Knee Reconstructive Surgery

If you play high impact sports, you probably already know about the risk of knee injuries. However, you don’t have to play sports to fall victim to knee problems. The demands of a physically-challenging job, an active lifestyle or even the effects of aging may lead to knee problems that require surgery.

The knee is made up of the lower part of the femur (thigh bone), the upper part of the tibia (shin bone), and the patella (knee cap). Ligaments and cartilage in the knee help to control movement, stabilize the knee and absorb shock.

This complex interaction of bone, ligament and cartilage is unfortunately prone to injury and arthritis. Many times, knee injuries do not require surgery and may respond to other treatments. However, sometimes surgery may be required.

If you experience these knee symptoms, you should see a doctor:

• Pain or discomfort in the knees, especially night pain
• Trouble walking
• Swelling
• A popping sound or feeling in the knee
• Problems pivoting or changing direction when walking or running

Even if your symptoms go away, it’s best to have a doctor examine your knee. If left untreated, knee problems can lead to further injury and even arthritis.

Knee Reconstructive Surgery Procedures

Some knee problems are caused by sports or other injuries. Common activity-related knee problems include torn or damaged meniscus or a torn anterior cruciate ligament (ACL). These problems can usually be treated successfully through non-invasive outpatient surgery.

More serious problems, such as debilitating osteoarthritis, may require a knee replacement, a major surgical procedure that replaces damaged joint surfaces with metal and plastic prosthetic parts that create a new artificial joint.

The good news is that advantages in technology have greatly improved the success of knee replacements. This procedure can deliver a better quality of life with reduced pain.

Find a Knee Reconstructive Surgery Doctor

Finding the right surgeon can make all the difference in your knee reconstructive surgery experience. We work hard to connect you with the best doctors in your area. Our physicians are skilled and qualified in cutting-edge reconstructive surgery techniques. They perform surgery in accredited medical facilities, keep abreast of the latest developments in their field, complete continuing education in reconstructive surgery and follow the highest standards in patient care and safety.

Click on “Surgeon Locator” to search our physician directory for a surgeon in your region. You can read about physicians’ credentials, visit their websites, learn about the reconstructive surgery procedures they perform and see pictures of their offices and patients.

The first step toward your knee reconstructive surgery is setting up a consultation with a surgeon. During your consultation, your doctor will gather information about your medical history and ask you questions about your goals in pursuing reconstructive surgery. He or she will determine whether or not you are a candidate for surgery and which procedure will work best for your situation and produce the best results.

The only way to know for certain if you are a candidate for reconstructive surgery is to meet with a qualified surgeon.

The goal of reconstructive surgery is to improve your ability to accomplish everyday tasks, your sense of well-being and your life. We encourage you to take this important step by searching for a local doctor today.

ACL Reconstructive Surgery

ACL reconstructive surgery is a surgical procedure to replace the anterior cruciate ligament (ACL) in the knee. In this procedure, the ligament is replaced by grafting tissue from another part of the body. A common reason for an ACL reconstructive surgery is a sports injury to the knee. Reconstructing the ACL using tissue from elsewhere in the body restores function to the knee.

The ACL runs through the center of the knee, from the femur (thigh bone) to the tibia (shin bone). The major stabilizing force in the knee, the ACL allows a person to turn and change direction when walking and running. When a person’s ACL is torn or badly damaged, he or she will feel pain or a buckling sensation when attempting to change direction.

The procedure is performed with arthroscopy, a type of surgery that uses an arthroscope, a medical device inserted into a joint or organ that consists of a light, a tube and a lens. The arthroscope allows the physician to see inside the body to perform minimally-invasive surgery.

In most cases, ACL reconstructive surgery is successful and helps a patient return to his or her pre-injury athletic ability. Although ACL reconstructive surgery is often performed as an outpatient procedure and the patient may be able to walk soon after the procedure, full recovery can be a 6 month process and involves physical therapy.

Meniscus Damage

“Meniscus” refers to the cartilage in the knee. There are actually two menisci, and they rest in a C shape between the femur (thigh bone) and tibia (shin bone). The menisci provide lubrication to the joint, absorb shock and help to stabilize the joint.

Meniscus tears can occur during an accident, such as a sports injury, or can occur through the normal aging process.

A torn meniscus may be repaired by suturing, or, more commonly, the torn piece may be removed. If a meniscus is damaged badly enough, the doctor may remove the whole meniscus, although this leads to pain and degenerative arthritis. These are outpatient arthroscopic procedures, which means the doctor inserts a tube with a camera that allows him to perform minimally-invasive surgery with only small incisions.

