Treatment: arthroplasty

The knee: a complex joint

The knee functions through a series of interlocking and interdependent parts. The bones - the femur in the thigh, the patella in the knee, and the tibia in the leg - come together and are connected through this joint, which has muscles, ligaments, and tendons. At the front of the knee, the patella is this essential little pebble-shaped bone that allows all the movements of everyday life: flexion, extension...

Finally, two menisci are a protective cushion between the leg and thigh bones. To smooth the knee movement and protect the bones, the menisci contain cartilage, a thin elastic tissue. The meniscus is composed of fibrous cartilage that resists traction, and the other bones are terminated by hyaline cartilage, rich in collagen but devoid of vessels, which resists deformation.

Arthrosis of the knee or gonarthrosis: causes, symptoms and consequences

Because of this lack of vascularization, the cartilage regenerates poorly and less and less over the years. It, therefore, wears out little by little, and the regenerated parts, being of lesser quality, can tear and crack.
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This wear and tear are called arthrosis. Due to the disappearance of the protective cartilage, the femur, tibia, and patella gradually move, and the ends of the femur and tibia become deformed, causing pain and swelling of the joint, which becomes stiffer, and, therefore, increasingly difficult and painful to walk and function, sometimes even at rest.
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Gonarthrosis is not only a consequence of natural aging; it can also be accelerated by being overweight, following an accident, an operation (such as removing a part of the meniscus), or due to diseases (such as rheumatoid arthritis for example).
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The compensatory treatments are anti-inflammatory drugs, analgesics, and... the use of a cane. Indeed, the wear is definitive, walking becomes more and more complicated, and the pain becomes little by little challenging to tolerate. It is then the moment to consider a surgical intervention that will allow recovering good mobility of the knee and the disappearance of the pains.

Beforehand, the degree of pain and functional impotence will be evaluated during a clinical examination, and radiological assessments will be performed. If the intervention is necessary, the surgeon will propose to conduct an arthroplasty.

What is Arthroplasty?

Arthroplasty consists of removing the damaged ends of the femur and tibia, the areas of worn cartilage, and replacing them with artificial implants made of alloy (metal) or plastic of identical shape, which will play the same role.

The surgeon will choose this prosthesis with extreme care to adapt perfectly to the patient's anatomy and the bone and cartilage parts concerned in the femur and tibia. A polyethylene piece will be inserted between the replaced femoral and tibial parts to allow a flexible articulation between the two prostheses. It may also be necessary to place one of these on the patella.

To perform this arthroplasty, an opening will be made in the front of the knee to reach the joint. After cutting away the damaged parts of the femur and tibia, the surgeon will place the implants so that they form a perfectly fitting joint. Computer assistance is used to verify their correct positioning. Finally, the edges of the incision will be successively closed with an absorbable thread.

Finally, the edges of the skin will be brought together with staples that will be removed within two weeks by a nurse. This procedure of about one hour requires between 1 and 3 days of hospitalization.