When a knee is so severely damaged by disease or injury, an artificial knee replacement may be considered. Knee "resurfacing" is a procedure in which the surface of the bones is actually replaced. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone. The removed cartilage and bone is replaced with man-made components that recreate the surface of the joint.
These parts may be cemented or "press-fit" into the bone. The under-surface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Nearly 600,000 knee replacement surgeries are done each year in the U.S.; with the most common age being between 50 and 80 years old.
Who might be a candidate for knee replacement?
The most common condition that results in the need for knee replacement surgery is osteoarthritis. This is a degenerative, joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees. Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury can also lead to degeneration of the knee joint. In addition, fractures, torn cartilage, or torn ligaments also can lead to irreversible damage to the knee joint over the years.
The decision to replace the painful knee with an artificial one is a decision between you and your doctor. Other alternative treatments may first be used, including assistive walking devices, anti-inflammatory medicines, injections, and bracing.
Quadriceps-sparing total knee replacement
This newer surgical technique allows surgeons to insert the same time-tested, reliable knee replacement implants through a shorter incision using a surgical approach that avoids trauma to the quadriceps muscle, which is the most important muscle group around the knee.
This technique uses an incision that is typically only three to four inches in length and the recovery time is much quicker—often permitting patients to walk with a cane within a couple of weeks of surgery or even earlier. In addition to this technique, there are different quad-sparing approaches used by different surgeons throughout Main Line Health.