Total knee prosthesis

Knee joint replacement is the final treatment for knee wear and tear.

This can be accelerated by an old fracture or fractures that did not heal properly. The natural wear and tear of the joint can be due to biomechanical causes, aging, or certain diseases that attack components of our own body—in this case, the cells of the joint or the synovium, causing it to wear out a little faster.

When is surgery recommended?

It is recommended depending on the patient. If they have already gone through all the treatment steps—physical therapy, medications, some types of injections—and if nothing is working anymore, the solution is to get a new knee.

A knee prosthesis consists of several elements, three main ones in standard primary replacements: the femoral component, which involves making certain cuts in the bone at the end of the femur to place metal where there was once cartilage.

How is a total knee prosthesis composed?

The knee prosthesis consists of several elements, three main ones in primary replacements: the femoral component, which involves making certain cuts in the bone at the end of the femur to place metal where there was once cartilage.

Another part is a special, highly durable plastic in the middle, which will bear the load when you walk or perform activities with your knee.

There are many types and designs, and this depends on and is tailored to the type of deformity, whether there are ligament injuries or other issues.

The other part is the lower section, the metal piece that goes on the tibia, which can be cemented or uncemented. This also comes in different shapes depending on the type of prosthesis. Beyond the type of prosthesis, something that must be carefully considered when placing this component is how strong the base is—whether it’s too weak, if the bone is osteoporotic, if there’s a fracture, or if something else makes it an unstable foundation.

We may need to secure it further, so to speak, or give it a little more support from below. For this, something called a stem is added, which is essentially like a small tube that helps distribute the load, reducing the chances of it loosening prematurely.

The incision for placing the prosthesis is usually made in the middle of the knee, but once we reach the muscles, there are different types of incisions used depending on the surgeon’s experience and the goals of the procedure. The most common is called a parapatellar approach, which is basically a vertical cut on the inner side of the knee.

Types of surgical approaches

The incision for placing the prosthesis typically involves a cut in the middle of the knee, but once we reach the muscles, different types of incisions are used depending on the surgeon’s experience and the goals of the procedure.

The most common is called the parapatellar approach, which runs vertically along the inner side of the knee for better visibility. There are other types of incisions that may allow for slightly faster recovery in the first few weeks or provide better visibility if needed, but this depends on the specific case. Whether it’s a first-time (primary) surgery or a revision due to loosening, infection, etc., that’s something your doctor will decide.

If you’d like more information about knee replacement or are considering getting one, I invite you to schedule an appointment at 664 976 3510 or email me at: pacientes@mongeortopedia.com.