Osteoarthritis: Total Knee Arthroplasty’s Role in Managing Chronic Joint Degeneration

 

You have been suffering from knee osteoarthritis for years, with increasing pain and disability. Medications and physiotherapy have provided only temporary relief. Your orthopedic surgeon has recommended a total knee arthroplasty. Although the idea of major surgery may be worrisome, it could greatly improve your quality of life. In this article, you will learn about this procedure, how it relieves knee osteoarthritis, and the recovery process. This will help you make an informed decision about the opportunity for a total knee arthroplasty.

Understanding Osteoarthritis and Knee Degeneration

Osteoarthritis is a chronic joint disease that causes the deterioration of cartilage in the joints, especially in the knees. It leads to progressive pain, stiffness, and functional impairment.

Over time, the cartilage wears down, the subchondral bone thickens, osteophytes (bone spurs) form, and the joint becomes inflamed. This results in pain and loss of mobility.

Knee degeneration is the process in which the knee cartilage gradually wears down. It is often caused by:

  • Aging and normal wear and tear
  • Repeated traumas or microtraumas
  • Weight problems
  • Lower limb alignment issues

Initially, conservative treatments like physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), or injections may provide relief. However, in the long term, only surgery with total knee arthroplasty can replace the damaged joint.

Total Knee Arthroplasty involves resurfacing the bone surfaces and implanting prostheses to replace the joint surfaces of the femur, tibia, and patella.

When to Consider Total Knee Arthroplasty?

Total knee arthroplasty, also known as total knee replacement, may be considered to alleviate pain and improve function in patients with severe knee osteoarthritis. The procedure is generally recommended when conservative treatments like anti-inflammatory medications, injections, physiotherapy, and walking aids no longer control the symptoms.

It can be proposed in cases of significant functional limitations, pain at rest or during the night, and functional disability.

Total knee arthroplasty is also an option for patients whose quality of life is affected by knee osteoarthritis. Factors such as age, activity level, involvement of other joints, and overall health are crucial in the decision-making process.

A thorough evaluation by a multidisciplinary team is necessary to determine if the intervention is appropriate. While total knee arthroplasty generally provides significant relief from symptoms, it’s important to consider the risks and limitations of this major surgery before making an informed decision.

For a consultation, please make an appointment with Dr. Benoit by filling out the following form, or contact his assistant at 514 331-1400

The Process of Total Knee Arthroplasty

Total knee arthroplasty, also known as total knee replacement, is a surgical procedure aimed at replacing the damaged joint surfaces of the knee. Here are the main steps of this procedure:

  • Preoperative examination – Blood tests, radiological imaging, and cardiac evaluations are performed to ensure you are fit for surgery.
  • Anesthesia – General or spinal anesthesia is used to put you to sleep and block pain.
  • Incision – The surgeon makes a 15 to 20 cm incision at the knee to access the internal structures.
  • Bone resurfacing – The worn cartilage and underlying bone are removed, and the bone surfaces are prepared to receive the prosthetic components.
  • Component placement – The prosthesis, made of metal and plastic components, is attached to the ends of the femur and tibia bone.
  • Closure and dressing – The tissues are stitched, and a sterile dressing is applied.
  • Rehabilitation – Rehabilitation typically starts the same day, right  after surgery to regain mobility and muscle strength.

Follow your surgeon’s post-operative care recommendations carefully to optimize your recovery. Don’t hesitate to seek medical attention in case of complications.

Rehabilitation After Total Knee Arthroplasty

Rehabilitation is an essential part of the recovery process after total knee arthroplasty. It helps you:

  • Regain knee mobility
  • Strengthen the muscles around the joint
  • Improve balance and coordination
  • Learn to use the new joint correctly

Here are the typical stages of rehabilitation:

  • Gentle knee mobility exercises starting on the day after surgery.
  • Active range-of-motion exercises from the first week.
  • Light muscle strengthening from the second week.
  • Walking with crutches or a walker after 2 to 3 weeks.
  • Balance and proprioception exercises after 4 to 6 weeks.
  • Gradual return to normal activities between 2 and 3 months.

It’s important to follow the physiotherapist’s recommendations diligently to optimize your recovery. Rehabilitation is a long process that requires motivation and perseverance. However, it can help you regain mobility and independence and fully enjoy the benefits of your new knee prosthesis.

Finding a Good Orthopedic Surgeon in Montreal or Quebec

Total knee arthroplasty is a complex surgical procedure that requires an experienced orthopedic surgeon to achieve the best results. Here are some tips to help you find the right orthopedic surgeon in Montreal, Quebec, and/or Canada:

  • Ask for recommendations from your family doctor or other patients who have successfully undergone knee arthroplasty. Word of mouth is often the best way to find an excellent surgeon.
  • Ensure that the surgeon is certified by the Royal College of Physicians and Surgeons of Canada and specializes in orthopedic surgery.
  • Choose a surgeon with significant experience in knee arthroplasties, ideally performing at least 50 per year. More experienced surgeons generally yield better results.
  • Ensure that the surgeon operates in a reputable hospital with an experienced team and the latest technologies.
  • During the consultation, pay attention to how the surgeon communicates. A good surgeon will take the time to explain the procedure and answer all your questions.
  • Don’t hesitate to ask the surgeon about their complication rate and patient satisfaction rate. A good surgeon should have good outcomes.

Take the time to choose your orthopedic surgeon carefully—it’s an important decision for your health and quality of life. A qualified and attentive surgeon will give you the best chances of success for your knee arthroplasty.

Conclusion

In conclusion, total knee arthroplasty can be an effective therapeutic option for some patients with severe and refractory knee osteoarthritis. However, this major surgical intervention is not without risks and should be carefully discussed with your orthopedic surgeon. They will determine if you are a suitable candidate based on your age, overall health, and the degree of joint involvement. Tailored rehabilitation and diligent follow-up are essential to optimize functional outcomes and the longevity of the prosthesis. By adhering to your healthcare team’s recommendations, you can hope to regain mobility and quality of life.