Total Knee Replacement

Every patient and situation is different. You and Dr. Crossman will discuss your specific case/symptoms. Dr. Crossman will review with you your x-ray findings, your exam findings and history. At that time conservative treatment as well as possible surgical treatment will be discussed. Once the options have been discussed and your questions have been answered the decision for conservative or surgical intervention will be up to you. A total knee replacement brochure and informational packet will be provided to you as well for your review. The decision for surgery is an important decision for every patient. We will provide you with the information and answers to your questions as needed so you can make an informed decision. You may take as much time as you need to think about your options and discuss with family members. You may also make follow up appointments to further discuss questions and options.

The surgery itself usually takes about 1.5 hours and you will be in the hospital for 1-2 days. Some patients may be candidates for outpatient/same day total knee replacement based on medical history and social conditions. The majority of patients will start immediate outpatient physical therapy when discharged from the hospital. You will have a followup appointment with Dr. Crossman 1-2 weeks postoperatively and then continued regular followup appointments. You will transition from a walker, to a cane and then to no assistive device as tolerated safely.

Are you a candidate for knee replacement surgery?

Every patient and situation is different. I general candidates for knee replacement surgery include:
- Pain restricting work, recreation and activities of daily living
- Patients who have failed conservative treatment consisting of:
  - Intermittent use of anti-inflammatories/pain control
  - Physical therapy
  - Activity modification
  - Injections
- Significant joint stiffness
- Loss of mobility
- X-ray evidence of severe/advanced arthritis.

Knee Anatomy

The knee is a large joint and is required to perform most activities throughout our day.

The knee consist of the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the knee cap (patella).

A smooth substance known as articular cartilage covers the ends of these 3 bones. This articular cartilage allows the 3 bones to move easily and smoothly.
The meniscus acts as a shock absorber and cushion between the femur and tibia.
Ligaments including the lateral collateral, medial collateral, anterior cruciate and posterior cruciate hold the knee bones together and provide stability.
Long muscles of the thigh allow for mobility and strength for the knee.
A thin aligning known as synovium surrounds the knee and releases of fluid to lubricate the articular surfaces reducing friction.

Three Main Causes of Arthritis:

Osteoarthritis - age related wear and tear. The smooth cartilage that covers the knee bones wears away and the bones rub against one another causing pain and stiffness.
Rheumatoid arthritis - An inflammatory arthritis caused by mild thickening and inflammation of the synovial membrane. Over time this inflammation can damage cartilages leading to loss of cartilage, pain and stiffness.
Post-traumatic Arthritis - Serious injury to the knee, such as fractures, can damage the articular cartilage resulting in knee pain, stiffness debility.

Description of Surgery:

A series of thin cuts are made at the end of the femur and tibia to remove the damaged cartilage.
Metal implants are positioned to replace the removed bone to recreate the joint. The metal implants are either cemented or press-fit onto the bone.
Depending on the condition of the patella, the patella may or may not be resurfaced with a plastic button.
A medical grade plastic spacer is then inserted between the metal components to create a smooth gliding surface.

TOTAL KNEE REPLACEMENT FAQ