For some patients, nonsurgical treatment can provide relief from knee arthritis, allowing them to carry on with their normal activities. However, when nonsurgical treatment fails to relieve pain and stiffness in the knee, surgical intervention may be recommended.
Knee replacement surgery can be an effective solution for patients suffering from severe knee arthritis. Knee replacement surgery can improve knee function, allowing patients to more easily participate in everyday activities.
Anatomy of the Knee
The knee is formed where the upper end of the shinbone (tibia) and the lower end of the thighbone (femur) meet. The kneecap (patella) is positioned at the front of the knee, and the joint surfaces are lined with articular cartilage to protect the bone and allow the joint to move more easily.
The joint is also covered with a tissue called the synovial membrane, which secretes a small amount of fluid to lubricate the joint. Wedge-shaped pieces of cartilage called the menisci are located between the thighbone and the shinbone, absorbing shock within the joint. Ligaments called the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) stabilize the knee.
Arthritis can affect the cartilage in the knee, causing it to wear down over time. This can lead to pain and stiffness in the knee, which may eventually require surgery.
When Is Knee Replacement Recommended?
If nonsurgical treatments like medications and physical therapy do not relieve symptoms of knee arthritis, you may be a candidate for knee replacement surgery.
Knee replacement surgery may be recommended if pain and stiffness in the knee limit normal activities, like walking or climbing stairs. For some patients, pain may persist even while at rest. Chronic swelling and inflammation may also indicate the need for surgery if medications do not help. Knee replacement surgery can also correct knee deformity, such as a bowing in or out of the knee.
Knee Replacement Procedure
Knee replacement is best thought of as “resurfacing.” During a knee replacement, Dr. Tiberi removes the damaged portions of the knee, resurfacing them with metal implants designed to improve knee function. A plastic spacer is inserted between the two implants to allow the metal components to glide smoothly. In some cases, the back of the kneecap may also be resurfaced.
The knee is divided into three compartments. If only one compartment of the knee is damaged, a partial knee replacement may be recommended instead of a total knee replacement. During this procedure, only the damaged compartment of the knee is replaced with prosthetic components.
Dr. Tiberi keeps current on the latest advances in knee replacement surgery, and employs many state-of-the-art techniques and technologies in his practice, including robotic-arm technology and ACL preserving approaches.
Robotic-Arm Assisted Partial and Total Knee Replacement
With Mako Robotic-Arm Assisted Technology, Dr. Tiberi can create a customized plan for patients undergoing knee replacement surgery. The process starts with a CT scan of the knee prior to surgery, which is then uploaded into the Mako System software. The software creates a 3D model of the knee, which allows Dr. Tiberi to plan the procedure ahead of time.
During the procedure, Dr. Tiberi uses the Mako Robotic-Arm to guide him in placing the implants, based on the pre-defined surgical plan. This technology allows for more accurate sizing and placement of the implants.
ACL Preserving Knee Replacement
In a typical total knee replacement, the ACL is removed and the implants take on the job of stabilizing the knee. This procedure is helpful for restoring stability, alignment, and function for many patients.
However, if a patient’s ACL is healthy, an ACL preserving knee replacement may be an option. Specially designed knee implants allow the ACL to remain attached to provide stability to the knee. While this procedure may not be an option for every patient, Dr. Tiberi offers this procedure for patients who are good candidates.