Osteoarthritis, also known as degenerative joint disease, is a chronic condition that commonly affects the large weight-bearing joints, such as the knees. (Hips, hands, feet and spine also are common targets.) It is a progressive disease that most often worsens with time. The easiest way to describe the cause of osteoarthritis is “wear and tear” of cartilage of your joint.
Symptoms of osteoarthritis include activity-related pain, stiffness, muscle weakness, swelling and joint deformity. Progressive cartilage degeneration of the knee joints can lead to the outward curvature of the knees (referred to as “bowlegged”). Patients with osteoarthritis of the knees also can develop a limp. The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction can be relieved through non-operative treatments. In others, conservative measures don’t work at all. Severe osteoarthritis of the knees is one of the most common reasons for knee replacement procedures in the United States.
Cooper University Hospital orthopaedic surgeon Dino Nicol E. DeJesus, D.O., who specializes in joint replacement, answers some questions about treatment for osteoarthritis of the knees.
What are non-operative treatments for osteoarthritis of the knee?
Physical therapy, non-steroidal anti-inflammatories and cortisone injections may effectively alleviate pain and restore mobility for some patients with degenerative joint disease for a period of time.
Who are candidates for knee replacement surgery?
- Patients with severe pain which limits activities of daily living.
- Patients with severe pain that has not responded to non-operative treatment.
- Patients with joint stiffness and loss of mobility.
- Patients with knee X-rays consistent with severe degenerative joint disease.
What’s the difference between total and partial knee replacement?
The knee is a hinge-type joint. There are three compartments in the knee: medial, lateral and patella-femoral. A total knee replacement (TKA) involves replacement of all three compartments of the knee, and replacing it with a metal cap on the lower end of the thigh bone (femur) and on the upper end of the leg bone (tibia) and a plastic bushing in between. The knee cap (patella) is also resurfaced with either plastic or metal and plastic. This allows the artificial knee joint to glide smoothly.
A partial knee replacement, called unicompartmental arthroplasty (UKA), involves replacement of either the lateral or medial compartment of the knee, and leaving the rest of the compartments alone and preserving more bone for future surgery. This surgery is less invasive than the conventional TKA and recovery is quicker. However, not all patients are candidates for this procedure. You should consult with your orthopaedic surgeon to determine if this surgical procedure is indicated for you.
What can be expected from joint replacement surgery?
Total joint arthroplasty is a very predictable and satisfying operation in treating degenerative joint disease of the knee, and of the hip. However, the successful outcome is also dependent on the post-operative rehabilitation. Most patients will require home therapy, outpatient therapy, or both. The first phase in rehabilitation is working on obtaining full range of motion. The last phase is strengthening and endurance. On average, it takes about three months to feel comfortable with your new knee or hip. However, improved results may be seen up to a year after surgery.
What is Cooper’s Blue Distinction Center for hip and knee replacement?
Blue Distinction® is a designation awarded by the Blue Cross and Blue Shield companies to healthcare facilities that have demonstrated a commitment to achieving excellent outcomes and quality patient care. This national recognition is based on rigorous selection criteria established in collaboration with expert physicians’ and medical organizations’ recommendations. Those centers that achieve excellent overall patient outcomes are recognized as a Blue Distinction Center.
Joint replacement surgery is a very predictable and successful orthopaedic procedure. I feel that the improvements in joint replacement surgery have not only been in the development of newer orthopaedic implants but, most importantly, on how we care for patients requiring replacement surgery.
At Cooper University Hospital, we have a multi-disciplinary approach in our care for patients with hip and knee arthritis. We have an experienced team of orthopaedic surgeons, anesthesiologists, nurses, social workers and therapists that works together from the pre-surgical process to the post-surgical process and rehabilitation.
Our hip and knee replacement Blue Distinction Center recognition at Cooper is a testament to our dedication to achieving quality patient care.