Minimally invasive knee replacement is an orthopedic surgical procedure that is similar to the traditional knee replacement but involves less cutting of the tissue surrounding the knee. Knee replacement or knee arthroplasty is performed to replace the worn out or damaged surfaces of the knee. Instead an implant or “prosthesis” is introduced to alleviate pain and increase mobility of the knee joint. Here, we discuss in detail about the procedure, the likely candidates for this procedure, and the associated risks and benefits.
What is minimally invasive knee replacement?
The knee is made up of several parts–femur or the lower end of the thigh bone, tibia or the upper end of the shin bone, and the patella or knee cap. Cartilage caps, present at the ends of these bones, keep the bones from grinding together. In case of damage to the knee joint, these bones may abnormally scrape together and cause pain.
During minimally invasive knee replacement, a cut is made to access the shinbone and thighbone. Next, a portion of the bones that make up the knee joint is removed. Instead, metal components that recreate the joint surface are inserted. For smooth gliding of these metal parts, a layer of plastic is placed in between the metal components. The entire procedure is carried out under general or spinal anesthesia.
Reasons for minimally invasive knee replacement
If you are into sports, a significant damage can be caused to your knee joint. Other medical conditions can also lead to damage of this joint, including osteoarthritis (most common), rheumatoid arthritis, osteonecrosis, bone tumor in the knee joint, and injury or fracture to the knee joint. If conventional treatment methods such as pain medicines and corticosteroid injections have failed, you may need to opt for a minimally invasive knee replacement.
Risks vs benefits
The benefits of minimally invasive knee replacement include less pain and blood loss, faster recovery post-surgery, shorter stay in hospital, and more rapid return to normal activities. As with any procedure, there are certain drawbacks or risks associated with minimally invasive knee replacement too. Possible complications that are known to occur are infection, excess bleeding, blood clots, injury to nearby nerves, limited range of knee motion due to stiffness, loosening of the knee components, and need for a revision knee surgery in the future.
Eligibility criteria
Not everyone can undergo a minimally invasive knee replacement surgery. A person is eligible to undergo this surgery if he/she meets the following criteria:
- Age: Should be less than 65 years of age.
- Body type: Only thin individuals who are not obese or extra muscular are ideal candidates for this surgery. The reason for the exclusion of obese and extra muscular people is that this body type would require a longer incision.
- Structural deformity: If a person suffers from joint and bone deformities such as bow legs, knock knees, and osteoporosis, they are not suitable to undergo a minimally invasive knee replacement surgery.
- Overall health: You should enjoy good, overall health in order to undergo this surgery.
During the surgery
- General or spinal anesthesia is administered to reduce any pain or discomfort during the procedure.
- Vitals such as blood pressure and heart rate are checked by the healthcare professional before the surgery begins.
- Antibiotics may be given during and after the procedure to reduce the chances of acquiring infections.
- An incision is made over the middle of the knee, cutting through the skin and underlying tissue.
- After removal of the damaged portions of the thigh and shin bone, metal implants are placed into the joint space, cementing them into the remaining bone.
- A plastic spacer is introduced into the space between the metal implants.
- Finally, the layers of skin and muscle will be surgically closed.
Post-surgery care
After the surgery, one may experience pain for which your healthcare provider will prescribe medicines. An imaging test such as an X-ray may be carried out to see the results of the surgery.
Following the surgery, your movements may be restricted and you may be asked to use a cane, walker, or crutches for a few days so that undue weight does not fall on your legs. You may notice some fluid draining out from the site of incision, which is normal. Any increase in redness, inflammation, or draining of fluid should be brought to the notice of your healthcare professional. Keeping your follow-up appointments is important while you are in the recovering stage.
After a week or so, the stitches or staples can be removed, after which a physical therapist can help you maintain your range of motion and strength. Often, a revision surgery may be needed at some point in the future.
KM NU hospitals is an orthopedic multispecialty hospital situated in Ambur. This hospital is the first of its kind that specializes in knee pain treatment, especially knee replacement surgeries. To avail the best orthopedic treatment in Ambur, come and get expert consultation from the experts at KM NU hospitals!
References:
- Are you a candidate for minimally invasive knee replacement? Bone & Joint Care Center.
https://boneandjointcare.co.in/are-you-a-candidate-for-minimally-invasive-knee-replacement/. Accessed on 9 October 2023. - Minimally Invasive Total Knee Replacement. Johns Hopkins Medicine.
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/minimally-invasive-total-knee-replacement. Accessed on 9 October 2023. - Minimally Invasive Total Knee Replacement. OrthoInfo.
https://orthoinfo.aaos.org/en/treatment/minimally-invasive-total-knee-replacement/#:~:text=Minimally%20invasive%20knee%20replacement%20is,the%20knee%20is%20less%20invasive. Accessed on 9 October 2023. - Minimally Invasive Total Knee Replacement. University of Rochester Medical Center.
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=135&contentid=352. Accessed on 9 October 2023.
Author: Dr. Tahir Ahmed