• Knee Replacement at Littleton Adventist Hospital

  • What is total knee replacement ?
    An arthritic or damaged knee joint is removed and replaced with an artificial joint called a knee prosthesis.

    Knee Replacement What is a joint?
    The ends of two or more bones that are connected by thick tissues form a joint. The lower leg bone, called the tibia or shinbone, and your thighbone, called the femur, form your knee joint.

    The bone ends of a joint are covered with a smooth layer called cartilage. Normal cartilage allows nearly frictionless and pain-free movement. However, when the cartilage is damaged or diseased by arthritis, joints become stiff and painful. A fibrous tissue envelope or capsule encloses every joint with a smooth tissue lining called the synovium. The synovium produces fluids that reduce friction and wear in a joint.

    Why is total joint replacement necessary?
    The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint. A physical examination, possibly some laboratory tests and X-rays will show the extent of damage to the joint. Total joint replacement will be considered if other treatment options will not relieve the pain and disability.

    How is total joint replacement performed?
    Under anesthesia the surgeon will replace the damaged parts of the joint. In an arthritic knee the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function.

    The materials used in a total joint replacement are designed to enable the joint to move just like a normal joint. The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Several metals are used including stainless steel, alloys of cobalt, chrome, titanium and ceramic. The plastic material (polyethylene) is durable and resistant to wear. Plastic bone cement may be used to anchor the prosthesis into the bone. Joint replacements also can be implanted without cement when the prosthesis and the bone are designed to fit and lock together directly. This type of surgery generally takes between one and two hours.

    Is total joint replacement permanent?
    Most people can expect their total joint replacement to last 15 years or more. It will give years of pain-free living that would not have been possible otherwise. Younger joint replacement patients may need a secondary surgery at some point. Materials and surgical techniques are improving through the efforts of orthopedists working with engineers and other scientists. Total joint replacements can improve quality of life through greater independence and healthier pain-free activity.

    Reasons for a total knee replacement

    • Severe knee pain that limits everyday activities, including walking, going up and down stairs and getting in and out of chairs. It is hard to walk more than a few blocks without significant pain and the need to use a cane or walker.
    • Moderate or severe knee pain while resting, either day or night.
    • Chronic knee inflammation and swelling that does not improve with rest or medications.
    • Knee deformity - bowing in or out of the knee.
    • Knee stiffness - inability to bend and straighten the knee.
    • Failure to obtain pain relief from non-steroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness in controlling knee pain varies greatly from person to person. These drugs may become less effective for patients with severe arthritis.
    • Inability to tolerate pain medications.
    • Failure to substantially improve with other treatments such as cortisone injections, physical therapy or other surgeries.

    What to expect from knee replacement surgery
    Understanding what the procedure can and can't do for you is an important factor in deciding whether to have total knee replacement surgery.

    More than 90 percent of individuals who undergo total knee replacement experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not make you a super athlete or allow you to do more than you could before you developed arthritis.

    Following surgery, you will be advised to avoid certain activities for the rest of your life including jogging and high-impact sports.

    Even with normal use and activities, an artificial joint (prosthesis) develops some wear over time. If you participate in high-impact activities such as running, tennis and basketball or are over-weight, this wear may accelerate and cause the prosthesis to loosen and become painful.

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