Total Knee Replacement (TKR)
The most common need for a knee replacement is osteoarthritis. Knee joint osteoarthritis is a degenerative disease resulting in the wearing away of the lubricating cartilage of the knee joint. This causes the end of the thigh and shin bones to rub together, resulting in pain with standing, walking, stairs, and activity. Sometimes, a bow-legged or knock-kneed appearance of the leg may develop. Pain can be felt all over the knee, or be localized to certain areas, depending on where in the joint the arthritis is. Degeneration can occur in three areas of the knee joint: the medial (inner) knee, the lateral (outer) knee, and behind the knee cap. Patients with end stage osteoarthritis, or osteoarthritis in two or more areas of the knee joint, could be considered candidate for a total knee replacement.
A total knee replacement is an option for patients with pain that affects their activities of daily living and quality of life. Typically, a knee replacement is indicated after exhausting conservative treatment options including steroid injections, viscosupplementation “gel” injections, anti-inflammatory medication, physical therapy, bracing, activity modification, lifestyle changes and/or weight loss.
A total knee replacement is a surgical procedure in which the knee joint surfaces are replaced with artificial implants. This consists of replacing the ends of the thigh and shin bones of the natural knee, and resurfacing the back of the knee cap. A plastic spacer is placed in between the metal implants of the thigh and shin to mimic a joint space. A total knee replacement helps to relieve pain, increase knee motion, correct knee alignment, and improve function.
There have been advancements made in the total knee replacement procedure over the years. Dr. Durkin performs a “minimally-invasive” technique which allows for a smaller surgical incision, and does not cut the quadriceps muscle, which assists in easier recovery. He also uses an MRI-based technology for patient-specific preoperative planning. A patient is requested to obtain a special MRI scan of the knee 6 weeks prior to surgery. This MRI is used to develop a guide that Dr. Durkin uses during surgery to help determine the optimal knee alignment and correct size of the knee implant.
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While many patients with knee joint osteoarthritis are best suited for a total knee replacement, some patients with osteoarthritis and pain localized to only one area of the knee joint may be a candidate for a partial knee replacement.
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