If a piece of torn meniscus is removed, you will likely be able to walk without crutches within a couple days, although you may need to avoid certain activities for up to 6 weeks. If the torn meniscus is repaired, recovery will take longer as the body needs more time to heal.

If the meniscus is damaged badly enough, partial or total knee replacement may be necessary.

Knee Replacement Surgery

Knee replacement, also called “knee arthroplasty” is performed to relieve chronic pain and disability caused by osteoarthritis. Osteoarthritis is a painful joint disorder resulting from the deterioration of the cartilage in the knee. As the cartilage wears away over time, the joint becomes more and more painful because of the loss of cushioning.

When osteoarthritis becomes severe enough that conservative treatments such as physical therapy and medication no longer provide satisfactory relief, knee replacement surgery may become necessary to improve quality of life.

Knee Reconstructive Surgery Procedure

Knee arthroplasty involves replacing the damaged joint surfaces in the knee with metal or plastic parts, or “prostheses.” The doctor first makes a vertical incision from the lower thigh to the upper shin. The knee cap, or patella, is moved to the side to expose the joint. Next, the surgeon cuts the end of the thigh bone (femur) and the shin bone (tibia) and contours them, preparing them for the prosthetic parts. The surgeon normally removes the cartilage and ligaments. Once fixed into place, the prosthetics produce an artificial joint that will eventually mimic the movement of the knee, allowing the patient to walk.

In some procedures, a prosthetic part is also applied to the patella. In most knee replacement procedures, the quadriceps muscle is cut. Knee replacement procedures and components vary, so you should discuss with your doctor the type of procedure he or she uses and what prosthetic parts are involved.

In some cases, a surgeon may recommend partial knee replacement, or “unicompartmental arthroplasty.” Many surgeons believe that total knee replacement is the better long-term solution. However, partial knee replacement surgery is becoming more accepted as recent research suggests a slightly lower failure rate when compared to total knee replacement.

You may be a candidate for partial knee replacement if your arthritis has only affected one of the three areas of your knee. Most patients with severe arthritis have considerable degeneration in two or three areas, making total knee replacement the better alternative.

Because the knee is a complicated joint, designing a solution that mirrors the knee’s movement is difficult. Although a knee replacement can relieve debilitating arthritic pain and improve range of motion, it will not result in a complete restoration of the normal functioning of the knee.

Recovery From Knee Replacement Surgery

Knee replacement, whether total or partial, is a major surgical procedure and should not be taken lightly. Recovery involves a hospital stay, pain management, exercises to restore range of motion and physical therapy. Full recovery may take three months.

Knee Arthritis Requiring Knee Replacement

The most common reason for a knee replacement is to relieve the pain and disability caused by severe osteoarthritis, which is a joint disorder. Osteoarthritis is caused by the progressive deterioration of cartilage in the knee. Cartilage in the knee absorbs shock and provides lubrication, so the loss of cartilage can become very painful.

Many older adults have osteoarthritis and do not require surgery. However, when the pain becomes debilitating or causes a loss in range of motion severe enough that the individual cannot perform normal daily activities, a knee replacement surgery may be required.

Severe osteoarthritis is more common in the elderly. Although osteoarthritic symptoms may occur in middle age or younger, the condition may not become debilitating until the patient is older. Osteoarthritis is treated with medication, physical therapy, the wearing of braces and other conservative treatments until the pain becomes severe enough to require surgery.

Most sufferers of severe osteoarthritis are older individuals. However, knee problems can be caused or aggravated in younger people due to overuse and stress of the knee in sports or injuries or fractures in the knee.

Although osteoarthritis is the most common condition treated with knee replacement, the procedure can also be used for patients with other knee problems, such as rheumatoid arthritis.

Am I a Candidate for Knee Reconstructive Surgery?

Whether you are a candidate for knee reconstructive surgery depends on the nature and severity of your knee problems.

Only your doctor can determine for sure whether or not you are a candidate for knee reconstructive surgery. If you experience pain and discomfort in your knees, you should have them examined by a doctor. Left untreated, knee problems can lead to further injury and arthritis.

To determine the extent of damage, your doctor will examine your knee and talk to you about your symptoms. Your doctor may also order x-rays or an MRI. Some conditions can be diagnosed through only a physical examination, such as a torn ACL. However, your doctor may recommend knee arthroscopy to examine the knee. Arthroscopy is a procedure that uses an arthroscope, a medical device inserted into a joint or organ that consists of a light, a tube and a lens. Requiring only a small incision, the arthroscope allows the surgeon to see the internal knee on a video screen.

In some cases, a doctor may determine that surgery is not needed. Non-surgical treatments may include anti-inflammatory medications and physical therapy to restore range of motion. For ACL injuries, surgery is likely to be recommended if you are young, work a physically-demanding job or play high-impact sports.

