Surgical treatment options for knee OA
When all non-surgical treatment interventions have been exhausted and no longer help to alleviate the pain, and mobility is severely compromised, your doctor might suggest a knee replacement surgery. The best time and type of surgery can be determined with the help of an orthopaedic surgeon.
Total knee replacement
This procedure is only considered when there is clearly significant damage to the surfaces on both sides of the bones and the patient is in severe pain that cannot be alleviated by means of other treatment options. During surgery, the damaged joint surface of the knee is replaced with metal and plastic components shaped to allow continued motion of the knee.
Knee replacement is a major surgery that involves general anesthesia. It typically involves substantial post-operative pain and includes vigorous physical rehabilitation. Patients may need to use mobility aids (e.g. walking frames, canes, crutches) during recovery time. It usually takes a patient between 3 and 6 months to recover after total knee replacement surgery.
The life span of an artificial knee joint is around 10-15 years, on average, after which a second knee replacement surgery might be needed.
Partial knee replacement
If the damage from knee OA is restricted to one side of the joint only, the surgeon may consider an operation that will safeguard the healthy side. The procedure involves resurfacing only the diseased or affected side of the knee with metal and plastic, and it is usually called ‘unicompartmental knee replacement’.
Partial knee replacement involves smaller incisions, quicker recovery time and less blood loss than total knee replacement. It does however still require anesthesia, either regional or general. The disadvantages of partial knee replacement compared with total knee replacement include less predictable pain relief, and the potential need for more surgery in the future if arthritis develops in the parts of the knee that have not been replaced.
Post-operative physical therapy is needed after surgery and patients may need to use mobility aids (e.g. walking frames, canes, crutches) for the first days or weeks until they become comfortable enough to walk without assistance. Patients can usually resume their regular activities of daily living 6 weeks after a partial knee replacement surgery.
Used to realign arthritic damage on one side of the knee.When your surgeon restructures the bones, as happens in this kind of surgery, the stresses on the affected cartilage are shifted to more healthy tissue.
The surgery requires general anesthesia and due to the nature of the procedure, recovery may be extensive. A period of partial weight bearing only is usually needed for at least six weeks, often achieved through use of crutches. Putting too much weight on the knee too early may damage the bone surface and prolong healing time.
Swelling in the leg usually decreases over a span of 3 to 6 months after osteotomy surgery. Patients must exercise caution during all activities, including walking, until healing is complete. Between 6 weeks and 6 months’ time might be needed off from work, depending on how much patients rely on their knee to perform their job.
A less common surgical treatment for knee OA symptoms is arthroscopy, which usually involves the insertion of a small camera into the knee to get a clearer picture of what is happening and how best to treat it.