Knee arthroplasty, also called knee replacement surgery, is performed to relieve pain and restore function in severely diseased knee joints. The procedure involves removing damaged bone and cartilage from the thighbone, shinbone and kneecap and replacing the damaged portions with artificial components.
When is a knee arthroplasty indicated?
Knee arthroplasty is indicated for patients who experience pain and instability in the knee that has not responded well to conservative (non-surgical) treatments.
The most common condition that affects the knee in this way is osteoarthritis, which causes the breakdown of cartilage between the joint bones. People who have severe degenerative joint disease are unable to do normal activities that involve bending the knee, like walking or climbing stairs, due to knee pain. Other forms of arthritis, like rheumatoid arthritis, may also lead to degeneration of the knee joint.
Fractures, torn cartilage and torn ligaments may also lead to irreversible damage that requires knee surgery.
Types of knee replacements
Total knee replacement
Dr Nell removes the entire joint, including damaged cartilage and bone. The joint is then replaced with artificial components to restore function and alignment of the knee.
Uni knee replacement
also called partial knee replacement, Dr Nell only removes and replaces a portion of the knee joint.
Robotic knee surgery
Robotic knee surgery involves the use of computer assistance with the alignment and positioning of the new knee. The digital information is used to plan the procedure and execution is done with the help of a handheld robotic device. Robotic surgery is Dr Nell’s the preferred method for unicompartmental knee replacements and can be used with total knee replacements.
With total knee replacements the preferred technique is called pinnless navigation. With this technique the computer is used for planning and guidance, but a handheld robotic device is not used for execution. This technique has the benefit of simplicity and avoiding the additional small cuts associated with robotic devices while improving accuracy with the computer.
What happens during surgery?
During knee arthroplasty, you will be under spinal anaesthetic with sedation. Dr Nell will make an incision on your knee to access the joint and remove the damaged tissue. Depending on the severity of your condition, he may remove the entire joint or only the damaged portions. Prosthetic components made up of a combination of metal and plastic will cover your remaining exposed bone to function as a replacement joint. The natural ligaments are mostly left intact and acts as stabilizers for your new knee. Once complete, the incision will be stitched closed and dressed. You will then be transferred to the recovery ward.
You will most likely remain in hospital for 2 days after knee arthroplasty so that Dr Nell can observe your recovery and make sure you are healing well. Before you are discharged, he will prescribe pain medication and instruct you on how to care for your surgical wounds. In some cases, physical therapy may be necessary to rehabilitate the knee.
Dr. Dirk Nell
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