Explore different knee replacement surgeries and implant types. Discover the least invasive approaches and benefits of each to make informed decisions on your knee health.
Not all knee replacement surgery is the same. Surgeons will always opt for the least invasive approach – saving as much natural bone as possible. However, depending on the extent of the damage, several different surgical options and numerous types of knee implants exist.
In this article, we’ll explain the ins and outs of these different types of knee surgery and provide an overview of the knee implants currently available.
We’ll cover:
- Different Types of Knee Replacement Surgery
- Surgical Approaches to Knee Replacement Surgery
- Types of Knee Implants
Different Types of Knee Replacement Surgery
Struggling with continuous knee pain that doesn’t respond to treatment? You may need a knee replacement. If so, there are two broad types of knee replacement surgery commonly performed:
- Total Knee Replacement (TKR)
- Partial Knee Replacement (PKR)
Total Knee Replacement
First performed in 1968, total knee replacement surgery (TKR) has evolved considerably in the decades since. It involves removing the damaged cartilage surfaces (or ends) of both the thighbone (femur) and shinbone (tibia) in addition to a small amount of underlying bone.
After removing the bone, the surgeon will cement the metal tibial and femoral implants onto the bone or press-fit them. The term ‘press-fitting’ refers to implants designed with a rough surface that allows the bone to grow organically into them.
Next, a plastic button is placed on the inside of the kneecap (patella), or it could be resurfaced entirely. Finally, a medical-grade spacer is placed between the new implants to ensure the knee moves in a natural manner.
TKRs are highly successful. According to the American Academy of Orthopaedic Surgeons, 90% of people who’ve undergone TKR see a significant reduction in knee pain and an uptick in mobility and movement.
Partial Knee Replacement
Partial knee replacements are the preferred option for most orthopaedic surgeons, if possible. However, this procedure, also known as a unicompartmental knee replacement, relies on osteoarthritic damage being restricted to a single knee compartment.
Like with a TKR, the surgeon will remove the damaged portion of bone, inserting a metal and plastic replacement.
Being less invasive, PKR patients enjoy several benefits, including:
- Shorter hospital stay
- Shorter rehabilitation period
- Less pain following surgery
- Faster recovery times
- Less risk of blood loss and trauma
In older adults with more severe joint degeneration, PKR isn’t the go-to option. But, it’s the preferred procedure in younger individuals (under 65 years old) with plenty of healthy bone remaining. The only downside is that, with more bone leftover, the risk of undergoing TKR at a late date increase.
Surgical Approaches to Knee Replacement Surgery
After determining the best knee replacement surgery, your surgeon will choose a surgical approach. Usually, these differ in their level of invasiveness, with more invasive surgery carrying more risks and a longer recovery period.
Possible approaches include:
Traditional Surgery
In traditional knee surgery, surgeons make a long incision – between 8 to 12 inches – to open up the knee. The incision runs along the front midline or front side of the knee.
The approach involves cutting the quadriceps tendon to allow the surgeon to turn the kneecap and access the underlying arthritic joint.
A key benefit is the improved access to the joint. However, patients can expect to spend up to three to five days recovering in the hospital and a further 12 weeks for a complete recovery.
Minimally Invasive Surgery (MIS)
Minimally invasive surgery, as the name indicates, is a less intrusive approach to knee replacement surgery. The incision, normally 3 to 4 inches, is noticeably smaller, causing less trauma to the surrounding tissues.
There are two types of MIS approaches:
- Quadriceps-sparing approaches. During the procedure, the kneecap is gently pushed to the side, preserving the integrity of the quadriceps tendon. These approaches – subvastus or midvastus – take longer to perform but cause little to no trauma to the surrounding thigh muscle.
- Lateral approach. Often used in people whose knee bends outward, it spares much of the quadriceps by accessing the joint laterally – or from the side.
Unfortunately, not everyone is suitable for MIS; the surgeon will base their decision on the specific condition and their confidence in performing the surgery successfully.
Computer-Assisted Surgery (CAS)
Recent advances in technology are paving the way for computer-assisted surgeries. In this approach, the surgeon inputs the patient’s anatomical data to generate a three-dimensional knee model. Using this model, the surgeon can develop a detailed and tailored operational plan to reduce the need for large incisions and optimise the knee implant fit.
The enhanced precision can lead to reduced wear on the joint, ensuring a more durable and functional outcome for the patient.
Types of Knee Implants
It’s not just the procedure that can vary. Knee implants differ substantially in their core materials, including:
- Metal on Plastic: The most common and cost-effective implant, utilising metals like cobalt-chromium and titanium, can trigger immune reactions from worn, plastic particles.
- Ceramic on Plastic: Features a ceramic femoral component, suitable for those sensitive to metals like nickel, but can still lead to immune reactions from plastic wear.
- Ceramic on Ceramic: Both components are ceramic, minimising body reactions, though it may produce a squeaking sound and, in rare instances, can shatter under extreme pressure.
- Metal on Metal: Composed entirely of metal, this implant type has waned in popularity due to potential metal traces in the bloodstream and associated health concerns.
Save Money on Your Knee Replacement Surgery
Receive the highest quality knee replacement surgery at a fraction of the cost with Kardiolita Hospital. Based in Lithuania, our highly skilled and experienced orthopaedic surgeons work to remedy your knee pain and discomfort using the best procedures, techniques, and implants.
In fact, we use the newest 4th generation knee implants approved worldwide and renowned for their longevity.
Compared to conventional Irish options, operations at Kardiolita Hospital are often a tenth of the cost. And with excellent rehabilitation services, we’ll have you back on your feet within two weeks (as part of our comprehensive rehabilitation program).
Contact Kardiolita Hospital today to learn about booking your procedure.
