Knee Replacement (AKA knee arthroplasty) is an illness common among the elderly in their 50s and 60s. With increasing life expectancy, it is fast becoming one of the highly opted surgical procedures in most of the developed and developing countries globally. However, in the recent past it has been observed, people as early as in their 40s are experiencing the onset of this disorder.
Knee replacement, basically is a surgical procedure where worn, diseased or damaged weight-bearing surfaces of a knee joint are replaced with artificial surfaces to relieve debilitating pain and disabilities. Although there are several conditions which may lead to a need for knee replacement surgery, arthritis is beats them all. A number of other factors contributing to joint disease include genetics, developmental abnormalities, repetitive injuries and obesity.
Knee joint is the largest, most complex and also the most stressed joint in the body. It is this complexity and stress that causes arthritis; following are few common ones today:
- Osteoarthritis: An age-related wear and tear type of arthritis. It’s usual among people in their 50 years or above, but may occur in younger people too. It causes the cartilage that cushions the knee to soften and wear out. The bones then rub against each another, causing knee pain and stiffness.
- Rheumatoid Arthritis: An autoimmune disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. It is the most common form of a group of disorders termed “inflammatory arthritis.”
- Post-traumatic arthritis: It usually follows a serious knee injury like fractures of the bones surrounding the knee or tears of the knee ligaments which may damage the articular cartilage over time, causing knee pain and limiting knee function.
Some other major causes of pain include meniscus tears, cartilage defects and ligament tears.
A human knee constitutes of three major compartments that include the medial compartment (inside aspect of the knee), the lateral compartment (outside of the knee) and the patellofemoral compartment (in front of the knee).
A knee replacement surgery can be performed as a partial or a total knee replacement procedure. A partial or unicondylar knee replacement, as the name suggests, replaces only the affected compartment of the knee, whereas, in total knee replacement all three constituting compartments of a knee are substituted.
Knee replacement surgery (be it total or partial) is a big decision and is not the only way out for sufferers of debilitating knee pain. Treatment should begin with the most basic cure and progress to the more involved, which may or may not include surgery. Not all treatments are appropriate for every patient. Knee replacement is generally reserved for patients who have tried all of the other treatments and are still left with significant pain during normal activities. Here is a list of few alternatives to knee replacement surgery that one can explore:
- Knee Arthroscopy: Small incisions are made around the knee to insert a small pencil like instruments to trim and smooth out degenerated and worn cartilage.
- Cartilage Transplantation: This procedure involves replacing healthy cartilage, from an area of the knee that does not bear weight to another area of the knee where the weight-bearing cartilage has been damaged.
- Arthrodesis/ Knee Fusion: When the risk of failure of total knee replacement is considered to be very high, an arthrodesis is recommended. In this operation, the ends of the femur and tibia bones are cut flat, the cut ends are pressed together such that the leg is just slightly bent, and then held in this position by pins, or plates and screws.
Additionally, there are some non-surgical options for patients who have occasional pain and have not tried non-operative treatments or are just not ready for a knee replacement. The non-operative treatment options that such patients can try are:
- Specialized Braces: These braces are designed to create a force which transfers load from an area of the knee where the cartilage is more worn, to an area of the knee where the cartilage is less worn.
- Low-impact exercise: Regular exercise, including joint and muscle exercises, is important to improve strength and flexibility. It may lessen the pain, increase movement, reduce fatigue, and help you look and feel better.
- Weight management: Weight loss helps to ease pain by reducing stress on your joints. After all, your knees bear the full load of your weight plus everything you carry.
- Injections: Sometimes hyaluronic acid, a substance produced in natural, healthy joints, is used to provide temporary relief from knee pain. Anesthetics also may be injected with a corticosteroid anti-inflammatory medicine (usually cortisone) to numb your knee and help ease the pain.
Although, there have been several innovations in technology along with the medicinal breakthroughs to encounter knee joint discomforts, the sheer quantity of knee complaints in recent times is quite high. Consequently, much like in any other health disorders, the best way to deal with knee ailments is prevention and awareness. Awareness will keep us on the lookout for early symptoms, while preventive measures like exercise will keep our knee joints well oiled and smooth functioning. So “stay on the move” and make sure you maintain the health of your knees.