Knee Arthroplasty

"Knee Arthroplasty"  surgery is the process of replacing the damaged knee joint surfaces by creating an artificial joint with special implants obtained with metal and polyethylene material. During the surgery, the knee joint is explored, then the damaged cartilage and bone surfaces are removed and metallic implants are replaced. "Knee Arthroplasty" surgery, which was first applied in 1968, is being performed much more successfully today due to improved surgical techniques, advances in design and more compatible materials.

Causes of Osteoarthritis

Degenerative osteoarthritis

Rheumatoid diseases

Some metabolic diseases

After knee joint infection

Post-traumatic

Coagulation disorders

Knee problems caused by genetics

Advanced age

Obesity

Candidate Patient Group

Although patients are treated with non-surgical methods such as pain killers, rest, physical therapy methods, intra-articular injections and orthosis (walker, brace etc. ), patients whose pain cannot be controlled, whose daily life functions such as walking and climbing stairs are limited, and whose joint cartilages are damaged advencely are suitable candidates for surgery.  In spite of the fact that the patient age is usually between 55 and 80, the surgery should be applied at an early age in special cases such as rheumatoid diseases and osteonecrosis.

Operation and Post-operative process

During the preparations for the surgery, the patient’s chronic diseases, drug use, and general medical condition are examined, and patients are taken to the operation after being idealized. The surgery can be performed with general anesthesia, spinal or block methods. During the operation, the knee joint is reached and the involved bone surfaces are replaced with metallic implants. The duration of the operation is approximately one hour. The next day after the operation, the patients are able to walk with walker and to perform some knee movement exercises. When the patient can walk easily in the room and corridor, the patient can be discharged from hospital. This period varies between 3-7 days depending on the medical condition of the patient. It is necessary to use a walker for about 2-4 weeks after surgery and use blood thinning medication for about 4 weeks to prevent clot formation.

Expectations After Surgery

After "Knee Arthroplasty" surgery, more than 90% of patients have a marked reduction in knee pain and a significant improvement in daily life activities such as walking and climbing stairs. The time to start independent outdoor activities varies between 4-8 weeks depending on the condition of the patient. The return to sports activities can take 3-6 months. The curvatures and deformities existing in patients leg before surgery are also corrected during the surgery. The metal and polyethylene parts that make up the total  "Knee Arthroplasty"  are degenerated over time due to the friction that occurs during movement. The parts of the knee prosthesis can detach from the bone that it is attached to and can loosen by the body’s response to the invisibly small metal and polyethylene parts that occurred due to the abrasion. The life of knee prostheses made by using appropriate surgical techniques and modern prosthetic designs has been extended up to 20-30 years today. Loosened knee prostheses can be removed with a second operation in most patients and prosthesis can be revised. In order to diagnose problems such as abrasion and loosening earlier, it is appropriate to check patients knee prosthesis with regular examinations and x-ray images even if the patients do not have any complaints. The doctors will inform the patients when to come for a checkup.

Postoperative complications

Serious complications after total  "Knee Arthroplasty"  surgery occur at a very low rate. The most common problem is a blood clot in patients veins (deep vein thrombosis) due to the slowing down of blood flow in patients leg. To prevent this, protective treatment is applied with drugs that dilute the blood after surgery. Starting knee motion and walking in the early postoperative period and avoiding immobility will reduce this risk. After total  "Knee Arthroplasty", infection and inflammation of the prosthesis are between 0.1% and 2%. Infection elsewhere in the body (eg, urinary tract, teeth), presence of diabetes and other chronic diseases may increase this risk. It is necessary to treat infections that may occur elsewhere in the body prior to surgery. Preventive antibiotic treatment is performed during surgery and the risk of infection is reduced by taking special precautions during surgery. If infection develops in the total knee prosthesis, repetitive surgeries, removal of the prosthesis, strict antibiotic treatment and re-placement of prosthesis after a certain period of antibiotic treatment may be necessary.

Apart from the above, complications such as wound healing problems, vascular or nerve injuries, dislocation of some parts of the prosthesis, fractures around the prosthesis, fractures in the prosthesis itself can be seen but these are very rare.