If you have arthritis, severe pain, or deteriorating quality of life because of severe knee pain, a knee replacement procedure might be an option to consider. This is essentially an artificial joint that replaces a severely worn out natural joint.
The knee is made up of 3 compartments: medial (inner half that is closer to the opposite knee), patellofemoral (between the kneecap and the thigh bone), and the lateral (outer half that is further from the opposite knee).
Depending on the extent of wear and tear in your knee, you might be suitable for a partial or unicompartmental replacement which replaces only one of the 3 compartments, or a total knee replacement which replaces all 3 compartments. With an experienced knee surgeon, knee replacement has a very high success rate (in excess of 90%) and it can alleviate pain, improve quality of life and return the patient to full mobility.
Materials such as titanium and cobalt-chromium alloys, as well as durable plastics, are used to make an artificial knee. Small amounts of the damaged bone, tissue and cartilage, will be removed and replaced with the artificial knee during this total knee replacement procedure. A patient will begin walking right away, on the first or second day after the knee replacement surgery with a support frame, and are generally discharged three to four days after the procedure. Many of Dr Lee’s patients can walk short distances only 2 weeks post surgery, without any assistance or walking aids.
Our medical director, Dr Kevin Lee is a member of the American Association of Hip and Knee Surgeons and he performs all his total knee replacements via a minimally invasive approach and works only with anaesthetists who specialise in pain management. In special situations, he uses computer-assisted surgery (CAS) to perform the knee joint replacements.
Recent surgical advancements in knee replacement surgery include:
1. Minimally invasive techniques, such as cutting less soft tissue and making smaller skin incisions.
2. Great improvements in post-surgery pain management protocols
3. High flexion designs that improve the range of motion and bending ability of the replaced knee
4. Implants are now gendered specific, meaning women get their own specially designed knees
5. Higher quality implant materials are now used
6. The use of computer navigation in difficult cases to improve accuracy
These improvements mean that patients have much less post-surgery pain, are discharged from hospital earlier and recover much faster.
Most recently, a technique using Patient Specific Instrumentation (PSI) has been developed in an effort to improve accuracy and shorten the surgical time. MRI scans of the knee provide us with a 3-dimensional model which allows unique custom fitted positioning guides to be designed specifically for the particular patient’s total knee replacement surgery.
Dr Kevin Lee was trained in Stanford University by Professor William Maloney on this technique and he performed National University Hospital’s first PSI case in 2010. He also performed Southeast Asia’s first bilateral PSI knee replacement procedure in 2011. Dr Lee delivered a talk “Customized Instrumentation For Knee Replacement” at Stanford University, USA in February 2012 and has been interviewed multiple times about his experience with this total knee replacement surgery technique. Dr Lee also performs Makoplasty (partial robotic-assisted knee replacement), a new and less invasive partial knee replacement surgery that has recently introduced in Singapore.
After the surgery, there are several things to look out for in your daily living and home arrangements, find out more in our article on “Preparing For Life After Knee Replacement“.