was that particular choice made?
  5. How long can I expect the knee replacement to last?
  6. Will I have any restrictions on activities or movements after the surgery?
  7. What are the chances of needing a revision surgery in the future?
  8. How experienced are you in performing knee replacement surgeries?
  9. Are there any alternative treatments to consider before deciding on knee replacement surgery?
  10. What steps can I take to optimize my recovery and ensure the best outcome from the surgery?

Reference

Authors: Jaffe WL, Dundon JM, Camus T. Journal: J Am Acad Orthop Surg. 2018 Oct 15;26(20):709-716. doi: 10.5435/JAAOS-D-16-00428. PMID: 30134305