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Knee Reconstruction and Replacement

Last Updated 7/15/2011 2:17:09 PM

Prior to the development of modern knee replacement surgery in the 1960s, when a patient developed painful osteoarthritis of the knee, the best care physicians could offer was a bottle of aspirin. In other words, arthritic patients just had to go on with life, dealing with the debilitating pain as best they could.

But thankfully today, if you suffer from chronic knee pain, stiffness and swelling, you will find that many, many more options are available to you.

At El Camino Hospital, our surgeons typically suggest non-surgical options first, such as medication and physical therapy, to ease your pain. Often these types of treatments will work for some time.

But, when it becomes clear that non-surgical options are no longer helping to manage your pain and you can no longer perform your regular daily activities, knee replacement surgery is recommended.

At El Camino Hospital, we perform more than 500 joint replacements each year, making us one of the leading centers for joint replacement in Northern California. To learn more about our award-winning knee replacement surgery program.

About Knee Replacement Surgery

Knee replacement surgery has grown increasingly popular in recent years, with more than 450,000 knee replacements performed each year in the United States.

For more than three decades, knee replacement surgery has been a successful solution for patients who have had knee pain, stiffness and swelling, primarily due to osteoarthritis.

Knee replacement has become increasingly popular in the past two decades. In 1991, there were roughly 160,000 total knee replacements in the United States, according to the Integrated Healthcare Association (Oakland, Calif.). Today there are more than 454,000 performed each year (per 2004 data).

When it comes to total joint replacement surgery, knee replacements are twice as popular as hip replacements. Although some knee replacements are done on younger patients, the majority -- more than two-thirds -- of patients choosing to have knee replacements today are over the age of 65.

El Camino Hospital has been a high-volume knee replacement center for many years; today we perform several hundred knee replacements every year.

How Knee Replacement Works

In knee replacement surgery, a surgeon essentially resurfaces the inside of the knee to replace the worn-out cartilage.

In a normal knee, smooth, slippery surfaces inside the knee joint allow the knee to glide properly without any pain. But, when the knee becomes arthritic, the inside is pitted and rough, and when those rough surfaces try to glide past each other, it’s extremely painful.

So, to eliminate the pain, a surgeon must replace the damaged cartilage in the knee joint with new, prosthetic materials (metal or plastic) that resurface the ends of the bones. The new joint is attached to the thigh bone, shin and knee cap with cement or another material. When fit together, the attached artificial parts form the whole joint, and surrounding muscles and ligaments provide support and function. That allows for pain-free, smooth motion once again.

The knee replacement can be a complete - or total - knee replacement or just a partial knee replacement, where only the most damaged part of the knee is replaced. At El Camino Hospital, most cases we perform are total knee replacements.

Advances in Knee Replacement Surgery

Knee replacement surgery has changed dramatically over the years - today, both implant materials and surgical techniques have improved significantly.

Improved Materials:
In the past two decades, we’ve seen enhancements in the quality and durability of prosthetic materials for knee replacement. In particular, plastic implants are much stronger and longer-lasting than ever before.

Improved Surgical Techniques:
Computer Navigation - For knee replacements to last a lifetime, surgeons have found that the alignment of the new joint is critical. Because of that, El Camino Hospital surgeons now use computer navigation during surgery. Computer navigation allows physicians to see a 3-D view of a patient’s knee on a computer screen while surgery is underway. This ensures that all components of the knee replacement are put in perfect position.

Muscle-Sparing, Minimally-Invasive Surgery:
Another development in knee replacement surgery is muscle-sparing or minimally-invasive surgery. This type of knee replacement uses a much smaller incision -- three to five inches (on the side of the knee), versus the standard eight to twelve inches. There is reduced tissue trauma because the surgeon works between the fibers of the quadriceps muscles instead of requiring an incision through the tendon. This technique can lead to less pain, decreased recovery time and better motion due to less scar tissue formation. However, certain factors, such as a patient's age, weight, bone size and severity of the arthritis, can influence whether or not minimally-invasive surgery is appropriate.

Recovery from Knee Replacement Surgery

At El Camino Hospital, patients typically stay just two days in the hospital after surgery. Most folks are able to get up and walk either the day of surgery or the day after surgery.

The recovery period varies from patient to patient. Getting back to normal activities often depends on how active you were prior to the surgery. Some people who opt for surgery are tennis players looking to get back in the game, well others are simply hoping to be able to take a walk around their neighborhood without pain.

For most patients, after a month, you should be able to drive your car and go to the store. To resume athletic activities, it may take two to three months.

Physical therapists and discharge planners will work closely with you during your recovery.

Choosing a Hospital and Orthopedic Surgeon

Experts recommend that you choose carefully when deciding where to have your knee replacement. Be sure to look at both the surgeon and hospital, and ask lots of questions.

Surgeon - You’ll want to choose a board-certified orthopedic surgeon who has a lot of experience with knee replacement surgery, and does the procedure on a regular basis. Ask questions such as: How long have you been doing knee replacement? How many surgeries do you do each year?

Hospital - The hospital is important when it comes to both helping you prepare for surgery and helping you recover from surgery. At El Camino Hospital, our focus is on teamwork (physicians, nurses, physical therapists, occupational therapists, nurse educators and discharge planners all work together to achieve the best patient outcome) and on rapid recovery (we want to get you back on your feet as soon as possible). If the hospital team is not in place and is not working together effectively, patient recovery can be negatively affected.

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Video: Lifetime Knee Replacements

Image of Dr. Rodney Wong talking about knee replacement surgery. Click to watch this video.

In this knee surgery video, Dr. Rodney Wong discusses the benefits of these navigation improvements from a patient's perspective.

The Joint Commission Gold Seal of Approval®

Image of Joint Commission Gold Seal of Approval

Our Mountain View program has been certified by the Joint Commission in three areas for hip and knee surgery: hip replacement, hip fracture and knee replacement. The first California hospital to achieve this in all three areas. Read more...

Our Los Gatos program has been certified by  the Joint Commission in Hip and Knee Replacement and Spinal Fusion. Read more...