Knee arthroplasty (เปลี่ยน ข้อ เข่า เทียม which is the term in Thai) is knee surgery generally used for the treatment of knee osteoarthritis. The operation replaces the affected joint with a metal and polyethylene implant, the so-called knee prosthesis. This is fixed to the bone using a block of special cement.
The osteoarthritis knee result of a degenerative process for wear of the cartilage in the knee naturally occurring with the progression of age or secondarily caused by the overweight, the axis deviation knee fracture or trauma or injury to ligaments. Knee arthroplasty is used to treat gonarthrosis, an alternative to outdated knee arthrodesis.
Knee surgery has undergone the most evolution in recent years, thanks to advances in implants and better knowledge of knee biomechanics. In most cases of arthrosis of the knee, it allows a frank reduction in pain and a remarkable improvement in the quality of life for the patient.
In the early stages of the disease, knee arthrosis surgery can be joint-sparing and includes a series of procedures such as arthroscopy of the knee with shaving and microfractures of cartilage lesions or knee osteotomies to correct limb alignment.
Surgery to place a prosthesis in the knee is essential to cancel the pain in the knee in more advanced stages of arthrosis. The success rate of this intervention is very high (more than 90% of patients preserve their prostheses for up to 20 years).
However, it is essential to correctly select the candidate to undergo surgery since patients with tricompartmental disease require total knee arthroplasty. In contrast, others with mono compartmental reach may be functionally well only with partial knee arthroplasty.
The surgical knee replacement is performed through a midline incision 10-12 cm in length, approx. Then, moving the kneecap laterally, exact cuts are made in the femur and tibia using specific instruments for this purpose.
It is then confirmed: the alignment of the knee, the size of the knee prosthesis, and an adequate ligament balance are performed. There are currently customized (adapted) knee prostheses for each patient individually, requiring prior planning of the total prosthesis surgery.
Although called total dentures, in many situations, it is not necessary to apply any patellar component, just a “toilet” of the patella with the cleaning of the marginal osteophytes. For this, it is necessary that the latter still present a relatively preserved articular cartilage.