What is Total Knee Replacement?
Total knee replacement, also known as total knee arthroplasty, is a surgical procedure designed to relieve pain and restore function in a severely damaged knee joint. This procedure involves removing the damaged or diseased surfaces of the knee joint and replacing them with an artificial implant made of a metallic alloy along with a plastic (polyethylene) liner.
Common hip conditions requiring a knee replacement:
- Severe Arthritis: Osteoarthritis (arthritis of wear and tear), rheumatoid arthritis (an autoimmune disease), or a severe infection (infective arthritis) can cause significant damage to the hip joint, leading to pain, stiffness, and limited movement.
- Severe deformities of the knee: Patients with severely deformed knees and associated joint destruction may require a total knee replacement to correct the deformity as well as relieve pain and regain function.
- Severe fractures involving the knee joint: Some fractures directly involving the knee joint or involving the lower part of the femur (thigh bone) and/or the upper part of the tibia (shin bone), especially in older patients, may require knee replacement surgery to restore function.
- Bone Tumours: Tumours, both benign and malignant, involving the bone(s) of the knee joint can lead to structural damage, sometimes requiring a knee replacement.
Benefits of Total Knee Replacement
- Pain Relief: One of the primary benefits of a total knee replacement is substantial pain relief. By replacing the damaged joint surfaces with smooth, artificial components, most patients experience a significant reduction in pain.
- Improved Mobility: After recovery, many patients find they can move more freely and comfortably. This can help you return to activities you enjoy and improve your overall quality of life.
- Enhanced Quality of Life: With reduced pain and improved mobility, you’ll likely find it easier to perform daily tasks and enjoy life more fully.
- Durable and Effective Solution: Modern knee implants are designed to be durable and long-lasting, providing a reliable solution for many years.
Minimally invasive Sub-vastus technique
The conventional technique of TKR surgery involves cutting through the quadriceps muscle (extensor muscle of the knee). Dr. Korday specialises in using a minimally invasive technique called the ‘sub-vastus approach.’ This is a muscle-sparing (quadriceps sparing) technique which preserves the function of the extensor mechanism of the knee, which is responsible for achieving extension of the knee after surgery.
This technique has the advantage of reduced post-operative pain, faster recovery of quadriceps function after surgery and better patellar tracking. This, along with aggressive post-operative pain management in collaboration with his anaesthesia team ensures that patients have pain-free recovery and early return to function after knee replacement surgery.
What is Partial Knee Replacement?
Partial knee replacement, also known as uni-compartmental knee replacement (UKR), is a surgical procedure designed to replace only the damaged portion of the knee joint while preserving the healthy areas. Unlike a total knee replacement, which involves replacing the entire joint, a partial knee replacement involves replacing only the specific compartment of the knee that is affected by arthritis or damage.
Why Consider Partial Knee Replacement?
Localised Damage: If your knee pain is confined to one part of the joint - such as the inner, outer, or knee cap - a partial knee replacement can target just that area.
Less Invasive: This procedure involves smaller incisions and preserves more of your natural bone and tissue compared to a total knee replacement.
Faster Recovery: Patients undergoing partial knee replacement experience quicker recovery times, less postoperative pain, and can pursue an active lifestyle.
The advantages of a partial knee replacement (UKR) over total knee replacement
UKR is performed using a smaller incision over the knee. It involves removing only the damaged cartilage and bone surfaces from the affected compartment and replacing it with a metallic implant and a plastic liner. There is significantly reduced pain, faster recovery and early return to function after UKR surgery.
Choosing between TKR and UKR surgery
Choosing the best possible knee replacement option (TKR versus UKR) for any patient involves a careful consideration of the patient’s age, symptoms, as well as a close evaluation of the patient’s X-rays and/or MRI scans. Dr. Korday, with his experience and expertise of treating a vast number of patients with knee arthritis, will help you to choose the best option based on your functional needs.
Robotic knee replacement surgery
Robotic surgery involves the use of a ‘robotic arm’ to assist the surgeon during knee replacement surgery. The use of robotic technology allows for a more accurate and precise cutting and shaping of the bone and the soft tissues in preparation for implant placement. It should be noted that the robot only assists or guides the surgeon in executing the bone cuts and soft tissue releases, while the actual surgery is undertaken by the surgeon and his surgical team!
Benefits of robotic surgery
The potential advantages of robotic knee replacement are improving the accuracy of bone cuts and implant placement, and achieving a more predictable limb alignment during surgery.
At the present time, though robotic surgery in knee replacement is very promising, it has not been shown to improve the overall outcomes and results after surgery, as compared with the conventional technique. Also, there is an additional cost involved in robotic surgery. Dr. Korday will assist you in deciding the best option for a given patient after a careful evaluation of the patient and their functional requirements.