Knee Arthroplasty

Total knee replacement, or total knee arthroplasty, is a surgical procedure in which parts of the knee joint are replaced with artificial parts (prostheses).

A normal knee functions as a hinge joint between the upper leg bone (femur) and the lower leg bones (tibia and fibula). The surfaces where these bones meet can become worn out over time, often due to arthritis or other conditions, which can cause pain and swelling.

REASONS FOR KNEE REPLACEMENT

Total knee replacement is one option to relieve pain and to restore function to an arthritic knee. The most common reason for knee replacement is that other treatments (weight loss, exercise/physical therapy, medicines, and injections) have failed to relieve arthritis-associated knee pain.

The goal of knee replacement is to relieve pain, improve quality of life, and maintain or improve knee function. The procedure is performed on people of all ages, with the exception of children, whose bones are still growing. It is important to have significant pain and/or disability prior to considering this procedure. Because the replacement parts can break down over time, and healthcare providers generally recommend delaying knee replacement until it is absolutely necessary.

Knee Arthroscopy

Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint. During the procedure, your surgeon will make a very small incision and insert a tiny camera — called an arthroscope — into your knee. This allows them to view the inside of the joint on a screen. The surgeon can then investigate a problem with the knee and, if necessary, correct the issue using small instruments within the arthroscope.

Arthroscopy diagnoses several knee problems, such as a torn meniscus or a misaligned patella (kneecap). It can also repair the ligaments of the joint. There are limited risks to the procedure and the outlook is good for most patients. Your recovery time and prognosis will depend on the severity of the knee problem and the complexity of the required procedure.

Meniscal Repair

A meniscus tear is a common injury to the cartilage that stabilizes and cushions the knee joint. The type of the tear can determine whether your tear can be repaired. Radial tears sometimes can be repaired, depending on where they are located. Horizontal, flap, long-standing, and degenerative tears-those caused by years of wear and tear-generally cannot be repaired.

Your doctor will likely suggest the treatment that he or she thinks will work best for you based on the zone where the tear is camera.gif, the pattern of the tear, and how big it is. Your age, your health, and your activity level may also affect your treatment options. In some cases, the surgeon makes the final decision during surgery, when he or she can see how strong the meniscus is, where the tear is, and how big the tear is.

If you have a small tear at the outer edge of the meniscus (in what doctors call the red zone), you may want to try home treatment. These tears often heal with rest.
If you have a moderate to large tear at the outer edge of the meniscus (red zone), you may want to think about surgery. These kinds of tears tend to heal well after surgery.
If you have a tear that spreads from the red zone into the inner two-thirds of the meniscus (called the white zone), your decision is harder. Surgery to repair these kinds of tears may not work.
If you have a tear in the white zone of the meniscus, repair surgery usually isn’t done, because the meniscus may not heal. But partial meniscectomy may be done if torn pieces of meniscus are causing pain and swelling.

Treatment of Knee Fractures

A patellar fracture is a break in the patella, or kneecap, the small bone that sits at the front of your knee. Because the patella acts as a shield for your knee joint, it is vulnerable to fracture if you fall directly onto your knee or hit it against the dashboard in a vehicle collision. A patellar fracture is a serious injury that can make it difficult or even impossible to straighten your knee or walk.

Nonsurgical Treatment

If the pieces of bone are not out of place (displaced), you may not need surgery. Your doctor may apply a cast or splint to keep your knee straight and help prevent motion in your leg. This will keep the broken ends of bone in proper position while they heal. Depending upon your specific fracture, you may be allowed to bear weight on your leg while wearing a cast or brace. With some fractures, however, weight bearing is not allowed for 6 to 8 weeks. Your doctor will talk with you about restrictions on weight bearing.

Surgical Treatment

If the pieces of bone are out of place (displaced), you will most likely need surgery. Fractured patellar bones that are not close together often have difficulty healing or may not heal. The thigh muscles that attach to the top of the patella are very strong and can pull the broken pieces out of place during healing.

Knee Arthroplasty

Knee Arthroscopy

Meniscal Repair

Treatment of Knee Fractures

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