Total knee replacement: the right choice ?


Updated Dec 28, 2017

When is the right time to choose a total knee replacement ?

total-knee-replacementA total knee replacement consists in implanting three artificial components (tibial, femoral and patellar), which will replace the damaged parts of the knee joint. Over 50 000 operations are carried out each year in France, in particular to treat advanced cases of knee osteoarthritis.
The decision to undergo a total knee replacement is not taken lightly. This solution is chosen only when the patient considers that the pain and discomfort are too bad and persist despite medical treatment, which is generally envisaged initially. An x-ray is also carried out to assess if the state of wear of the joint justifies its replacement.

Overall satisfaction of patients with total knee replacements

In 90% of cases, the outcome of the knee replacements is regarded as excellent. This success rate even exceeds that of hip replacements, which are considered a benchmark.

The first factor observed concerns the disappearance of the pain, which, let us not forget, is the main reason for choosing a total knee replacement. In 60% of cases, the pain totally disappears. It reappears episodically in 30% of cases, but is moderate enough not to require any treatment. In 10% of cases, medical treatment may be required to provide the patient with occasional relief.

The second criterion, knee mobility, is largely recovered enabling once again normal use of the knee: walking without crutches, going up and down stairs… Patients having undergone the operation even resume physical activities, being careful to choose them accordingly.

Lifespan of the implants

We now have over 25 years of experience in total knee implants, and there is no denying they can last all that time! According to statistical research, 80 to 90% of implants are still in place after 15 to 20 years. However, it is clear that the risk of loosening and wear increases with time.

The age of the patient thus remains an important factor to be taken into account. Indeed, an implant is more likely to loosen or wear in a young, active patient than an older subject. Nevertheless, the operating conditions for a total knee replacement are now such that a possible revision can be undertaken in very good conditions.

Dr Philippe PAILLARD, MD

About the Author:

Specialist in orthopedic surgery and sports surgery, Dr. Philippe Paillard operates on patients with hip, knee, shoulder, elbow or ankle disorders or injuries.

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