Total Knee Replacement: Part I

Degenerative joint disease or osteoarthritis of the knee occurs when the articular cartilage located on the ends of the femur and tibia is damaged in response to wear and tear. Excessive bone formation occurs at the site of this “bone on bone” occurrence causing, in most, cases a malalignment at the knee joint. Those diagnosed with osteoarthritis of the knee complain of increased pain with weight-bearing activities such as walking, standing, climbing stairs as well as simply getting out of a chair (functional squat position). Those persons also commonly experience “morning stiffness” which improves once the knee “warms up”. Knee pain is more apparent at rest as the disease progresses. There is no cure for osteoarthritis or degenerative joint disease. After conservative care is exhausted, those affected usually undergo a total joint arthroplasty.

Total knee replacement is a surgical procedure used to resurface the knee joint with metal and plastic. The articulating surfaces of the tibia and femur, as well as the cartilage, are removed and resurfaced with metal. The original cartilage is replaced with a plastic version. Advances in knee prosthetics make it possible for the surgeon to determine the appropriate fit for the patient depending on size and gender for the best cosmetic option. Recent advancements in operative sedation have been made to reduce possible side effects caused by pain medicine while still maximizing pain control. This improves the patient’s awareness of their leg which in return promotes increased safety and muscle activation during early walking.

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