If you have osteoarthritis or other knee pain that is chronic and is no longer responding well enough to conservative treatments, your doctor may recommend a total or partial knee replacement. Because this is a major surgery, you should discuss all your options with your doctor and make sure to ask any questions you have about this procedure.

Your candidacy for knee replacement will depend on your age, health, and other factors. One factor is your ability to keep up with recovery requirements and physical therapy after surgery. For example, this may include the strength of your support system, including family and friends who can help you get around after your surgery and who will support you while you recover.

Knee Reconstructive Surgery Risks

As with any surgical procedure, knee reconstructive surgery is not without risk. Risks that come with any surgery include:

• Risks of anesthesia, including allergic reactions
• Bleeding
• Infection

Risks of knee reconstructive surgery include:

• Possible stiffness and pain in the knee
• Loss of some range of motion
• Weakness in the knee
• Failure of grafted tissues to attach and heal properly
• Blood clots in the leg, also called deep vein thrombosis
• Injury to nearby blood vessels

Before Knee Reconstructive Surgery

Your doctor will conduct a physical examination to determine whether your knee will require surgery. Your doctor may order x-rays or an MRI or may conduct knee arthroscopy to look inside the knee and determine the extent of the damage.

Before your procedure, you should discuss with your doctor any drugs you take, including non-prescription drugs and supplements. It’s important that you are honest and upfront about your drug use, smoking habits and use of alcohol, as these substances may affect your recovery.

Your doctor will give you specific instructions regarding which medications you should stop temporarily and which you may continue taking. If you take maintenance drugs for a medical condition, such as heart disease or diabetes, you should discuss these medications and your upcoming surgery with the doctor who treats these conditions.

Your doctor will direct you to refrain from eating for a specified number of hours before your surgery and will give you further instructions to follow to prepare for your knee reconstructive surgery. It’s normal to be nervous before surgery. You must follow your doctor’s instructions carefully and be sure to ask him or her any questions you may have.

If you are receiving a knee replacement surgery, you will undergo a thorough evaluation and tests will be run to reduce the risk of complication during surgery. Your surgeon will order X-rays of your knee. You should discuss anesthesia options with your surgeon.

After Knee Reconstructive Surgery

Procedures to repair the meniscus and ACL are often outpatient procedures, so you will normally be able to return home the same day as your surgery. However, a knee replacement is major surgery, often requiring a several-night hospital stay. You may need to stay at the hospital from 1 to 14 days, depending on your procedure, age, progress in recovery and support system at home.

Immediately after your knee reconstructive surgery, a Continuous Passive Motion (CPM) machine may be used to reduce stiffening of the knee and help aid recovery. This device elevates the leg and slowly moves the knee joint without the use of the patient’s muscles.

Your doctor will dress your wounds and give you instructions for how to care for them until the incisions heal. Your doctor may prescribe medications to relieve pain. You can also discuss with your doctor which over-the-counter medications may help you manage your pain. Some post-surgery pain and discomfort is unavoidable, and your doctor can explain how much pain is normal and to be expected.

After knee replacement surgery, you will need to walk using crutches or a walker until your doctor determines that you can walk with only a cane and eventually without aid. After less-invasive procedures, it may be possible to walk without aid immediately; however, your doctor may recommend crutches in some cases.

The Role of Physical Therapy in Knee Reconstructive Surgery

An important part of knee reconstructive surgery recovery is physical therapy. Returning to normal daily activities too soon can cause injury, so it’s important to carefully follow your physical therapist’s instructions exactly.

If you have received an ACL reconstructive surgery, physical therapy is imperative for a return to sports and normal daily activities. You must carefully follow your physical therapist’s instructions.

After knee replacement surgery, exercises and the use of CPM machine may be used right away to begin restoring range of motion. The quicker you can achieve a desirable range of motion the better; recovery will depend on how well you can move the joint. It’s important to carefully follow your physical therapist’s instructions to ensure that your muscles heal properly and that you learn to use your new joint successfully.

Knee Reconstructive Surgery Results

The results of minimally-invasive routine procedures, such as meniscus repair and ACL reconstruction, are normally very good, restoring many patients to pre-operative conditions, allowing individuals to return to normal activities and even high-impact sports.

If you are receiving a knee replacement surgery, you should thoroughly discuss the procedure in advance with your surgeon and talk about your expectations and goals. Although knee replacement surgeries help restore range of motion and relieve debilitating pain for thousands of people every year, your prosthetic knee will not exactly mirror a natural knee’s function.

Although you may not be able to perform some high-impact activities after a knee replacement, the procedure is generally successful and helps restore freedom and quality of life.