Knee pain can be more than just an inconvenience; it can be a barrier to the joys of daily life, an obstacle to the activities you cherish, and a source of constant discomfort.
At Greater Pittsburgh Orthopaedic Associates Inc., we understand how critical it is to find a respite from the pain and regain the freedom to move without limitations. With our patient-centered approach, we offer a spectrum of specialized knee surgeries designed to meet the unique challenges of each individual we serve.
Today, we reveal several types of knee surgery, how they work and whether they might be right for you.
What Are the Different Types of Knee Surgery?
1. Total Knee Replacement
Total knee replacement is one of the most commonly performed knee procedures. We most often recommend it to clients who have suffered an extensive knee injury, osteoarthritis or another type of arthritis. The pain, damage and extensive inflammation from one of these conditions can make your range of motion nearly nonexistent.
Over time, you will be unable to perform the most basic of daily activities, such as lying down or sitting, without extreme pain. This procedure has been performed since 1968 and is often seen as the gold standard in knee procedures. It is one of the safest, most effective orthopedic procedures.
What to Expect During This Procedure
During this procedure, some bone and cartilage is removed from your shinbone and thighbone where they connect to your knee joint. The portion of the knee at the thighbone is replaced with a metal implant. The portion of the knee at the shinbone is given a plastic implant.
This provides both bones the requisite smooth surface that allows you to flex and bend your knee freely and painlessly. In some cases, we may also replace the undersurface of your kneecap with a plastic coating.
How Long the Results Last
The results of total knee replacement last, on average, between 15 and 20 years. According to research conducted by the American Academy of Orthopaedic Surgeons, over 90% of people who receive a total knee replacement are satisfied with the replacement 15 years after their procedure.
More research conducted by the American Association of Hip and Knee Surgeons indicates that there is an 80% to 85% chance that your total knee replacement will last 20 years, depending on the amount of wear and tear it sustains.
2. Partial Knee Replacement
Partial knee replacement is most often recommended to clients with only a bit of damage or arthritis in the knee. This approach requires a smaller incision and results in less bone loss. Moreover, the recovery time is shorter compared to those who received a total knee replacement.
What to Expect During This Procedure
During a partial knee replacement, the surgeon will make a smaller incision compared to a total knee replacement. The damaged part of the knee will be removed and replaced with a prosthesis, which is typically made of metal and plastic. This procedure usually involves minimal blood loss and is associated with a low rate of complications. It's important to note that the specific steps can vary depending on the individual patient's condition and the surgeon's approach.
How Long the Results Last
The benefits of a partial knee replacement can be long-lasting. Many patients find that their partial knee replacements are still functioning well 10 years after surgery. However, individual results can vary based on factors such as age, activity level, and overall health.
After your surgery, you'll work closely with a physical therapist to regain strength and mobility in your knee. You can usually expect to walk without a cane or walker after 1 or 2 weeks, and most patients are back to their usual activities within a few months.
At the end of the day, a partial knee replacement can be a game-changer, helping you get back on your feet and back to the activities you love.
3. Kneecap Surgery
There are several techniques that may be used to perform kneecap (patella) surgery. In extreme cases, we may need to perform open surgery. This involves cutting, tightening or moving soft tissue and bone. However, we most often use arthroscopy, a method that involves the use of tiny incisions and specialized instruments.
For instance, releasing tissue may be accomplished via open surgery or arthroscopy. Releasing the retinaculum allows the kneecap to move into its proper position by reducing the pull on the kneecap. Releasing a plica band is often done to ease pain. Quad transfer (moving the quadriceps muscle) or patellar realignment are performed under open surgery.
What to Expect During Recovery
During recovery from kneecap surgery, you will need to take things easy at first. During your initial consultation, our orthopedic surgeon will provide you with a comprehensive list of post-op care steps you will need to take. Your knee will be wrapped, and you will be given a brace to protect your kneecap as it heals.
By committing to rest when your body needs it, you will drastically improve your recovery time, comfort and range of motion. We strongly recommend that you keep your knee raised above your heart as you rest to help circulation. We also strongly recommend a physical therapy or rehabilitation program.
4. Complex Knee Surgery
Complex knee surgery is used to treat a complex knee injury. A complex knee injury is defined as an injury affecting several ligaments within the same knee. Such ligaments include the MCL (medial collateral ligament), PCL (posterior cruciate ligament), ACL (anterior cruciate ligament) and LCL (lateral collateral ligament).
Such an injury usually occurs after a major accident, such as a knee dislocation that occurs during a fairly traumatic sporting fall or event. This procedure requires a combined surgical reconstruction.
Candidates for This Procedure
There are several factors that go into determining if you are a good candidate for this procedure or not. First, we will take an X-ray of your knee to identify the extent of the ligament damage. If two or more of your ligaments are damaged, there is a very good chance that you are a good candidate for this procedure.
The primary exception to this is if your ACL and MCL are damaged. This procedure is so strongly recommended to people with multiple damaged ligaments because your ligaments rely on each other for your knee to function properly. However, it is equally important that you be in fairly good health otherwise and have realistic expectations.
What to Expect During Recovery
Rehabilitation after this procedure is crucial. In fact, we strongly encourage our clients to begin physical therapy the day after their procedure. The sooner you start to work on your range of motion and muscle reactivation, the better the outcome of your procedure and recovery. Working closely with a physical therapist with experience in rehabilitating clients after this type of procedure is ideal.
