Total knee replacements (TKR) at a glance.

What are they?

An implant also known as a prosthesis made up of metal (alloy of titanium, cobalt and chromium) and high grade resistant plastic. The implant effectively replaces the damaged cartilage that covers the ends of the thigh bone (femur), shin bone (tibia) and knee cap bone (patella). This provides a new articulating surface for the bones of the joint to move on. Improving (not fully) range of movement, and potentially improving the pain level.

How are they done?

Surgical procedure

https://www.nhs.uk/conditions/knee-replacement/what-happens/

Why can we have them?

At times when there is destruction or degeneration to the knee beyond what the body can cope with functionally and symptomatically. This can be through age, disease/illness, or injury.
There is no question that our own knee is better equipped to dealing with the forces/strains of normal weight bearing mobility/function. However when we are unable to function because of the lack of mobility at the joint and the pain is beyond coping mechanisms, then a new knee has to be in contention.

When is the time to get them?

Evidence shows that only because there is degeneration of the cartilage and exposure of bone there is not necessarily pain.

✅ As we know pain is not equal to damage. We have many patients who never ever experience any problems with a joint but do have signs of degeneration (I.e. hard end feel and reduction of specific movement patterns).

✅ We have patients who do have a problem which highlights the a degenerative joint but does not mean it is the arthritis/cartilage disruption that is the issue.

✅Evidence shows that conservative treatment can successfully manage a ‘flare up’.

We need to ask ourselves:

✅ how often are we experiencing ‘flare ups?’
✅ how is it affect our functioning? Our life practically?
✅ how consistent is the pain? Being realistic.
✅ have we tried conservative treatment and medication (if needed) adequately and appropriately? If we have have we been realistic.
✅ are our expectations of surgery realistic, valid and factual?
✅ do we understand this is a major operation that we need to recover from and are sure we will be proactive in achieving realistic goals you have set ourselves prior to the surgery.
✅ the implant lasts approximately 15 years, after this time revision will be inevitable.
✅ is a TOTAL knee replacement needed? Is there any need?

Could you be a candidate for a uncompartmental or bi-compartmental replacement where more of the true knee is preserved?