Total Knee Replacement
 By Jack Goldstein, MD
127 School St.
Pawtucket, RI
729-9400
A person with
advanced arthritis of the knee joint resulting in severe pain is a
candidate for total knee replacement.
When knee pain interferes with daily
activity, walking tolerance, and independence, it is time to consider this
alternative.
Many individuals choose a total knee
replacement so they can maintain normal activities of daily living.
Arthritis
The end of the femur and tibia form the knee joint. They are covered with
a thin, smooth layer of cartilage. In the knee, hyaline (surface) and
meniscal cartilage cushion the joint and absorb shock. Normally this
cartilage is lubricated by a few drops of synovial fluid. The lining of
the joint which produces this fluid is synovium. With cartilage debris
from wear, the synovium proliferates and produces excess fluid.
Cartilage has poor healing capabilities;
as it wears away, bone becomes exposed. Bone surfaces rubbing against each
other cause pain, while cartilage has no sensation. There are no
predictable or satisfactory methods for reversing the damage of arthritis.
When nonsurgical alternatives cannot bring a suitable level of relief,
total joint replacement is a realistic alternative.
Prosthesis
appearance
A total joint replacement consists of three pieces. These are made of
rugged polyethylene (high density plastic) and alloy metals. These pieces
resurface the three bones which comprise the knee joint (femur, tibia and
patella). The femoral component (the end of the thigh bone) is made of
metal. The tibial component (the top of the shin bone) has a metal tray
with a plastic insert which mates with the femoral component. The patella
component (the kneecap) also has a plastic surface which mates with a
groove in the femoral component. The knee replacement appears and
functions much like a normal knee.
Total
joint fixation
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