What is a Knee Replacement?
Knee Replacement Surgery
Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis.
Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
What Causes Knee Joint Deterioration?
Knee arthritis (inflammation of your knee joint) is a major cause of knee joint deterioration. The most common arthritis is osteoarthritis, which is inflammation related to wear and tear of the knee joint.
Wearing of your knee joint is a common problem with ageing. However, certain conditions can accelerate the process of wear.
Injury to your knee joint, surgical procedures, muscle weakness or increased body weight all accelerate the load and hence the wear and tear of the knee joint.
Rheumatoid disease, gout or infection can also increase your joint wear and tear.
Interesting fact: If you lose just 10 kilograms of weight you can reduce the load on your knees by half!
What are the Symptoms of Knee Joint Arthritis?
The obvious sign of wear and tear of the knee joint is pain. Knee pain can be achy or sharp and may be accompanied by swelling.
Because your knees do not wear equally across the joint surface, a deformity may begin to appear over time. This can be both knock kneed or bow legged in appearance, or windswept knees (one of each).
You may also find one or both knees lacking full movement, especially extension.
How is Knee Arthritis Diagnosed?
On examination, your physiotherapist or doctor will look for signs of limited knee movement and deformity, swelling and, importantly, knee pain. In most cases an X-ray will be sufficient to show the degree of wear and tear. An MRI may also be used to to exclude soft tissue pathology.
What is the Treatment for Total Knee Replacement?
Pre Operative Physiotherapy
Pre-operatively you may be prescribed a course of physiotherapy to better prepare your knee and its surrounding muscles for the upcoming surgery.
Studies indicate that the better your muscle strength and knee range of movement before surgery, then the better your recovery.
Post Operative Physiotherapy
Many patients who have a Total Knee Replacement (TKR) start to feel better within a few weeks of the surgery.
Post-operative physiotherapy is important to regain full knee motion, strength and day to day function.
Your post-operative physiotherapy treatment will aim to:
- Reduce knee pain and inflammation.
- Normalise knee joint range of motion.
- Strengthen your knee muscles: quadriceps (esp VMO) and hamstrings.
- Strengthen your lower limb: calves, hip and pelvis muscles.
- Improve patellofemoral (knee cap) alignment
- Normalise your muscle lengths
- Improve your proprioception, agility and balance
- Improve your technique and function eg walking, stair climbing, squatting and bending
- Minimise your chance of re-injury.
Risks of Knee Replacement Surgery
Risks of knee replacement surgery include: infection, persistent instability and knee pain, knee stiffness, and difficulty returning to your previous level of activity. The good news is that better than 90% of patients have no complications post-surgery.
The first Total Knee Replacement (TKR) was pioneered by Leslie Gordon Percival Shiers (FRCS) in 1954. He refused to patent his invention, but rather allow other surgeons to modify and improve on his ideas.
Return to Activity Post-Total Knee Replacement
Most activities can be returned to following a successful knee replacement. Unfortunately, because of the nature of the knee prosthesis, it currently not recommended to return to high impact activities such as running and jumping. Less high impact sports such as golf, bowls or swimming are encouraged.
Common Causes - Knee Pain
Knee pain can have many origins from local injury, referred pain, biomechanical issues and systemic issues. While knee pain can appear simple to the untrained eye, a thorough assessment is often required to ascertain the origin of your symptoms. The good news is that once a definitive diagnosis is determined, most knee pain quickly resolves with the correct treatment and rehabilitation.
Knee Ligament Injuries
- Knee Ligament Injuries
- ACL Injury
- PCL Injury
- MCL Sprain
- LCL Sprain
- Posterolateral Corner Injury
- Superior Tibiofibular Joint Sprain
Knee Meniscus Injuries
- Chondromalacia Patella
- Fat Pad Syndrome
- Patella Dislocation
- Patellofemoral Pain Syndrome
- Osgood Schlatter’s Disease
- Sinding Larsen Johansson Syndrome
Knee Tendon Injuries
- Corked Thigh
- Thigh Muscle Strain
- Hamstring Strain
- ITB Syndrome
- Popliteus Syndrome
- Muscle Strain (Muscle Pain)
- DOMS – Delayed Onset Muscle Soreness
Children’s Knee Conditions
Other Knee-Related Conditions
- Runner’s Knee
- Plica Syndrome
- Stress Fracture
- Overuse Injuries
- Restless Legs Syndrome
For specific information regarding your knee pain, please seek the assistance of a healthcare professional with a particular interest in knee condition, such as your physiotherapist.