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x-ray example of knee arthritis and total knee replacement

Total Knee Replacement

What is arthritis?

There are a few types of arthritis, the most common of which is osteoarthritis.  Osteoarthritis is a "wear and tear" disease of joints in which the cartilage wears out over time.  The cartilage is the cushion of the joints between the bones.  When the cartilage wears out the space between the bones decreases until the joint is "bone-on-bone".  This is the case for the x-ray examples above on the left hand side for a knee.


Arthritis can be treated with a few different modalities before surgery is indicated.  Anti-inflammatory medications (NSAIDs), physical therapy or a home exercise program, injections, weight loss, and activity modification should be tried first before surgery.  If these treatment modalities are not working to help a patient achieve the quality of life they desire then joint replacement is often the next step.    

What is involved with total knee replacement surgery?

Total knee replacement involves making an incision over the front of the joint and cutting the ends of the femur and tibia bones to get rid of the arthritic portions.  Cutting guides are then used to shape the bones to fit the implants.  The ligaments on the sides of the knee are then tested until the tension on both sides is about equal, this is called "balancing" the knee and helps to improve the longevity of the implants.  The last step involves cementing the components into place.  


The recovery process for total knee replacement is often a little more difficult than a total hip replacement.  More rehab is required postoperatively to make sure the knee doesn't become stiff.  

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