Knee Arthritis and Knee Replacement Surgery
Knee Arthritis is increasingly common as one gets older and in 20% of us it becomes a limiting factor in our mobility. It may follow an injury to the knee years before or be the result of a spontaneous inflammation in the joint such as occurs with rheumatism.
It may affect only part of the joint such as the knee cap or inside (medial) part of the knee or it may be more generalised.
Initially the surface cartilage begins to thin and get rough, but later on the joint surface cartilage will wear right through to expose the underlying bone. It is at this stage that the symptoms tend to become more severe. Eventually, the bone itself begins to wear away and joint pain in the knee occurs.
Investigations including X-rays or possibly scans help determine the correct treatment whether it be knee replacement surgery or other treatments. The treatment of knee arthritis is varied and dependant on the degree and pattern of the disease.
Initially exercise to strengthen the muscle, possibly with the help of a physiotherapist, and with painkillers will be all that is needed. Injections can help in some cases, but if the symptoms progress then there are several different options available which are effective. These include removing debris from the joint if there are symptoms of locking and giving way. Or proceeding to either realigning the joint so that the weight goes through a good bit of the joint or replacing part or all of the joint.
If the damage to a knee from either arthritis or injury is severe, and other treatments are not controlling the joint pain in the knee, then it may be best to replace either part of the joint, or all of it. through knee replacement surgery.
Modern knee replacements remove little bone and the types favoured by Edward Crawfurd are essentially surface replacements. So this means he generally keeps the majority of the patient’s own ligaments with minimal disruption to the surrounding soft tissues.
Partial Knee Replacements
If the wear in a knee just involves one part of it, such as the joint between the knee cap and the front of the thigh bone, then Edward Crawfurd will do a partial replacement resurfacing the affected part. Most commonly it is the inner (medial) part that wears, and if the rest of the knee is in good order there is nothing to be gained by removing good joint surface as well as the bad. Resurfacing part of a knee can be done through a smaller incision than a full knee replacement and the recovery tends to be quicker and a greater range of movement attained.
Total Knee Replacements
If the knee is badly worn or deformed then a full or total knee replacement will be required. In this procedure a sliver of joint surface is removed from the end of the thigh bone and the top of the shin bone. They are then both resurfaced with a thin layer of metal before a thin plastic bearing is put between the two. At the same time the kneecap may be resurfaced if it is also worn.
It does take a while to get over a knee replacement and the patient has to work hard at physio and exercises. Walking sticks will be needed at first and activities such as driving will not be resumed until about 6 weeks after the operation. Full recovery carries on for many months and patients often realise that the knee continues to improve for over a year.
Like any operation there can be complications such as blood clots, bleeding, infection, stiffness, and some numbness beside the wound but luckily serious complications are rare.