- Today, let's talk about total knee arthroplasty.
Let's answer some questions
about this type of knee replacement.
What parts of your knee are involved?
What does your knee pain feel like, and
how does it affect your everyday life?
How do you decide when to have a knee replacement?
What happens during the surgery?
What comes out?
What goes in?
How long do you have to be in therapy after surgery?
Finally, how do you protect your new total knee?
Let's now look at the normal anatomy,
then show what happens to this normal anatomy
during osteoarthritis.
First of all, we have the
thigh bone.
The thigh bone normally
has a nice, smooth surface
on its ends that's very teflon-like.
This sits on the leg bone.
The leg bone has the
two shock absorbers that are
called the meniscus.
Again, the end of the thigh bone
has a nice, smooth
surface that's very much,
in appearance, like teflon, so,
teflon-like,
smooth surface.
These surfaces ride on
this shock absorber,
that's called the meniscus.
I'm drawing this shock absorber
in three-dimension.
Shock absorber
called the meniscus.
This is the
normal parts list.
Now, what happens with osteoarthritis?
Well, with arthritis
we have the following changes
that happen first
to the thigh bone.
Also, to the leg bone,
and the meniscus.
With the thigh bone,
we have a wear-and-tear
of these surfaces,
that are normally, as we just said,
nice and smooth.
Here's the end of the thigh bone.
Instead of that nice, smooth teflon surface,
we have a lot of jagged edges,
large pieces of bone chips
that have been thrown off,
and, in summary, a very worn out surface.
This is severe
wear and tear
arthritis.
On the ends of the thigh bone,
as we find on the ends of the leg bone,
we can also develop
some fairly significant bone spurs.
These are bone spurs that end up
also causing significant pain.
The meniscus
degenerates, tears,
and by degenerating I mean,
gets very thinned out,
frayed looking,
and often has some big tears in it.
This is a torn meniscus.
Again, a severe
torn meniscus,
with a severe wear-and-tear pattern
on the thigh bone,
with significant bone spurs.
A picture of advanced
osteoarthritis.
Finally, I'd like to mention that
the space between the bones,
if again, we'd look at the thigh bone
and the leg bone.
Instead of a normal
space between the bones,
we have a collapse of this space
between the thigh bone and the leg bone.
Sometimes the collapse is on one side.
Sometimes the collapse is on both sides.
So we speak of a joint
space collapse
in severe osteoarthritis.