Osteoarthritis is an erosion of the cartilage of the knee joint. The rubbing surface between femur, tibia and patella is progressively worn away.
This degradation causes pain and/or stiffness.
It develops slowly and progressively with painful peaks and less painful phases.
When the erosion is not too severe, a treatment by injections into the knee joint can be provided. This can sometimes help delay the operation for a few months or a few years.
For a surgeon to opt with his patient for a total knee replacement two conditions are required :
– Rough pain and/or discomfort, enduring and resistant to medical treatment
– And an x-ray of the knee that will confirm the evolved erosion of the joint.
A thorough pre-operative assessment will be mandatory including consulting an anaesthesiologist and a cardiologist, taking a blood test, a specific x-ray that will allow to take the dimensions of the required prosthesis.
During surgery :
The skin incision is made on the anterior part of the knee
The procedure lasts approximately 1.30 hours
A blood recovery system allows to reinfuse the blood volume lost during surgery.
A knee prosthesis is usually made of 4 elements that replace the eroded rubbing zones. Some elements are fixed to the bones (femur, tibia and patella), others are assembled together.
The most conventional components used for such prosthesis are metal (various cobalt chromium, titanium or oxynium based alloys) and polyethylene ( special industrial plastic material). There are dozens of prosthesis types the surgeon can opt for according to each condition.
Returning to the hospitalization room in the unit is allowed only after a minimum one to two hour surveillance phase in recovery room.
After surgery :
On the second day after surgery the patient is able to sit; walking starts with forearm crutches as early as possible in the days following the operation to prevent risk of phlebitis (formation of a blood clot in a leg vein)
The Redon drains (small tubes inserted under the scar to suck blood and prevent hematoma) are removed three days after the operation
On an average, the stay at the clinic lasts a week but tends to become shorter due to the latest medical breakthroughs.
A 2 to 4 week rehabilitation program is necessary; most of the time in a specialized centre. .
The knee will remain moderately swollen for several months after the operation, which is normal.
Latest breakthroughs :
The latest prosthetic knee systems allow to expect optimal recovery of the joint function : this is provided by prosthetic joint with rotating platform or hyperextension platform.
These systems can be implanted with or without cement; each option can present its benefits and drawbacks.
New implantation techniques with or without computer assistance allow to implant these modern systems by using minimally invasive procedure that reduces the skin and muscular incision.
For over a year, the clinic has been equipped with the computer navigating systems with which all knee prosthesis are fixed.
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