Joint replacement is required when all or part of a joint is worn out or arthritic. After thorough assessment treatment is tailored to the individual patient.
Surgical options include
- Partial knee replacement
- Total knee replacement
- Joint preservation surgery (for more information see Knee Osteoarthritis treatment page)
- New – MAKO Robot Assisted Knee replacement surgery (Partial or Total)
What is involved in a Partial Knee Replacement?
This is an operation where only a part of the knee joint is replaced. This is only possible if the wear in the joint is restricted to one compartment. The knee has 3 main compartments:
- Medial tibio-femoral compartment (inside of the knee)
- Lateral tibio-femoral compartment (outside of the knee)
- Patello-femoral compartment (behind the kneecap)
The great advantage of this type of procedure is that only the arthritic part of the joint is resected and replaced, leaving intact all the ligaments and the rest of the healthy knee. The result is a more natural feeling knee.
It is a smaller operation, via a smaller incision and the recovery is generally quicker, and the patients often report that the knee feels like their own knee.
The other advantage is that you can delay having a total knee replacement for as long as the partial replacement still functions well.
After a period of time, usually up to 10 years (sometimes less), the partial replacement becomes loose or the rest of the knee becomes arthritic, and a further operation is required. The next operation is always a Total Knee Replacement.
The main disadvantage of this type of procedure is the unpredictability of how long the prosthesis will function well, and so it is highly recommended that you seek an experienced knee surgeon regularly performing this type of surgery, to get the best possible outcome.
What is involved in a Total Knee Replacement (TKR)?
This is an operation where the whole of the knee joint is exposed via an incision at the front of the knee. The knee dimensions and alignment are measured, and decisions made around how much of the arthritic joint is to be removed. Usually, a minimum amount of bone is removed.
The appropriate sized implants are selected and the new knee surfaces are cemented into place using special bone “cement” (Polymethylmethacrylate – PMMA).
This is a significant operation and appropriate preoperative planning is required to ensure a safe procedure and good outcome for the patient.
TKRs usually last on average around 15 years and provide great pain relief and restoration of knee function.
What is a Mako Robot Assisted Total Knee Replacement?
This is a new evolution in the approach to total knee replacement surgery.
Recent development in robotics and computer software templating has resulted in the development of the Mako robot assisted total knee replacement.
This involves performing a preoperative CT scan of the patient’s knee. The images are loaded onto a special software which the surgeon uses to measure the level of arthritis and perform intensive and intricate preoperative planning of the surgery. This helps to ensure a highly accurate approach two joint replacement surgery.
With the MAKO system, can plan and carry out both:
- Total Knee Replacement
- Partial Knee Replacement
The surgeon carries out the incisions to expose the knee joint and the robot as controlled by the surgeon to perform the bone cuts for the operation. The prosthesis is then implanted by the surgeon as usual.
What are the advantages of Mako Robot Assisted Surgery?:
Some studies have shown:
- Less bone and soft tissue damage
- Less requirement for strong analgesics after surgery
- A reduced length of stay in hospital
- Lower requirement for inpatient physiotherapy sessions
- Less post-operative pain
What are the disadvantages of Mako Robot Assisted Surgery?:
- Requirement for CT scan pre surgery
- Slightly longer operative time