Knee pain, whether from arthritis or an injury, can impact your quality of life. At the Department of Orthopaedic Surgery at the University of Michigan, we have a team of surgeons who specialize in knee replacement, performing more than 250 total knee replacement surgeries each year. Our focus is on improving the quality of the surgery, using new techniques and technologies to address each patient’s individual needs.
While we most often treat patients with degenerative arthritis, we also offer surgical solutions for other issues, including:
- Inflammatory arthritis
- Significant injury to knee joints from post-traumatic arthritis
- Meniscus tears (rubbery, C-shaped cartilage between the thighbone and shinbone that cushions the knee)
- Problems with the kneecap
- Ligament injuries
If you have knee pain, it’s important to know that seeking medical care early on can mean avoiding – or at least prolonging – the need for surgery. Your doctor can help you with lifestyle changes, including starting an exercise program and losing weight, which can slow the progression of arthritis.
Knee Surgery
We make every effort to try to find non-surgical solutions for knee pain, including lifestyle changes, medications, braces and injections. However, when patients get to the point where these interventions aren’t working and the knee trouble is interfering with both sleep and lifestyle, that’s when we look to surgery.
There are three types of knee surgery available:
- Preservation surgery
- Partial knee replacement
- Total knee replacement
Joint Preservation
There are some options for joint preservation in the knee. Typically, these are treatments that would be performed before the patient progresses to severe arthritis, such as a knee arthroscopy (making tiny incisions on the knee and using a camera and small surgical instruments) to remove or repair a tear. Another option is an osteotomy, which involves making a cut in the bone to realign the leg by shifting the weight away from the part of the knee that’s wearing out.
Joint Replacement
When there’s severe degenerative damage and the joint has worn down, we consider joint replacement surgery. The knee can be thought of as three separate joints: the inside joint, the outside joint and a joint under the kneecap. There are techniques to replace each of these compartments, called partial knee replacement, which only replaces the part of the knee that’s damaged. The most common partial knee replacement is the inner knee joint.
Total Knee Replacement
Total knee replacement replaces the entire knee. A variety of artificial joints are available and are chosen based on the patient’s age, body and lifestyle.
Typically patients recover from total knee replacement in 6-12 weeks. For partial knee replacement, recovery takes about 4-8 weeks. Most patients will require physical therapy, which generally lasts 4-6 weeks, depending on how well the patient progresses. We have a team that conducts an education class with each patient before the surgery. Patients start therapy either the day of surgery or the day after to start moving them toward independence. Most patients will begin using a walker, progress to a cane and then finally walk without an assistive device.
About 90 percent of total knee replacements will still be in place 15 years later. Those under age 55 tend to wear out their joints sooner, which is an important reason why we use non-surgical techniques first.
We are working to improve the overall quality of knee replacement in the state, acting as the coordinating center for the Michigan Arthroplasty Registry. As an academic center, we’re actively involved in cutting-edge research, including computer-assisted surgery.