All About Knee Pain part 6 of 6


Arthroscopy is a relatively minor surgery performed with the use of a miniature camera (arthroscope). Arthroscopic knee surgery is commonly used to diagnose and treat knee pain. This surgery takes about an hour. During the procedure, an orthopedic surgeon can repair tissue and cartilage tears, or scrape and cut away bone and cartilage fragments to ease knee pain. Advances in arthroscopy have made this process more accurate and effective than ever before.

Recovery – In most cases, arthroscopy is an outpatient procedure. Patients often can return to office work within a week and to a normal lifestyle within a month or two. Physical therapy is important for recovering mobility.

Benefits – This surgery involves small incisions for the arthroscope and other tools, meaning a quicker recovery. Arthroscopy can provide relief from knee pain and improve mobility, allowing patients to return to a normal, active lifestyle with greater comfort.

Who is a candidate? – Patients with knee problems such as ACL tears, meniscus tears and cartilage wear are good candidates for arthroscopic surgery. The surgery can be performed on patients of all ages, depending on the condition of the knee.

Risks – Knee arthroscopy is a safe procedure with few complications. Risks may include swelling, stiffness, bleeding, blood clots, infection or continuing knee problems

There are three compartments to the knee. In a resurfacing, only the damaged areas are replaced.

Focal Knee Resurfacing

For the right patients, resurfacing is a great alternative to a knee replacement. This newer procedure replaces only a specific area of the knee cartilage surface. Broken down cartilage is removed and replaced with a custom-made, metal implant that is cemented to the bone.

Recovery – Patients are encouraged to walk soon after surgery. Many are able to drive after a week or two. Physical therapy is an important part of getting back mobility in your knee.

Benefits – Knee resurfacing may be the wave of the future in treating severe knee pain. It is less invasive than a knee replacement. Because less bone is cut away, patients are left with more of a “real knee.” It also can feel more natural than a knee replacement because the implant is custom-made to fit a patient’s knee. Recovery can be shorter than it is with a knee replacement.

Who is a candidate? – Knee resurfacing may be ideal for younger, more active patients. It can be effective for patients with focal cartilage defects and early to mid-stage osteoarthritis.

Risks – Possible (but rare) complications of surgery include blood clots, infection and nerve damage. Long-term complications may include continued pain, infection or a loosening of the implant.

Durability – Knee resurfacing is a new procedure and is predicted to last 10 to 15 years.

Partial knee replacement

Partial knee replacement may be an option for you if parts of your knee are free of disease or injury. This minimally invasive procedure may be possible when just one or two of the three compartments of your knee are damaged. In a partial knee replacement, cartilage and bone is shaved away and replaced with an implant in the affected compartment(s). This means a smaller incision and a shorter recovery time than with a total knee replacement.

Recovery – Patients usually can start moving the knee the day after surgery. Physical therapy is key to recovery and regaining mobility. Patients can be back to full activity in about a month. However, high-impact exercises, jogging and running are discouraged because implants have a surface that can wear.

Benefits – Compared to a full knee replacement, a partial knee replacement has a shorter recovery time, less post-operative pain, less blood loss during surgery and a smaller incision. In addition, more of the patient’s healthy bone and soft tissues are preserved, which means you could a have better range of motion and knee function than you would with a full knee replacement. Patients who have partial knee replacements also are still candidates for a full knee replacement, if needed, down the road.

Who is a candidate? – The ideal candidate has osteoarthritis that is severe (but not advanced) and whose pain can no longer be managed with conservative treatments. This is not a procedure for patients with significant deformity.

Risks – Possible (but rare) complications of surgery include blood clots, infection, nerve damage and other risks. Long-term complications may include continued pain, infection, and a failure, loosening or dislocation of the prosthesis.

Durability – Approximately 85 percent of knee implants will last 20 years.

Total knee replacement

When all of the parts of a knee need repair, total knee replacement may be the best option. This involves removing brokendown cartilage and bone and replacing it with the right artificial joint for you. This prosthesis is made of plastic and metal and provides fluid and free movement. It is attached to the bone with acrylic cement or can be press-fit, allowing bone to grow into the implant. Surgeons also perform any needed ligament repair. To work properly, the new joint needs support from the patient’s muscles and ligaments.

Total knee replacement in our aging and active culture is increasingly common. By 2030, it is estimated that more than 3 million total knee replacements will be performed each year.

Recovery – Following a total knee replacement, most patients spend only one to two days in the hospital however, many are done as an outpatient procedure. Patients can stand and move the joint the day after surgery and use a cane, walker or similar aid for several weeks. Physical therapy is crucial to restore motion to your joint. After six weeks, most patients are able to put full weight on their knee with the use of a cane. Full recovery and rehabilitation typically takes about six months. Patients are able to return to an active lifestyle, except for highimpact activities, such as running and jumping.

Benefits – Most patients experience dramatic improvement and relief from pain within weeks of surgery.

Who is a candidate? – Total knee replacement can be a good option for people with painful knee deformities, severe degenerative changes, or advanced or end-stage arthritis.

Risks – The risk of complications is rare in total knee replacement surgeries, occurring in less than 2 percent of patients. Your surgeon may prescribe blood thinners to prevent blood clots after surgery. Some patients notice some loss of motion, stiffness or pain. For a very small percentage of patients, the joint may fail. Studies have shown this is more common in obese patients.

Durability – Doctors have been performing total knee replacements since the early 1970s, and it is one of the most successful surgeries for knee arthritis. New data suggest that contemporary knee replacements may last more than 30 years. Approximately 85 percent of knee replacements done 20 years ago are still functioning well.

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