Knee Replacement Surgery

Knee pain can affect your daily life, making even the simplest tasks difficult. Everyday activities like walking, bending, and climbing stairs can become difficult, if not impossible.

Conditions known to cause chronic knee pain, such as arthritis and injuries, can often be managed with nonsurgical treatments like medications and physical therapy. However, for some patients nonsurgical treatment is not sufficient in relieving pain.

If nonsurgical treatments are not effective in managing your knee pain, knee replacement surgery may be an option for you.

How the Knee Functions

Before we explain how a knee replacement can help, it’s helpful to understand how the knee works.

The knee is formed by the upper end of the shinbone (tibia) and the lower end of the thighbone (femur). The kneecap (patella) sits in front of the joint. In a healthy knee, articular cartilage covers the ends of the bones where they meet to allow the knee to glide with movement. C-shaped wedges of tissue called the menisci are also located between the shinbone and thighbone to absorb shock. Ligaments hold the joint together for stability.

The knee is divided into 3 major sections, or compartments: the medial compartment (the inner part of the knee), the lateral compartment (the outer part of the knee), and the patellofemoral compartment (the front of the knee).

Arthritis and some injuries can cause the articular cartilage to wear down. Eventually, the cartilage may completely wear away in some places, causing the bones to rub together. Sometimes, this damage is limited to one section or compartment of the knee, and sometimes it occurs throughout the knee. This can be very painful and may indicate the need for surgical intervention.

Candidates for Knee Replacement

If you think knee replacement surgery might be right for you, an orthopedic evaluation will be necessary to determine whether surgery is appropriate.

If you experience one or more of the symptoms below, knee replacement surgery may be an option for you.

• Pain and/or stiffness in the knee that is severe enough to limit daily activities like walking, standing, bending, or climbing stairs.
• Knee pain that persists even while at rest.
• Inflammation and/or swelling in the knee that does not improve with rest or medication.
• Bowing in or out of the knee.
• Chronic pain, stiffness, and/or inflammation in the knee that does not improve with nonsurgical treatments, including anti-inflammatory medications, injections, and physical therapy.

Knee Replacement Procedures

At Orthopedic Specialists of San Diego, Dr. James Bates, Dr. Mark Jacobson, Dr. Steve Allsing and Dr. Ralph Rynning offer surgical options to treat knee arthritis, including knee replacement surgery. The majority of patients who have knee replacement surgery experience improved knee function and reduced pain after recovery.

Depending on the location and severity of cartilage damage, there are two different options for knee replacement surgery. Your doctor will work with you to determine your options and choose the best procedure for your condition.

Partial/Unicompartmental Knee Replacement

If damage is limited to just one compartment of the knee, a partial or unicompartmental knee replacement may be an option. During a partial knee replacement, the damaged compartment of the knee is replaced with metal components, and a plastic spacer is inserted between them. The healthy compartments of the knee are left intact.

Benefits of partial knee replacement may include less blood loss during surgery, a quicker recovery time, and less pain after surgery. Some patients who have undergone a partial knee replacement report that it feels more natural and bends more easily than a total knee replacement because the healthy parts of the knee remain intact.

However, a partial knee replacement is not appropriate for patients whose arthritis damage extends beyond one compartment of the knee. For these patients, a total knee replacement may be recommended.

Total Knee Replacement

During a total knee replacement, the ends of both the thighbone and the shinbone are resurfaced with metal implants where they meet to form the knee joint. The damaged cartilage and a small amount of underlying bone are removed to fit the implants into place, and a plastic spacer is inserted between them to allow the knee to bend more easily.

Many total knee replacements function well 15 or more years after the procedure. Physical therapy is an important part of recovery for both total and partial knee replacements, and regular light exercise will help you maintain strength and function in the new knee.

Revision Total Knee Replacement

The majority of knee replacements function well for years after surgery. However, in some cases a revision procedure may be needed years down the road to ensure proper knee function. Common reasons for revision total knee replacement include infection in the knee and implant wear and loosening over time.

During a revision total knee replacement, the old knee implants are removed and replaced with new ones. The revision implants typically vary slightly in size and shape from the original implant to help restore alignment and stability in the knee.

Knee Replacement Surgery in San Diego

At Orthopedic Specialists of San Diego, we serve patients with knee arthritis in San Diego and surrounding communities, providing surgical solutions like total or partial knee replacement when knee arthritis symptoms do not respond to nonsurgical treatment. If you have any questions about knee replacement or would like to schedule an appointment with Dr. Bates, Dr. Jacobson, Dr. Allsing or Dr. Rynning, please call our office at 619-286-9480.

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