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Knee Prosthesis – Types, Surgery and Recovery
A knee prosthesis replaces the damaged knee joint with an artificial implant. It is used in cases of severe arthritis or injury to relieve pain and restore mobility.
Add as Preferred SourceThings worth knowing about "Knee prosthesis"
A knee prosthesis replaces the damaged knee joint with an artificial implant. It is used in cases of severe arthritis or injury to relieve pain and restore mobility.
What is a Knee Prosthesis?
A knee prosthesis – also known as a knee endoprosthesis or total knee replacement (TKR) – is an artificial joint that fully or partially replaces a damaged or destroyed knee joint. It typically consists of metal and plastic components that replicate the natural joint surfaces, allowing pain-free movement.
Indications – When is a Knee Prosthesis Used?
A knee prosthesis is recommended when conservative treatments such as physiotherapy, pain medications, or joint injections no longer provide sufficient relief. Common indications include:
- Advanced gonarthrosis (knee osteoarthritis): The cartilage in the knee is severely worn down or completely destroyed.
- Rheumatoid arthritis: An autoimmune disease that causes significant damage to the knee joint.
- Severe knee injuries: For example, irreparable joint damage following accidents.
- Osteonecrosis: Death of bone tissue in the knee area.
Types of Knee Prosthesis
Total Knee Replacement (TKR)
In a total knee replacement, all three joint surfaces of the knee are replaced: the medial (inner) side, the lateral (outer) side, and the rear surface of the kneecap. This is the most commonly performed procedure.
Partial Knee Replacement (Unicompartmental Prosthesis)
A partial knee replacement, also called a unicompartmental or unicondylar prosthesis, replaces only the affected part of the knee joint – usually the inner (medial) compartment. It is less invasive and suitable for patients where only one part of the joint is affected.
Patellofemoral Prosthesis
This type of prosthesis replaces only the joint between the kneecap and the thighbone and is used in cases of isolated patellofemoral arthritis.
The Surgical Procedure
A knee replacement surgery typically takes between 1 and 2 hours. It is performed under general anesthesia or spinal anesthesia. The surgeon removes the damaged cartilage and bone areas and secures the prosthetic components using bone cement or by allowing biological bone ingrowth (cementless fixation).
Rehabilitation and Aftercare
Rehabilitation after knee replacement surgery is essential for a successful outcome. It typically includes:
- Early mobilization starting on the first day after surgery
- Physiotherapy to restore strength and range of motion
- Pain management and thrombosis prevention
- Inpatient rehabilitation in a specialist facility
Full recovery generally takes between 3 and 6 months. Many patients report a significantly improved quality of life after successful rehabilitation.
Risks and Complications
Like any surgical procedure, knee replacement surgery carries certain risks:
- Infections around the implant
- Deep vein thrombosis or pulmonary embolism
- Loosening of the prosthesis over time
- Nerve or blood vessel damage
- Joint stiffness (arthrofibrosis)
Modern prostheses have an average lifespan of 15 to 20 years. If necessary, a revision surgery (replacement of the prosthesis) can be performed.
References
- National Institute for Health and Care Excellence (NICE): Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226, 2022.
- American Academy of Orthopaedic Surgeons (AAOS): Clinical Practice Guideline on Total Knee Arthroplasty, 2015.
- Insall JN, Scott WN: Surgery of the Knee. 4th edition, Churchill Livingstone, 2005.
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