Knee Arthroplasty

Knee Arthroplasty

In cases where osteoarthritis is severe or has not improved after medication, physical therapy, and behavioral modification, knee replacement surgery is another option to reduce pain, increase joint range of motion, and improve quality of life. Currently, knee replacement surgery can be performed in several ways.

From studies of knee replacement surgery, the results are excellent, with a lifespan of 10 and 15 years for more than 90%. The material of the artificial knee joint surface is made of metal and polymer, which is strong and safe for the body, and has received international certification from the United States (FDA). The artificial knee surface is attached to the bone with cement (bone cement) to increase the strength of the adhesion between the metal and bone surfaces. Currently, there are many types of artificial knees to choose from, depending on the doctor's discretion, the patient's needs, and the budget. Today's knee replacement surgery is no longer scary. Because the administration of more effective painkillers along with modern surgical techniques allows patients to recover faster. And most patients can walk with a walking aid within a day after surgery if there are no complications, shortening the hospital stay after surgery to just 5-7 days on average.

Unicompartmental Knee Arthroplasty (UKA)

Today, unicompartmental knee arthroplasty is a good option for patients with partial osteoarthritis. Doctors may recommend a partial knee replacement if the patient’s arthritis is limited to one part of the knee.

The knee joint is usually divided into three main compartments: the medial compartment (the inner part of the knee), the lateral compartment (the outer part), and the patella compartment. In a unicompartmental partial knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and other healthy bone remain intact, unlike a total knee replacement.

Advantages of a partial knee replacement

• Very fast recovery

• Less pain after surgery

• Less blood loss

Total Knee Arthroplasty

A surgical procedure used to treat severe osteoarthritis of the knee that removes the damaged knee joint surfaces and replaces them with a total artificial knee surface, including the femur, tibia, and patella. A total knee replacement involves removing all of the damaged knee surfaces of the femur and the upper part of the tibia (the medial and lateral compartments).

Who is a total knee replacement suitable for?

Patients with severe knee pain that reduces their quality of life, are unable to perform daily activities as usual, such as standing up and sitting, walking up and down stairs, shopping, or pain that occurs even when resting, etc.

Patients may not have severe knee pain or not all the time, but the pain affects their quality of life or daily life, such as not wanting to walk up and down stairs, having difficulty helping themselves, being unable to stand by themselves and needing to be supported all the time.

Patients have used other treatments, such as taking medication, biological treatments, physical therapy, and their symptoms do not improve, or improve with treatment.

Patients have severe bow legs, stuck knees, reduced mobility, cannot fully straighten their knees, and can bend their knees less than 90 degrees.

It can be performed in middle-aged and elderly people aged 50-60 years and above, along with the above factors. Patients must not return to activities that cause a lot of impact on the knees, play contact sports, or lift heavy objects.

This surgery is not suitable for very young people because the equipment wears out over time. It is usually 15-20 years old, so repeat surgery may be required.

If the patient has certain bone diseases, such as severe osteoporosis, rheumatoid arthritis, or certain types of cartilage diseases, such as osteoporosis Care must be taken in the surgery.

Limitations of knee replacement surgery There are many advantages, but this technique cannot be used in all patients with osteoarthritis, such as:

Patients with severe osteoarthritis and excessive knee flexion.

Patients with severe knee stiffness who cannot move their knee during surgery.

Patients who are overweight are not suitable for this surgery.

However, knee replacement surgery using computer technology has been proven to be highly accurate and cost-effective when compared to increasing the chance of the artificial knee surface lasting longer without having to undergo revision surgery later.

Recovery after knee replacement surgery

Patients can sit up, move their legs and ankles immediately after surgery to prevent blood clots in the veins of the legs. In patients who are at high risk for this condition, they may receive injected or oral anticoagulants for 2-3 weeks.

Generally, after surgery, patients should be able to bend their knees at least 90 degrees and extend them almost completely before being allowed to go home to continue their recovery. After knee replacement surgery, patients can shower if they choose to close the wound with waterproof glue. For other general patients, the surgical wound must be kept dry and water must not be allowed to enter the wound for about 10 to 14 days after surgery. It is not recommended to soak in the bathtub or swim in the first month of surgery.

Most patients can immediately put weight on their body after surgery, along with using a walking aid for the first 4 weeks, starting with a four-legged walking aid for stability while walking and reducing pain from putting weight on their legs. When patients can put more weight on their body, they may consider changing their walking aid to a cane or a walking stick. However, putting weight on and walking depends on the discretion of the surgical team.

Factors that cause osteoarthritis that require knee replacement surgery

“Osteoarthritis” is the most common form of “arthritis”. Most patients with osteoarthritis are found with an average age of 50 years and older, with a higher incidence in women than in men due to hormonal, bone, and muscle factors. Currently, osteoarthritis is also found in younger people, and this group of people is at risk of developing osteoarthritis before their time, as the knee joint is a joint that is used a lot. And it directly supports the weight of the body or has a chronic disease such as rheumatoid arthritis or gout. These diseases will gradually destroy the cartilage. When the cartilage on the joint surface is more worn, it causes knee pain. And it also stimulates inflammation in the knee joint, causing swelling and stiffness of the knee joint in the end.