A partial or total replacement of the knee joint with prosthetic components.
Knee arthritis is a common condition where cartilage in the knee joint is worn down and the protective space between the bones decrease. This results in bone rubbing on bone producing irritation and painful bone spurs. The most common type of arthritis is osteoarthritis, caused by chronic wear and tear of the joint. Other common types of arthritis include rheumatoid arthritis and posttraumatic arthritis (See “Knee Arthritis” in our Conditions section for more information). There is no cure for arthritis and therefore initial treatment is centered around symptom relief. Lifestyle modifications, physical therapy, NSAIDs, braces, and/or cortisone injections are often used in combination to treat symptomatic knee arthritis. In cases of rheumatoid arthritis, immunosuppressant medication may be prescribed. We also offer hyaluronic acid injections (i.e. Synvisc, Orthovisc) to help alleviate knee arthritis symptoms. These injections are a viscous gelatinous substance that work by increasing lubrication in the joint and therefore decreasing the amount of friction and pain when the knee is in motion. If nonsurgical treatment options are no longer alleviating pain and your activities of daily living are affected, a partial or total knee replacement (arthroplasty) may be indicated.
Partial Knee Arthroplasty
In order to qualify as a candidate for a partial, or unicompartmental, knee arthroplasty (replacement) your arthritis must be advanced in only one compartment of the knee. An x-ray is used to evaluate the knee joint and determine which compartment is affected. The most common type of partial knee arthroplasty performed is in the medial compartment, the compartment located at inside of the knee. This surgery is done in a hospital setting where the surgeon will remove the arthritic bone surfaces of the affected compartment and replace those surfaces with metal implants. Finally, the joint space is preserved by inserting a plastic spacer between the metal implants creating a smooth gliding surface. Most patients who undergo this type of surgery will have a short hospital stay to ensure post-operative pain is controlled and to begin a formal physical therapy program to maintain adequate motion of the knee.
Total Knee Arthroplasty
A total knee replacement is reserved for patients who have advanced arthritis in more than one compartment of the knee, their arthritis symptoms greatly affect their normal activities of daily living, and they are medically sound to undergo this elective surgery. Medical clearance from the appropriate physicians are routinely obtained to make sure you are an optimal candidate for this invasive surgical procedure. Like a partial knee replacement, total knee replacements are performed in the hospital setting. The procedure begins by removing the articular surfaces of the knee which include the bottom of the femur, the top of the tibia and the articular surface of the patella. Next, metal implants are fit and fixated to the femur and the tibia while a plastic “button” is placed on the articular surface of the patella. Finally, a plastic spacer is inserted between the metal implants to maintain the appropriate joint space and create a smooth gliding surface. Patients often stay in the hospital for 1-3 days and begin a rigorous physical therapy program where the patient is able to apply their full body weight onto the leg and work to obtain full range of motion of the knee. Physical therapy is an important step initiated shortly after surgery to avoid any complications that may arise without proper rehabilitation. Most patients will be able to resume normal activities of daily living within 6 weeks of surgery, however it takes several months of physical therapy to regain full motion, strength and mobility of the surgical knee.
Every Patient Matters
Every patient receives an in-depth consultation to devise a treatment plan that is right for their problem. Our specialists prefer non-operative and non-invasive treatments whenever possible, including physical therapy, medications, and/or injections. When we require surgery, we will then use minimally invasive surgical techniques to fix your problem, whether it is fixing a broken bone or repairing a tendon. Our goal is always to get you back to living your life normally as soon as possible.
With proper treatment, Dr. DeNoble can treat and fix even complete tears. He is an expert in the current minimally invasive standard of arthroscopic repair, avoiding the need for large incisions, and ensuring you can get back to your life in tip-top form.