The knee is not only the largest, but also one of the most complex joints in the body. The lower end of the thighbone (femur), shinbone (tibia), and kneecap (patella) form the knee joint. Large ligaments attach the bones together, providing stability during movement. These ligaments are the anterior cruciate (ACL), posterior cruciate (PCL), medial collateral (MCL), and lateral collateral (LCL). Additionally, joint surfaces are covered with articular cartilage, a smooth substance that cushions the bones, enabling them to move easily.
Injuries, such as ligament and cartilage tears, cause a great deal of pain to the patient; however, the most common cause for pain is usually related to arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are the most common forms.
This form of the disease is typical in patients over the age of 50, with a family history of arthritis. The cartilage that pillows the bones wears away, allowing the bones to rub against each other and causing great pain and stiffness.
Rheumatoid Arthritis is a chronic disease that occurs when the synovial membrane becomes thickened and inflamed, producing too much fluid that overfills the joint space. This inflammation can damage the cartilage causing stiffness and pain.
This type of arthritis is usually the result of a serious knee injury. A knee fracture or severe tear of the knee ligaments may damage the cartilage immediately or over time, causing knee pain and limiting the range of motion.
In arthritis, it is common that pain develops gradually; however, in some cases, sudden onset is possible. When this happens, the joint becomes stiff and swollen, making it hard to bend or keep a straight knee. The stiffness increases in the morning, or when the knee has been in the same position for an extended period of time. Some patients report that weather changes affect the degree of pain caused by arthritis.
The orthopaedic surgeon will initially perform a physical examination that focuses on patient walking ability, range of motion in the limb, and joint swelling or tenderness. Imaging tests, such as magnetic resonance imaging (MRI), X-rays, and other similar tests, may be needed to efficiently diagnose the problem with the knee joint.
The orthopaedic surgeon will initially suggest non-surgical approaches, such as physical therapy, medications, change of lifestyle, and resting. However, if these treatments fail to alleviate joint pain, the surgeon may suggest surgical intervention.
For this surgery, the patient will most likely be admitted to the hospital on the day of the surgery. The first step is to be evaluated by the anesthesia team, who will decide the type of anesthesia used for the surgery.
The procedure usually takes around two hours, during which the orthopaedic surgeon will remove the damaged cartilage and bone and position the new metal, plastic, or ceramic joint surfaces to restore function of the knee.
There are three components involved in this type of surgery: the femoral (made of metal), tibial (made of durable plastic), and patellar (durable plastic).
After surgery, the patient will stay in a recovery room for about two hours to recover from the anesthesia. After waking up, the patient will be moved to a hospital room.
Dr. Haar, a board-certified orthopaedic surgeon with over 25 years of experience, uses cutting edge, state-of-the-art orthopaedic procedures in the treatment of his patients. Call us at (212) 876-7000 to schedule a consultation with Dr. Haar, or to request more information.