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Knee Prosthesis and Revision

In cases of advanced osteoarthritis and joint rheumatism where a positive response is not obtained from physical therapy, knee replacement surgery is used to regenerate cartilage.

Knee Replacement Surgery 

The knee joint is often subjected to deformities because of its frequent use in activities such as walking, sitting, and carrying weight. It has a complex structure consisting of bones, cartilage, soft tissue, and joint fluid, which enables movements like walking, running, jumping, and standing. Chronic knee joint conditions such as rheumatism and osteoarthritis can cause limited mobility and persistent pain. Knee replacement surgery is a successful orthopedic procedure in cases where the knee joint negatively impacts daily life.

What is Knee Replacement?

Knee replacement involves the substitution of a damaged knee joint with artificial components, either entirely or partially. The implant options include total prosthesis and unicondylar (partial) prosthesis made of metal and polyethylene. The knee prosthesis, which is usually implanted in place of the damaged cartilage, restores the mobility of the knee joint and relieves the pain caused by contact, pressure, and irritation.

In Which Situations Is Knee Prosthesis Performed? 

Physical therapy and medication are typically the first line of treatment for knee pain and limited mobility, as determined by the patient's physical examination and the extent of knee joint degradation. However, surgery may be considered as a primary treatment option in cases of advanced calcification, joint rheumatism, and extensive cartilage damage resulting in joint fluid loss. Knee replacement surgery may be necessary if the patient experiences any of the following conditions:

  • Limited joint movement and knee locking

  • Difficulty in activities such as walking, standing up, and climbing stairs

  • Bone-on-bone contact due to advanced cartilage loss

  • Severe knee pain

  • Pain that interferes with sleep and causes sleep disturbances

  • Knee deformity.

How is Knee Replacement Surgery Performed?

Knee replacement surgery is performed using the open surgery method and under general anesthesia. During the procedure, the damaged cartilage is removed from the bones, and metal alloy is used to cover the bones forming the joint, which are then fixed in place to prevent rubbing. The use of a robotic surgery system may be considered as an alternative. Patients typically take their first walk the day after the surgery, and are discharged from the hospital after walking around 70-80 steps, usually on the 2nd day. Physical therapy is continued after discharge. The surgery can be performed on one knee or both knees at the same time.

Knee Replacement Revision

The second or third operations performed on people who have had a knee prosthesis before are called knee prosthesis revision surgeries.

The expiration of the prosthesis, infection, deterioration of the bone and soft tissue surrounding the metal prosthesis, of the prosthesis implant, recurrent joint stiffness, feeling of instability in the joint and gait disturbances are the conditions that cause the knee replacement surgery to be repeated.

Prosthetic infections usually occur in 2 stages. First of all, the infected knee prosthesis is surgically removed and replaced with a temporary prosthesis called a spacer with antibiotics, after 2 months of antibiotic treatment and after the clinical and blood infection values return to normal, a second surgery is performed and the patient is restored to health. The process proceeds as in primary knee replacement.

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