The knee is a complex joint made up of three bones in a hinge formation: the patella (kneecap), the end of the femur (thigh bone), and the top of the tibia (shin bone). These bones articulate with each other forming the three compartments of the knee. In a healthy knee a highly specialised and naturally lubricated cartilage covers the surface of the bones in the joint and lets the joint surfaces glide smoothly over each other. This joint is controlled by groups of powerful muscles of the thigh and the leg.
A large number of diseases and injuries can damage the knee to the point where it becomes painful or will not function properly.
Although a large number of diseases can cause knee pain, the following are the most important ones: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis
In an arthritic knee the joint cartilage gets degenerated and the normally protected nerve endings in the bone gets exposed giving rise to severe pain. Also secondary effects like inflammation of synovium (soft tissue lining the joint), joint effusion, muscle spasm are present. Ultimately the joint end up in permanently deformed and a painful state restricting not only work and recreation, but also ordinary daily activities.
The surfaces forming the joint are removed and a highly polished metal prosthesis is inserted. The metal glides smoothly on a high grade plastic insert. The soft tissue imbalance is also corrected and any deformity is also corrected simultaneously.
Unfortunately in spite of all these measures, the arthritis is progressive in most cases. In case of grade 4 arthritis, bone rubs against bone giving rise to severe pain, in which case, surgical management is the only option.
As already pointed out, various modalities of managing the pain and preventing disease progression are available. But in advanced stages the joint worsens and no intervention is successful. Someone who is in constant pain, wheelchair bound, not able to walk without stick and not responding to non-surgical treatment should consider the option of replacement. The ultimate aim of total knee replacement is complete pain relief and restoring joint movement.
In many ways, a total knee replacement is similar to changing a set of car tyres. How long the tyres lasts depends on how much the car is used, on what types of roads the car is driven, how heavy the car is, and whether or not the car is properly serviced and maintained. Similarly, how long a total knee lasts depends on how much it is used, what types of activities it is used for and whether you have regular follow-ups.
Average life of Total Knee replacement is 12-15years.
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