Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to be more active. Your doctor may recommend it if you have knee pain and medicine and other treatments are not helping you anymore.

When you have a total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a man-made surface of metal and plastic. In a partial knee replacement, the surgeon only replaces one part of your knee joint. The surgery can cause scarring, blood clots and, rarely, infections. After a knee replacement, you will no longer be able to do certain activities, such as jogging and high-impact sports.

Is Total Knee Replacement for You?

Whether to have total knee replacement surgery should be a cooperative decision made by you, your family, your family physician, and your orthopaedic surgeon. Your physician may refer you to an orthopaedic surgeon for a thorough evaluation to determine if you could benefit from this surgery. Alternatives to traditional total knee replacement surgery that your orthopaedic surgeon may discuss with you include a unicompartmental knee replacement or a minimally invasive knee replacement.

Reasons that you may benefit from total knee replacement commonly include:

• Severe knee pain that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
• Moderate or severe knee pain while resting, either day or night
• Chronic knee inflammation and swelling that does not improve with rest or medications
• Knee deformity: a bowing in or out of your knee
• Knee stiffness: inability to bend and straighten your knee
• Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness in controlling knee pain varies greatly from person to person. These drugs may become less effective for patients with severe arthritis.
• Inability to tolerate or complications from pain medications
• Failure to substantially improve with other treatments such as cortisone injections, physical therapy, or other surgeries

Many of the so-called minimally invasive procedures are simply variations of existing techniques to implant total knees, except that they are done through smaller incisions. Other techniques are genuine advances that go much beyond just making a smaller skin cut. The ultimate goal is not only to make a shorter skin cut, but also to reduce deep muscle trauma associated with surgery, such that pain is lessened, discharge is expedited, and the need for prolonged physical therapy is reduced." 

If your orthopedic surgeon has training and experience in MIS, there can be several advantages to going with this new surgical technique. However, it is important to note that not every patient's situation will allow for the procedure. In the case where the surgeon is experienced and the patient's situation allows for MIS, then this may be an option to consider. 

Dr. Bal, Associate Professor of Orthopedic Surgery at the University of Missouri Health Sciences Center, writes, "In experienced hands, these procedures have superb short term outcomes, with faster recovery, less pain, and shorter down time. But not all surgeons can deliver these results. Research the issue, ask questions, speak with your surgeon, carefully weigh your options, ask more questions, kick the tires, and make a decision." 

Clearly, the advantages of MIS knee replacement surgery involve short-term results. This includes an "earlier discharge from the hospital, less pain, and a faster return to day-to-day activities" (University of Missouri-Columbia School of Medicine). In addition, "The need for physical therapy following surgery is minimized by techniques that reduce trauma to the skin, muscles, and tendons" (U of M-C). 

While MIS surgical procedures may reduce some risks and complications associated with traditional knee replacements, they may also introduce new ones. MIS is by no means "risk-free". Nevertheless, the new techniques, causing less injury to the body, a shortened recovery time, and greater short-term results, continue to position MIS as a method of surgery worth considering.