Knee replacement

Abstract

Knee-replacement surgery is frequently done and highly successful. It relieves pain and improves knee function in people with advanced arthritis of the joint. The most common indication for the procedure is osteoarthritis. We review the epidemiology of and risk factors for knee replacement. Because replacement is increasingly considered for patients younger than 55 years, improved decision making about whether a patient should undergo the procedure is needed. We discuss assessment of surgery outcomes based on data for revision surgery from national joint-replacement registries and on patient-reported outcome measures. Widespread surveillance of existing implants is urgently needed alongside the carefully monitored introduction of new implant designs. Developments for the future are improved delivery of care and training for surgeons and clinical teams. In an increasingly ageing society, the demand for knee-replacement surgery will probably rise further, and we predict future trends. We also emphasise the need for new strategies to treat early-stage osteoarthritis, which will ultimately reduce the demand for joint-replacement surgery.

Do Various Factors Affect the Frequency of Manipulation Under Anesthesia After Primary Total Knee Arthroplasty?

“…One of the most important goals of TKA is to achieve a functional ROM [4]. According to gait analyses and biomechanical studies, patients require at least 83°of flexion to ascend stairs, 90°to 100°to descend stairs, 93°to 105°to rise from a standard or short chair, and more than 115°to squat or kneel [3,11,13].…”

A Promising New Treatment for Osteoarthritis

“…The pain and loss of function can be debilitating; in developed countries the resultant socioeconomic burden is large, costing between 1.0% and 2.5% of gross domestic product [2]. Traditionally, OA treatment consists of pain management with joint replacement for end-stage disease [3][4][5]. This approach does not address the morbidity associated with early disease or the limitations of arthroplasty surgery, which include the possibility of adverse outcomes and the finite lifespan of prostheses [5].…”

Functional gain following knee replacement in patients aged 75 and older: a prospective follow-up study

“…The criteria for surgery vary notably between surgeons [20,21], and the most deciding factors seem to be not directly health-related [22]. Hence there is a need for more specific evidence-based criteria for selection and prioritization, especially given the ever-increasing need for TKA in the population [23].…”