If you communicate effectively and give your best effort, you will experience minimal joint stiffness and return to normal muscle function quickly. Expect to work on your range of motion on your first day and weight-bearing exercises after six weeks. From there, you should start a progressive strengthening program.
What Are the Most Important Things to Know After Total Knee Replacement?
You Need to Manage Your Weight
Managing your weight after total knee replacement is critical for the long-term success of your prosthetic. When you walk, pressure equal to around four times your body weight is placed on your knee. This pressure is far greater when you engage in high-impact activities, like running, jumping, jogging, and skiing. Even kneeling can stress your knee.
Strive to maintain a weight within the healthy range for your height. This will become harder as you age because hormone levels fluctuate and cause you to feel exceptionally hungry and lethargic. Weigh yourself every 28 days. If over the course of several months, your weight appears to be trending up, speak to your general health care physician about a weight loss plan.
Watch Your Vitamin Intake Closely
Many people take nutritional supplements without looking at the ingredients closely. They know they have a vitamin B-complex deficiency, so they just eat a couple of gummies per day that have vitamin B and several other vitamins and nutrients. Unfortunately, you need to avoid vitamin K after your total or partial knee replacement.
Supplements and foods containing high levels of vitamin K should be avoided for two weeks post-op. Such foods include:
- Onions
- Cabbage
- Kale
- Soybeans
- Lentils
- Garbanzo beans
- Liver
- Green beans
- Brussel sprouts
- Cauliflower
- Broccoli
Vitamin K, along with Vitamin E, is known to thin the blood. After your procedure, it is important that your blood be able to clot appropriately, so you should avoid excessive amounts of these two vitamins. At the same time, you should take vitamin C and zinc to boost your immune system.
Other Types of Knee Procedures
Complex knee surgery, kneecap surgery, total knee replacement and partial knee replacement are by far the four most common orthopedic procedures performed on the knee. However, there are several other orthopedic procedures performed on the knee that may better suit your unique needs.
1. Meniscectomy
Meniscectomy is a procedure used to correct a meniscus tear. If you experience knee pain and swelling, but don’t have the range of motion limitations that indicate arthritis, you may have a meniscus tear. Your meniscus is the shock-absorbing bit of cartilage that sits atop your tibia and serves as a cushion for impact when you walk or run.
During this procedure, a portion of the torn meniscus is removed via arthroscopy. Since only tiny incisions are made to allow the small camera and surgical tools inside the knee, there will be no scarring and recovery will be quick.
2. Meniscus Repair
If your torn meniscus has an adequate blood supply, removal of a torn meniscus may not be necessary. In such a case, we recommend a meniscus repair. This procedure is also performed using arthroscopy. Moreover, leaving the entire meniscus in place mitigates the risk of future arthritis.
3. Meniscus Transplant
A meniscus transplant is recommended to clients who have previously undergone meniscectomy but now are experiencing more knee pain. This procedure, performed via arthroscopy, uses part of the meniscus from a donor patient to replace the damaged or arthritic part of your meniscus.
4. Plica Removal
Your plica is a tiny remnant of tissue from fetal development. Most people lose their plica over time. However, some people don’t lose all of their plica. In such cases, the tissue irritates the knee. If conservative treatment is ineffective, arthroscopy may be used to safely and effectively remove the plica from the knee and ease pain.
5. Microfracture
While microfracture may sound like an injury, it is actually a fairly commonly performed knee procedure. It is performed in knees with damaged cartilage inside the joint. This procedure is only performed when only a bit of the cartilage inside the knee is damaged. To determine the extent of cartilage damage inside your knee, we will take an X-ray of the affected knee.
6. ACL Reconstruction
Damage to the anterior cruciate ligament is the most common form of knee injury in athletes. But it doesn’t just affect professional athletes. It often affects weekend warriors. Unfortunately, the ACL is responsible for keeping the knee stable. If you tear your ACL, your knee may give out while you’re crossing the street. Therefore, it is absolutely crucial that you come in for this procedure.
ACL reconstruction involves removing the torn ligament via arthroscopy and a shaver. Your new ACL is made with own tissue and is harvested via autograft. This tissue may be taken from the hamstring tendon or knee cap tendon. Your orthopedic surgeon will tunnel through your bone to graft your new tissue. The new ligament is attached to the knee with screws.
Schedule Your Initial Consultation Today
Do you think your quality of life could be improved by knee surgery? If so, please contact us today at GPOA in Pittsburgh, PA to schedule your initial consultation. We can’t wait to meet you, assess your condition and put on the path to a quick, comprehensive recovery.
Call GPOA in Pittsburgh, PA today to get started on a new knee and the new, more comfortable life it can bring.
Frequently Asked Questions
What is the best knee surgery option?
The 'best' knee surgery largely depends on the patient's specific condition. For severe arthritis or extensive joint damage, a total knee replacement is often considered the optimal choice due to its high success rate and potential for significantly improving quality of life. However, for less extensive damage or specific injuries, less invasive options like partial knee replacement or arthroscopic procedures might be preferable.
What is the most painful knee surgery?
Total knee replacement is typically regarded as the most painful knee surgery. This procedure involves large incisions and extensive cutting and reshaping of the bone, which can lead to significant postoperative pain. The recovery process is also typically longer and more intense compared to other knee surgeries.
What is the easiest knee surgery?
Arthroscopic knee surgery is generally considered the easiest in terms of the surgical procedure and recovery. It involves small incisions, through which a camera and surgical instruments are inserted to perform the operation. This minimally invasive approach usually results in less pain, a lower risk of complications, and a quicker recovery time compared to open knee surgeries.
