If your knee is severely damaged by arthritis or injury, it may
be hard for you to perform simple activities, such as walking or climbing
stairs. You may even begin to feel pain while you are sitting or lying down.
The knee is the largest joint in the body and having healthy knees is required to perform most everyday activities. The knee is made up of the lower end of the thighbone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). The ends of these three bones are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily within the joint.
The menisci are located between
the femur and tibia. These C-shaped wedges act as shock absorbers that cushion
the joint. Large ligaments hold the femur and tibia together and provide
stability. The long thigh muscles give the knee strength. All remaining
surfaces of the knee are covered by a thin lining called the synovial membrane.
This membrane releases a fluid that lubricates the cartilage, reducing friction
to nearly zero in a healthy knee.
Normally, all of these components work in harmony. But disease or injury
can disrupt this harmony, resulting in pain, muscle weakness, and reduced
function.
Cause
: The
most common cause of chronic knee pain and disability is arthritis. Although
there are many types of arthritis, most knee pain is caused by just three
types: osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis.
Osteoarthritis.
This is an age-related wear and tear type of arthritis. It usually occurs in
people 50 years of age and older, but may occur in younger people, too. The
cartilage that cushions the bones of the knee softens and wears away. The bones
then rub against one another, causing knee pain and stiffness.
Rheumatoid
arthritis : This is a disease in which the synovial
membrane that surrounds the joint becomes inflamed and thickened. This chronic
inflammation can damage the cartilage and eventually cause cartilage loss,
pain, and stiffness. Rheumatoid arthritis is the most common form of a group of
disorders termed "inflammatory arthritis."
Posttraumatic arthritis : This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the particular cartilage over time, causing knee pain and limiting knee function.
A knee replacement (also called knee arthroplasty) might be more
accurately termed a knee "resurfacing" because only the surface of
the bones are replaced.
There
are four basic steps to a knee replacement procedure:
Prepare
the bone. The damaged cartilage surfaces at the ends
of the femur and tibia are removed along with a small amount of underlying
bone.
Position
the metal implants. The removed cartilage and bone
is replaced with metal components that recreate the surface of the joint. These
metal parts may be cemented or "press-fit" into the bone.
Resurface
the patella. The undersurface of the patella
(kneecap) is cut and resurfaced with a plastic button. Some surgeons do not
resurface the patella, depending upon the case.
Insert
a spacer. A medical-grade plastic spacer is inserted
between the metal components to create a smooth gliding surface.
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