Treatment: Knee replacement surgery or arthroplasty

Knee replacement surgery involves removing the damaged cartilage ends of the femur and tibia and replacing them with artificial implants.

This procedure is mainly recommended for patients suffering from severe pain and reduced function due to osteoarthritis, rheumatoid arthritis, or other forms of joint destruction.

Knee replacement, a surgeon specialised in arthroplasty

If you need a knee replacement, a surgeon you can trust is essential. Prof. Cavaignac can guide you through every stage of this surgery.

Knee surgery for a replacement: conditions requiring an arthroplasty

The knee functions through a series of interlocking and interdependent parts, if those parts don’t function well together, a knee surgery for a replacement may be prescribed.

Knee replacement surgery is often indicated for patients with advanced joint degradation, which does not respond to medication or other conservative therapies. The decision to undergo this procedure depends on several factors, including the severity of symptoms and their impact on a patient's quality of life. The following medical conditions are indications for knee replacement surgery.

• Osteoarthritis: A knee prosthesis is a good solution for patients who suffer from osteoarthritis.  It is characterized by progressive wear of the joint cartilage, leading to intense pain and loss of mobility.
• Rheumatoid Arthritis: An autoimmune disease that attacks the joint linings, causing inflammation, pain, and sometimes joint deformity.
• Trauma: Previous injuries or fractures can significantly damage the knee, sometimes necessitating arthroplasty to restore joint function.

Knee replacement surgery: Procedure

For an arthroplasty, also known as a knee replacement surgery, the procedure consists of removing the damaged cartilage ends of the femur and tibia and replacing them with artificial implants made of alloy (metal) or plastic of identical shape, which will play the same role. For knee replacement surgery, the time of the procedure is about 1 hour while requiring 1 to 3 days of hospitalization.

Candidates for knee arthroplasty generally have severe symptoms that affect their daily lives.

• Persistent Pain: Constant pain that does not subside with rest or anti-inflammatory medications.
• Joint Deformity: Visible changes in the shape of the knee can indicate advanced joint deterioration.
• Stiffness and Loss of Mobility: Difficulty in bending or extending the knee, which negatively affect daily activities like walking, climbing stairs, or sitting.
• Decreased Functional Abilities: A noticeable reduction in walking range and autonomy in daily life activities.

Total knee replacement surgery

Total knee replacement surgery is indicated in cases of severe arthritis affecting the entire knee joint. This operation involves replacing all three compartments of the knee - femoral, tibial and patellar - and installing three corresponding artificial components. It is often necessary when there is widespread wear and significant pain along with loss of function.

After the full knee replacement surgery, a period of intensive rehabilitation is required to restore full mobility and strengthen the muscles around the knee. This process can often take several months.

Partial knee replacement surgery

In comparison, partial knee replacement surgery is less invasive and targets only the part of the knee damaged by osteoarthritis, whether medial, lateral or patellar.

There are many advantages to using a unicompartmental knee prosthesis, such as faster recovery after surgery, improved range of movement and mobility, as well as excellent functional and clinical results.

Unlike total replacement of the knee surgery, a partial prosthesis preserves the healthy parts of the joint and is preferred when there is localised cartilage wear. Choosing between a total or partial knee replacement therefore depends on the extent and location of damage to your knee joint.
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Procedure for Knee Replacement

A surgical knee replacement procedure begins with anaesthesia, followed by an incision at the knee to access the damaged joint. The surgeon then removes the damaged bone and cartilage parts, replacing them with new prosthetic components.

Key Steps

• Joint Approach: Professor Cavaignac uses a minimally invasive approach called the subvastus technique. This means that the muscle tissues are spread apart without cutting them, allowing patients to regain full function more quickly.

• Bone Preparation: The bone surfaces of the femur and tibia are carefully shaped to fit the prosthetic implants.
• Implantation of Prostheses: Metal components are attached to the bone to replace the joint surfaces.
• Insertion of Interface: A plastic insert is placed between the metal components to provide a smooth gliding surface and reduce friction.
• Closure: The muscle tissues are repositioned, and the skin is closed with adhesive, which allows for quicker patient self-sufficiency.

New-generation knee replacement prosthesis

New-generation knee replacement prosthesis offer significant advances in terms of materials and surgical techniques, improving durability and comfort.

By using the latest technological innovations, Prof. Étienne Cavaignac is committed to offering his patients cutting-edge care to optimise their recovery and improve their quality of life. These innovative implants are designed to better mimic the natural biomechanics of the knee, enabling faster recovery and improving postoperative comfort.

Revision Surgery

Revision arthroplasty is performed to replace a previous knee implant that has failed or caused complications. This intervention is more complex than the first knee replacement surgery due to bone changes and scarring.

Knee Replacement: Rehabilitation

After knee replacement, rehabilitation is crucial to the success of the procedure and begins immediately following surgery.
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• Early Physiotherapy: Mobilization of the knee is encouraged starting on the day after surgery to promote blood circulation and prevent complications. Particular focus is placed on waking up the muscles, especially contraction of the quadriceps.
• Progressive Exercises: A program of progressive exercises is established to strengthen the muscles around the knee and recover the range of motion. Following a rehabilitation protocol and working with a physiotherapist are keys to successful rehabilitation. This protocol will be given to you when you are discharged from the hospital.
• Regular Follow-Up: Regular postoperative visits are done to monitor your progress and adjust the treatment if necessary. A very early follow-up around the 21st postoperative day is recommended via video consultation.

Knee Replacement: Preventing Complications

After knee replacement, the recovery period is crucial for the patient's rehabilitation. Preventing complications and managing progress is essential to the success of the procedure.
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• Infection Prevention: The use of antibiotics during surgery and meticulous wound care after knee replacement surgery is vital to prevent postoperative infections.
• Pain Management: Medications and non-pharmacological strategies, such as cryotherapy, are implemented to control postoperative pain.
• Long-Term Monitoring: Regular check-ups are done to assess the condition of the implant and the knee’s function, allowing for prompt intervention if complications arise.

The healing time for knee arthroplasty is generally several months. The superficial wound heals within a few weeks, but complete recovery and total bone healing typically require 6 months to 1 year.

Cryotherapy

Cryotherapy is often used after knee replacement surgery. This involves applying cold to the operated area, which helps minimize swelling and speed up healing.
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• Benefits of Cryotherapy: Reduces postoperative pain, decreases inflammation and swelling, and improves mobility.
• Cryotherapy Tips: Use ice packs or specialised cryotherapy devices for 15 to 20 minutes several times a day. Always place a barrier between the skin and the cold source to prevent ice burns.

Orthense: A Digital Knee Arthroplasty Follow-Up System

Orthense is a digital healthcare solution that offers continuous support to patients before and after their surgery. Used by the Toulouse University Hospital, this platform provides patients with personalised remote monitoring.

Patients follow a protocol established by their doctor, including online interactions such as information, questionnaires, and specific instructions. This system provides regular monitoring without the need for frequent hospital visits. It enhances communication between the patient and surgical teams, contributing to a more effective and personalised rehabilitation.

Knee arthroplasty is an effective solution for patients suffering from severe joint pain and functional limitations. With a thorough understanding of the procedure, appropriate preparation, and a commitment to rehabilitation, patients can expect a successful return to normal activity and a substantial improvement in their quality of life.

Do not hesitate to schedule an appointment now with knee specialist ProfessorEtienne Cavaignac. You can easily contact him by email at contact@professeur-cavaignac.com or by filling out theonline contact form.