The second most frequent joint replacement is the knee joint. Total knee replacement is a surgical operation that recreates damaged elements of the knee joint with the help of artificial implants, restores the limb axis, and increases the amount of movement in the joint.
Total knee replacement is used for degenerative-dystrophic diseases (osteoarthritis, arthritis of various etiologies), the consequences of injuries to the knee joint, which led to a significant change in the articular ends of the bones involved in the formation of the joint.
Indications for knee replacement surgery are significant pathological changes in all parts of the joint, pain syndrome, angular deformities, contractures that cause a persistent violation of static-dynamic function that does not respond to conservative therapy, mainly in patients of older age groups with the following nosological forms:
- ideopathic and secondary gonarthrosis;
- aseptic necrosis of the condyles of the femur or tibia;
- rheumatoid polyarthritis, ankylosing spondylitis;
- consequences of injuries and osteosynthesis of the distal end of the femur and proximal end of the tibia (no earlier than 3 months after removal of metal structures);
- periarticular tumors of the femoral and tibial bones, as well as soft tissues of the knee joint.
A clinical case
Patient S., 63 years old, was in the trauma department with the following diagnosis: Bilateral deforming osteoarthritis of the knee joints of 3-4 degrees. Severe pain syndrome is more pronounced on the left. Combined contracture of the left knee joint. Left lower limb dysfunction. was treated on an outpatient basis with no positive dynamics. The pain syndrome when moving in the joint was significant, the patient was forced to move only with additional support.
She was admitted for planned surgical treatment – total knee replacement (X-rays before surgery Fig. 1, 2)
Total endoprosthetics of the left knee joint was performed. During the operation, a significant number of osteophytes (bone growths) were identified and removed.
The patient was activated on the 2nd day after surgery. The patient is allowed a full load on the operated limb.
On the 6th day after the operation, the patient was transferred to rehabilitation treatment, and control examinations showed a gradual recovery of the lower limb function.
The length of the limb was restored, the maximum amount of movement possible for a total knee replacement was restored, and the pain syndrome was practically stopped. The patient can load the operated limb with the entire body weight.