Knee Replacement Surgery

KNEE JOINT ANATOMY

The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee:

• The anterior cruciate ligament prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur).
• The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur).
• The medial and lateral collateral ligaments prevent the femur from sliding side to side.

Two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia. Numerous bursae, or fluid-filled sacs, help the knee move smoothly.

KNEE REPLACEMENT SURGERY

Total joint replacement is one of the most commonly performed, elective surgical procedures in the United States.

600,000 knee replacements are performed in the United States each year.

Knee replacement surgery, or knee arthroplasty, provides pain relief and restores movement to people who have knee pain or stiffness.

Most knee replacements are performed to remedy knee arthritis. This is where cartilage between the bones of the knee joint wears down. The bones then scrape together, causing more damage, as well as pain and stiffness. Arthritis of the knee can make it painful for a person to walk or even to get in or out of a chair.

Knee replacement surgery is also used to fix injuries such as bone breaks, knee that grow incorrectly, and other conditions. Most people who get a knee replacement have these symptoms:

• Severe pain that gets in the way of their work and everyday activities
• Pain that is not relieved by taking anti-inflammatory medications, or by using canes or walkers
• Stiffness in the hip that slows them down

Contrary to popular belief, during a total knee replacement, the entire knee is not cut out. Only the damaged and arthritic portions of the femur (thigh bone) and tibia (shin bone) are removed, using special cutting guides, leaving as much bone behind as possible. Then, metal implants are sized and selected to replicate the original bone surfaces in a healthy knee joint. The implants are secured to the ends of the femur and tibia with bone cement or using a press-fit technique which allows your bone to grow into the implant. Once the metal components are secured, a high-density plastic (polyethylene) spacer is inserted between the two bones, acting like cartilage. Lastly, the patella (kneecap) is resurfaced with a plastic button to remove and address arthritic bone on the kneecap.

Our Philosophy

Our philosophy is to partner with our patients to help them claim victory over joint pain. The first step when making the decision about a knee replacement is for the patient to schedule an appointment with us to see if they are a candidate for total knee arthroplasty. During the initial visit, we take the patient’s medical history, perform a physical examination, and x-ray the knee.

Even if the pain is significant and the x-rays show advanced arthritis of the joint, the first line of treatment is nearly always non-operative. This may include weight loss if appropriate, modifying certain activities, medication, injections, and/or physical therapy. If the symptoms persist despite these measures, then we recommend that the patient consider a total hip replacement.

The decision to move forward with surgery is not always straight forward and usually involves a thoughtful conversation between our surgeons, the patient, and their loved ones. The final decision rests with the patient based on how limited they are by hip pain. We often tell patients that when they have tried non-surgical measures, but continue to have to order their lives around what their knee pain will allow them to do, it is time to consider knee replacement.

To schedule a KNEE joint replacement appointment consultation with one of the below surgeons, call (205) 939-3699 and ask to speak with the appropriate staff member listed below.

• Jeffrey C. Davis, MD – Request Dr. Davis' appointment scheduler
• Benton A. Emblom, MD  – Request Dr. Emblom's appointment scheduler
• Wayne McGough, Jr., MD – Request Dr. McGough's appointment scheduler
• K. David Moore, MD –  Request Dr. Moore's appointment scheduler
• Marcus A. Rothermich, MD – Request Dr. Rothermich's appointment scheduler

Non-Surgical treatment

Non-surgical treatments and medications are highly recommended for younger patients before considering a total knee replacement. Older patients tend to have more reliable outcomes with total knee replacements; however, the procedure has also been successful in younger patients. Patients with knee arthritis who have failed to see improvements in their pain and/or function after non-surgical treatments are great candidates for a total knee replacement.