Types of Knee Replacement Surgery
Types of knee replacement surgery vary and knee replacement is one of the most common and most effective orthopaedic interventions with, along with hip replacement, some of the highest quality of life improvements of all medical treatments.
Depending on the situation with the patient's knee arthritis there are various types of knee replacement surgery and various surgical techniques and components.
Primary Knee Replacement
Primary total knee replacement is performed most commonly for osteoarthritis of the whole knee joint, which is the commonest disabling condition in the world which causes joint pain. The arthritic joint surfaces are replaced with stainless steel coverings and a plastic spacer is placed between them, with typically a plastic button applied to the back of the kneecap also.
Patients for this operation are usually over 60 and have disabling knee joint arthritis causing disturbance of sleep, limitation of walking distance and functional disability. Patients suitable for this operation will have intact ligaments for a stable joint and be fit enough to undergo a major operation with an extended period of rehabilitation under a physio.
Preparation for any kind of knee replacement should include good and complete information so that a patient can cooperate with the rehabilitation with the physio, which may include a knee replacement surgery video, or to avoid the anatomy and the blood, a knee replacement surgery animation. An orthopedics video is very useful as it gives a clear visual understanding of what has gone on in the operation, allowing the patient to follow the post operative programme with maximum knowledge.
Partial Knee Replacement (Unicompartmental Knee Arthroplasty)
Partial knee replacement or unicompartmental knee arthroplasty is designed to manage knee arthritis which is confined to one side or the other of a knee, either the medial (inner) or lateral (outer) joint compartments. This technique only works well if the other compartment is unaffected by arthritis and there may be a larger number of people suitable for this less expensive operation than is presently considered. Rehabilitation should be quicker under physiotherapy supervision and there may be fewer knee replacement complications and knee replacement surgery risks. A good way to understand what goes on in this procedure is to watch a partial knee replacement surgery video.
Revision Knee Surgery
Revision knee replacement may be necessary if the components become loose or the joint develops an infection. Revision is always a more extensive and difficult operation that the primary operation and more bone may need to be removed. Provided the joint remains stable the new components may be the same as a primary knee.
Rotating Platform Knee Replacement
Rotating platform knee replacements try to replicate the smaller degrees of rotation which occur in a normal knee during movement, in order to minimise the stresses through the components and limit wear. However it is not clear whether they confer any advantage in these or any other ways and there may even be disadvantages as compared to standard total knee replacement.
Rotating Hinge or Rotating Bearing Knee Replacement
Rotating hinge or bearing knee replacements are used in cases where the knee is unstable due to ligament laxity or bone loss such as in rheumatoid arthritis where joint destruction can be considerable. These joints have some inherent stability due to the hinge mechanism between the upper and lower part of the joint and the bearing or hinge forces a particular arc of movement on a knee which may be unable to do this for itself.
Minimally Invasive Knee Replacement
Minimally invasive knee replacement employs a smaller incision than the typical eight to ten inches in length. There may be advantages in lower blood loss and shorter hospital stay but it is not clear yet if this technique is better and disadvantages such as poorer positioning of the components have also be reported. The trend is to disturb the local tissues such as the muscles less and less and cause the minimum of surgical trauma.
Due to the complexity of the procedure and the long period of rehabilitation with a physio which may be required, it is useful to prepare for knee replacement surgery well beforehand. The clinic or hospital should provide good knee replacement surgery information and pre-operative consultations with a physiotherapist so that the patient can work on range of movement and muscle power.