Arthritis and total knee replacement
Arthritis is a disease which causes the cartilage in a joint to gradually degrade, resulting in pain and stiffness which can gradually become debilitating. Around 15% of Australians currently suffer from it in some capacity.
The most common type of arthritis is osteoarthritis. Also known as degenerative or ‘wear-and-tear’ arthritis, it most commonly affects the knee joint. It generally worsens over time and cannot be cured, although timely intervention can delay progression and effectively manage symptoms.
Symptoms & treatment
Primary symptoms for arthritis of the knee include pain, swelling, and joint stiffness. Pain may worsen when on movement or following periods of immobility, such as standing after sitting for a while or after getting out of bed in the morning.
This is often accompanied by ‘crunching’ sounds or sensations in the joint during movement, as well as a decreased range of motion.
Treatment for arthritis of the knee
The initial stages of arthritis in the knee are treated conservatively. Techniques such as activity management and anti-inflammatory medications can help manage pain. Your doctor may recommend a walking aid – such as a cane or crutches – to improve your mobility.
Surgery may be considered if symptoms cannot be managed effectively. The typical recommendation is knee joint replacement, which involves removing the diseased bone and replacing it with a prosthetic.
Total knee replacement surgery
Total knee replacement is used to treat arthritis which does not respond to conservative management and which is not localised to one area of the knee.
It involves cutting away the diseased sections of both bones in the knee and implanting a prosthetic replica.
Where arthritis is localised to one area of the knee, a unicompartmental (partial) knee replacement can often be performed. This is a less extensive surgery which replaces only one compartment.
Indications for total knee replacement
Ulceration of the skin around the knee or leg may impact your suitability as it greatly increases the risk of post-surgical infection. Very weak knee and thigh muscles may not provide sufficient support for the prosthetic and make replacement not viable.
The shape of the bone, extent of damage, and type of arthritis can also impact suitability. Dr Jonathan Cabot will assess your suitability for surgery and determine the ideal approach as part of your pre-surgical consultation.
Recovering from total knee replacement
Following your knee replacement, your physiotherapist will usually assist you to stand within the first 24 hours. You will be encouraged to move around using a walking aids, such as a cane, frame or crutches. You will usually remain in the hospital for 3-5 days.
Most patients can discontinue use of walking aids within 3-6 weeks of a total knee replacement.
The Arthroplasty Society of Australia and Australian Orthopaedic Association recommend avoiding driving until the patient does not require narcotic painkillers and can safely perform an emergency stop. This is typically 4-6 weeks following a knee replacement on the right leg. Bear in mind that some insurance providers have other requirements and these should also be considered.