Total Knee Prosthesis

Total knee prosthesis surgery aims to create an artificial joint surface by covering the worn articular surfaces with prostheses made of metal and polyethylene that are specially designed for painless joint motion. It was first applied in 1968, and became a much more successful treatment option owing to the advances in surgical techniques, materials used, and design of the prostheses.

Who is candidate for total knee prosthesis ?

Total knee prosthesis is appropriate for patients who have uncontrollable knee pain and high degree restriction in daily activities such as climbing stairs despite treatment methods including rest, medications, physical therapy methods, use of walking stick and intraarticular injection. It is preferably applied to patients aged between 60-80, but the prothesis can also be implanted to younger patients in case of special occasions such as rheumatoid arthritis or osteonecrosis.

How is total knee prosthesis implanted ?

Following proper anesthesia, an incision is made to the front side of the knee to reach knee joint. The worn cartilage tissue covering the contact surfaces of the three bones that contribute the joint is excised along with a thin layer of underlying bone tissue. Then, parts of the prosthesis in appropriate size are attached to the bone surfaces using a filling material called bone cement (polymethyl methacrylate). Thus, joint surfaces are covered with parts made of metal and plastic. The operation lasts about 1-2 hours. After the operation, pain control is often achieved with pain pumps which administer analgesic via epidural (from lower back) or intravenous route. You may be discharged from the hospital once you are able to walk freely. This takes about 3 to 7 days, greatly varying between patients. Anterior cruciate ligament (ACL) is one of the structures that connect femur and tibia bones together in the knee joint. This ligament has a very important role in normal function of the knee, and it is the most important structure that prevent forward displacement of the tibia. ACL injuries often occur during sudden twisting movement on one stationary foot. It usually occurs as a result of the movement of the sportsmen himself. Less frequently, direct impacts, traffic accidents, fall from height and industrial accidents may cause ACL injury. In such cases, ACL injury may be accompanied by injury to posterior cruciate ligament, lateral ligament and menisci. ACL is more frequent among female sportsmen because of their anatomical properties. The injury occurs as rupture of the ligament along its body in the adults, whereas it may be as shearing off a piece of bone where the ligament inserts to the bone in children. The operation is performed arthroscopically (closed method). The operation lasts 60-90 minutes on average, depending on presence of meniscus tear or other additional lesions.