DO YOU NEED A TOTAL KNEE REPLACEMENT
Whether to have total knee replacement surgery should be a COLLECTIVE decision made by you, your family, your family physician, and your orthopaedic surgeon. Your physician may refer you to an orthopaedic surgeon for a thorough evaluation to determine if you could benefit from this surgery. Alternatives to traditional total knee replacement surgery that your orthopaedic surgeon may discuss with you include a unicompartmental knee replacement or a minimally invasive knee replacement.
KNEE PROBLEMS FOR TOTAL KNEE REPLACEMENT
Severe knee pain that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
Moderate or severe knee pain while resting, either day or night
Chronic knee inflammation and swelling that does not improve with rest or medications
Knee deformity: a bowing in or out of your knee
Knee stiffness: inability to bend and straighten your knee
Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness in controlling knee pain varies greatly from person to person. These drugs may become less effective for patients with severe arthritis.
Inability to tolerate or complications from pain medications
Failure to substantially improve with other treatments such as cortisone injections, physical therapy, or other surgeries
Most patients who undergo total knee replacement are age 60 to 80, but orthopaedic surgeons evaluate patients individually. Recommendations for surgery are based on a patient\\\'s pain and disability, not age. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.if we are early enough we can go for another surgery
High tibial osteotomy
High tibial osteotomy is done in early to moderate stage of the knee arthritis. This is a process where in the axis of the knee joint is corrected.
The underlying priniciple is that in osteoarthritis one compartment of the knee carries more weight than the other compartment, mostly its the inner half that caries more weigh han the outer half and this uneven distribution of weight causes pain, mainly in the inner half.
In the surgery of high tibial osteotomy, the axis is corrected by creating a cleavage in the upper part of tibia and putting a plate to unite it.
Age: physiologic age < 60 yrs in an athlete, laborer, or anyone who needs to knee down such as for gardening (remember that a total knee replacemet will generally not allow the patient to kneel);
Angular Deformity:
- less than 15 deg of fixed varus deformity (often patients will have varus laxity);
- no more than 15 degrees flexion contracture
valgus deformities:
- valgus of upto 12 deg can be corrected by tibial osteotomy;