If I need a total knee replacement, what are my options?

The information provided below is meant to educateThe plastic bearing in your new knee joint will either
the patient about the options available to kneebe fixed or mobile-bearing. This means that the
replacement candidates. Ultimately your surgeon willpolyethylene insert is either clicked onto a stationary
make these decisions. Your doctor should explain toplatform (fixed) or able to move on a rotating metal
you which knee replacement is best for you andbase (mobile). Most people get a fixed-bearing
why.prosthesis that reduces knee pain dramatically and
When a surgeon considers a patient for a total kneemay last for many years. If you are younger, more
replacement, she takes into account theactive and/or overweight, sometimes a doctor may
patient’s age, lifestyle, and damage to the joint.recommend a mobile-bearing or a rotating platform
In addition, a surgeon’s decision to use oneknee replacement designed for potentially longer
procedure over another, or one type of implant overperformance with less wear.
another, often depends on that surgeon's training andIn addition, there is the medial pivot implant which
clinical situation. Each implant design has advantagesreplicates the rotating, twisting, bending, flexion, and
and disadvantages, but whichever implant yourstability of your natural knee, so it feels more like
surgeon decides to go with, it's good to know thatyour natural knee. This design "stays put" or is more
total knee replacement surgeries offer among thestabile during normal knee motion as opposed to
greatest success rates of all orthopedic operations.sliding forward slightly in flexion.
Nevertheless, we advise you to research yourCustom or special needs implants are another option
options so that you can intelligently discuss with yourwhen choosing an implant. This will depend on
surgeon what approach will be best for you.whether your skeleton is smaller or bigger than
What happens in knee replacement surgery?average. Research shows that regular-sized implants
A total knee replacement replaces the damagedmay overhang on the bone and lead to soft tissue
bearing surfaces in your knee that are causing pain.interference or mid-flexion instability in those people
At the lower end of the femur (thigh bone), thewith narrow femurs.
bone is trimmed to accept a specially shaped metalMaybe a total knee replacement isn’t necessary .
component and the upper end of the tibia (shin bone). .
likewise is trimmed to accept a metal tray. Into thisIn some cases, a surgeon will be able to preserve
tray will be fitted a plastic bearing.part of the knee through resurfacing or partially
The metal components can be secured to the cutreplacing components of your arthritic knee.
bone surfaces by the surgeon’s choice of bonePartial Knee Resurfacing is an innovative procedure
cement or a non-cement method called “bonedesigned to provide quicker recovery and improved
ingrowth”. The majority of knee replacementssurgical outcome. This is for patients with damage
are generally cemented into place. This is one optionconfined to only one part of the knee which can be
you can ask your surgeon about. “What type ofresurfaced without compromising the healthy bone
fixation will you use to hold my knee in place?”and tissue surrounding it. The implants are usually
The outer surface of the femoral component iscustom-made implants using CAD (computer aided
shaped to allow the kneecap (patella) to slide up anddesign) from a special digital imaging of the knee.
down in its groove. The surgeon may choose toAnother option is a partial knee replacement (also
retain the natural kneecap or re-surface it. You cancalled a unicompartmental arthroplasty or
ask your surgeon about this. “Will you behemiarthroplasty). This involves putting a smaller
replacing my kneecap or retaining it?implant on just one side (or compartment) of the
The Cruciate Ligaments are major ligaments insideknee where the damage is limited to that part rather
the knee. They provide support to and stablize thethan replacing the entire surface. A partial knee
movement of the knee. In total knee replacementreplacement is done if part of the knee joint is
surgery, the CL can be kept or removed and thisdamaged by arthritis and the other compartments
choice depends on their condition, the type of kneehave healthy, normal cartilage.
implant or the type of surgery the surgeon likes toAbout BoneSmart.org
do. This is another option you can ask your surgeonBoneSmart.org is a National Public-Awareness
about. “Will you be removing or retaining myCampaign for Knee and Hip Joint Replacement
cruciates?"Candidates. The BoneSmart® National Consumer
Sometimes the deterioration of the knee joint is suchAwareness Campaign’s mission is to raise patient
that total knee replacement can be avoided and yourawareness of the options available to persons
surgeon may suggest resurfacing or partially replacingdiagnosed as a knee or hip joint replacement
components of your arthritic knee. Preserving healthycandidates by providing an Internet portal for
bone stock is especially important to younger andawareness of the latest advances in joint
more active individuals. In the last section of thisreplacement materials, their longevity and suitability
article, we will talk about when a total kneefor various applications. With this information the
replacement may not be necessary.potential patient may be better informed when
What are the different types of implants?discussing options with his or her surgeon.