Why are Knee Replacements Performed?

Knee replacement surgery is performed for a number of conditions but the commonest is osteoarthritis. Osteoarthritis is often thought of as age related wear and tear. It is a disease which affects the whole joint including bone, ligament, muscle and of course cartilage.

Knee arthritis causes pain and stiffness. It may come on gradually. Pain can be worse with activity but may also be present at rest including in bed at night. Pain may limit how far you can walk and make it difficult to perform your normal activities such as golf, bowls, tennis or even surf. Joint stiffness may make it difficult to completely straighten or bend your knee. It may become difficult to walk up or down stairs.

The aim of knee replacement surgery is to relieve pain and restore function to enable you to walk, sit, sleep and perform your activities of daily living and leisure activities more comfortably. The surgery aims to improve your quality of life.

What Types of Knee Replacement Are There?

Knee replacement can be total or partial. In the majority of cases a total knee replacement will provide the best long term results. A partial knee replacement, where only one side of the joint is replaced, can be considered in very specific circumstances. You need to be aware, however, that a partial knee replacement may not last as long as a total knee replacement and when it fails the result of your revision (re-do knee replacement) may not be as good as if you had a total knee replacement to begin with.

Many different types of prostheses are available and the Australian National Joint Replacement Registry collects data which, along with your clinical and radiological findings, is used to help select the most appropriate prosthesis for your knee. 

Are There Different Ways to do a Knee Replacement?

Dr Freihaut, along with his anaesthetic team, pioneered the use of rapid recovery joint replacement in northern New South Wales, a technique now used in various forms throughout the country. Early mobilisation reduces your risk of complications and allow faster return of function. 

A number of different alignment options can be used when performing a knee replacement such as traditional mechanical alignment, adjusted mechanical alignment and kinematic alignment. This relates to how the prosthesis is positioned inside your knee. The kinematic alignment technique enables faster recovery and generally generates higher functional outcomes as it aims to replicate your normal knee anatomy unlike more traditional techniques.

There are a number of different tools that can be used by the surgeon. A combination of tools such as robots, computers, mechanical jigs and tensioning devices can be used to cut the bone to the surgeons chosen method of alignment. It is, however, the alignment method not the tool used which has the greatest influence on your outcome.

Do I Need a Knee Replacement?

If you have significant pain which is no longer responding to other forms of treatment such as exercise and medications, or you are struggling to work or look after people who depend on you, you may need to consider a knee replacement.