What is arthritis?

Arthritis it the process inside a joint when cartilage is worn down. This may be due to a slow mechanical process (osteoarthritis), chronic inflammation (inflammatory osteoarthritis), or in response to prior traumatic injuries to the joint (post-traumatic). In all these situations, the protective covering of the joint is broken down. This leads the joint to lose the normally smooth, low-friction movement and causes the joint to become stiff and painful.

What is a knee replacement?

A knee replacement is a surgery that is used to relieve pain and improve function in an arthritic knee joint. When arthritis causes the knee joint to lose the protective cartilage, it can become painful, stiff and/or unstable. A knee replacement shaves off this arthritic, damaged bone, and then uses protective metal caps secured on to the thigh bone (femur) and leg bone (tibia) as well as a specialized, medical-grade plastic (high-molecular-weight polyethylene, HWMPE) to restore your knee anatomy. The goal of the surgery is to re-build your knee to how it was before arthritis caused it to breakdown.

What is a minimally-invasive knee replacement?

Traditionally, knee replacements had large incision over the front of the knee, which allowed easy visualization of all the structures of the knee. While this makes the surgery easier, the larger incision makes recovery more difficult, and increases the risk of bleeding and wound healing issues, including infection. While it can be more technically challenging, performing the surgery through a smaller incision can lead to a quicker, easier recovery.

What about outpatient knee replacement surgery, can I go home afterwards?

As joint replacement surgery has gotten safer and our technology and protocols surrounding surgery have improved, the need to keep patients in the hospital after surgery to monitor them after surgery has become less common. In order to determine if you are healthy enough to recover from surgery at home, Dr. Bradley will talk with you about your current medical issues and what support you will have at home. For those patients that are healthy enough to have outpatient surgery, studies have shown that it is safe, without higher risks of medical or surgical complications, and an overall higher level of satisfaction with the surgical experience.

How is the implant secured to the bone, cement versus cementless?

There are two main ways that we secure the implants to the bone to make sure everything is stable after surgery. The traditional way is using a medical-grade cement (polymethyl methacrylate) that hardens during the surgery. More recently, implants have been developed that have a special surface that allows the bone to grow directly into the surface of the implant. While these “cementless” implants have the potential benefit of better long-term stability, they require hard bone to avoid shifting during the early healing process, and so are not appropriate for every patient. Dr. Bradley will help decide on the best implant for you specifically.

How is a partial knee replacement different than a full knee replacement?

In certain patients, the arthritis may only affect a portion of the knee joint. In these cases, Dr. Bradley may recommend replacing just that damaged portion of the knee, and preserving the rest of the knee joint. While the extent of the damage to the knee from arthritis is the main factor, there are other important factors, like overall motion of the knee, alignment, and stability that are also considered. The goal for a partial knee replacement surgery is to halt the destructive process of arthritis, and provide you with a long-term solution. This is NOT a temporary surgery meant to eventually lead to a full knee replacement, and recent studies have shown similar survivorship as full knee replacements.

Why would I get a partial knee replacement?

A partial knee replacement feels more normal than a full knee replacement, has a quicker recovery, less pain after surgery, and can allow people higher levels of function than a full knee replacement.

How do I know if I’m a candidate for a partial knee replacement?

Dr. Bradley will evaluate your x-rays and examine you during your clinic visit to assess if you are a good candidate for a partial knee replacement. He will only recommend a partial knee replacement in people he believes will have success after surgery, with the goal of avoiding a future full knee replacement. There are many people who end up getting full knee replacements who are good candidates for partial knee replacements, because some surgeons aren’t comfortable doing partial knee replacements. Dr. Bradley received specialized training with people who helped design many of the partial knee implants that are used all across the United States, and has experience identifying the best candidates and performing these surgeries. If you’re unsure if you’re a good candidate, don’t hesitate to ask!