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Knee Arthroplasty

By:
Simranjit Rekhi
History of Knee Arthroplasty
• Arthroplasty of the knee was first performed
in the late 1960s
• With improvements of arthroscopes and
higher-resolution cameras,
– the procedure has become highly effective for
both the accurate diagnosis and proper treatment
of knee problems
Who gets this surgery?
• People to experience severe pain in the knee
– Restricting ordinary activities of daily living
• People usually over 65 that have knee
cartilage wearing away
• 600,000 people worldwide have knee
replacements every year.
Significance of a Knee Joint
• Knee is that largest joint in the body
• Upper and lower leg bones are joined by a
complex array of ligaments, tendons, muscles and
cartilage
• Kneecap, or patella, which serves as a bony
fulcrum for the knee muscles to slide over and
amplify strength and torque
– knee can not only bend and flex, it can twist and rotate
Knee Anatomy
• Hyaline cartilage - Thick
cushioning (cartilage) covers
and protects the ends of
your bones.
• Meniscal cartilage or
meniscus, acts like a shock
absorber between the
bones and keeps the knee
joint stable by spreading out
the load evenly across the
joint
• Articular cartilage, a smooth
substance that cushions the
bones and enables them to
glide freely
What causes Knee Arthroplasty
• Torn meniscal cartilage
• Loose fragments of bone
or cartilage
• Abnormal alignment or
instability of the kneecap
• Inflammation of the
Synovial membrane
– Fluid lubricates knee
(reduces friction)
• Torn ligaments, including
the anterior and posterior
cruciate ligaments.
Osteoarthritis
• The cartilage
that protects and
cushions the
knee joint breaks
down over time.
• Bone surfaces
rub against each
other
– Damage to
tissue and bone
Knee Arthroplasty Procedure
Non-Constrained Knee Replacement

• The artificial components inserted into the knee


are not linked to each other
• Rely exclusively on the body’s muscles,
ligaments, and tendons to keep the kneecap in
place.
• no stability built into the system.
• Most common type of replacement
Constrained Knee Replacement
• Used when the knee is highly unstable and the
person's ligaments will not be able to support
the other type of knee replacements
• Severely damaged knees
• The two pieces are connected with a hinge-like
device that keeps the joint in-line and helps
support the kneecap's proper alignment and
function.
– Though It doesn’t last as long as the other knee
replacements
Unicondylar Knee Replacement
• It is performed if the damage is limited to one
side of the joint only with the remaining part
of the knee joint being relatively spared
• The incision is only three inches compared to
8 inches for a total knee replacement
• Less invasive and more successful
Post Surgery
• Physical Therapy
• Gradually return to normal
activities
– Walking, climbing stairs
– No running, playing tennis as it
may wear the artificial joints
• Doctors recommend a CPM
(Continuous Passive Motion)
– It slowly and smoothly bends
and straightens your knee
• Stationary Bicycle – regain
strength in knee and leg
muscles
• Swimming
Different models of Knee Replacements
• Stryker & Wright Medical Technology Inc.-
produce metal implants made from nickel
chrome alloys
– Though there is toughness in these systems, they
tend to roughen and scratch over time

Scorpio TS Revision
Scorpio NRG Implants Front View ™
Knee Flexed ™
ADVANCE STATURE® Triathlon PS
Knee Knee System ™
Continued…
• Smith & Nephew Orthopaedics – enhanced the
Genesis II and Profix, to Oxinium
– Durability
– Reduced the rate of polyethylene wear by 85%
– 93% survival rate 10 years after surgery

PROFIX™
GENESIS II ™
Websites used
• http://www.ehealthmd.com/library/totalkneereplacement/TKR_types.html#non
• http://en.wikipedia.org/wiki/Knee_replacement
• http://emedicine.medscape.com/article/1250275-overview
• http://arthritis.webmd.com/knee-replacement-surgery
• http://orthoinfo.aaos.org/topic.cfm?topic=a00299
• http://physicianlink.uams.edu/casestudies/csknee.asp
• http://www.ehow.com/about_5501233_semi-constrained-knee-replacement-
information.html
• http://www.physicaltherapyweb.com/news/wp-
content/uploads/2010/02/total_knee_arthroplasty_200.jpg
• http://www.medcompare.com/spotlight.asp?spotlightid=55
• http://www.stryker.com/en-
us/products/Orthopaedics/KneeReplacement/Primary/ScorpioNRG/index.htm#
• http://global.smith-nephew.com/master/OXINIUM_GENESISII_PROFIX_22462.htm
• http://global.smith-nephew.com/us/PROFIX_TOTAL_KNEE_SYSTEM_2972.htm