PROCEDURES

Arthroplasty

Total and partial knee replacement

Joint replacement surgery, also known as arthroplasty, is done for joints which have been damaged by arthritis or as a later complication or fracture. For knees, a partial knee replacement or total knee replacement may be the most suitable option to relieve pain and restore the mobility of the joint.

What would surgery entail?

In severe cases, Dr Bismilla would advise a total knee replacement. Under general anaesthesia, an incision will be made across the front of the knee to gain access to the knee joint. The knee cap is then rotated out of position to allow your orthopaedic surgeon to access the other parts of the knee beneath it. After removing the damaged cartilage, soft tissue and bone, the thighbone (femur) needs to be prepped. The bone is hollowed out to make space for the prosthetic component to slot into it. The prosthetic component is then connected to the thighbone and cemented in place. The same is done to the shinbone (tibia). Finally, the prosthesis is fitted and fixed into the knee joint. The last step is to test the joint and ensure it bends and flexes properly before closing the incision.

In cases where only certain parts of the knee have been damaged, a unicompartmental (partial) knee replacement may be considered instead of replacing the entire joint. Although this surgery isn't done by every orthopaedic surgeon, Dr Bismilla has extensive experience in this niche surgery. This surgery is, of course, less invasive than that of a total knee replacement and involves the preserving of healthy cartilage, bone and ligaments. By removing only the damaged compartment of the knee and replacing it with a prosthetic part made from metal, ceramic and plastic, the recovery is quicker, and the knee joint itself should feel more natural.

Whether or not you are a candidate for a unicompartmental (partial) knee replacement will be decided upon inspection of the joint during surgery. Once he has made an incision, Dr Bismilla will explore the main three components of the knee and see if the cartilage damage is limited to one compartment. That specific part of the knee is then replaced with a prosthetic compartment. If this isn't the case and the cartilage damage is more severe, a total knee replacement may be done instead.

What can I expect after surgery?

You should be able to feel a drastic improvement in the mobility and pain in the knee joint roughly 4-6 weeks after surgery.
Recovery will depend on whether or not a total or partial knee replacement was done. Of course, a partial knee replacement should involve less pain and quicker recovery time. You will be asked to get up and walk the same day or one day after surgery. This is done to aid mobility and recovery of the joint and is done with the help of crutches or walking aid. Each person's recovery process is unique, but you can expect swelling and some pain for the next few weeks.
To aid in improving the mobility and motion of the knee joint, you will be sent to physiotherapy during recovery to do exercises. These exercises should then be done daily to strengthen muscles and keep the swelling in the knee down.