Knee Replacement Surgery:Knee Replacement Surgery:The Procedure andThe Procedure and

Post Surgical TherapyPost Surgical Therapy

By: Tania MarksBy: Tania Marks

University of California Santa BarbaraUniversity of California Santa Barbara

November 30, 2004November 30, 2004

TopicsTopics

Anatomy of the kneeAnatomy of the knee Knee Replacement SurgeryKnee Replacement Surgery

– Basic procedure and pBasic procedure and prosthesisrosthesis– Conservative methods of treatmentConservative methods of treatment– Reasons for Knee replacement Reasons for Knee replacement

surgerysurgery Post operative TreatmentPost operative Treatment

- Physical Therapy- Physical Therapy

Benefits of Knee Replacement SurgeryBenefits of Knee Replacement Surgery

Reduce Pain Reduce Pain Live comfortablyLive comfortably Correct deformitiesCorrect deformities Increase mobility, movement and strengthIncrease mobility, movement and strength Procedure is common and very successfulProcedure is common and very successful

Anatomy of the KneeAnatomy of the Knee

Knee is a weak jointKnee is a weak joint Femur- thigh boneFemur- thigh bone Tibia- shin boneTibia- shin bone CartilageCartilage LigamentsLigaments Quadriceps musclesQuadriceps muscles Patella tendon and Patella tendon and

patellapatella Quadriceps tendonQuadriceps tendon

Figure 1: Side and front view of patellofemoral joint [Patient's Guide to Total Knee Surgery, 2004]

Knee Replacement Surgery ProcedureKnee Replacement Surgery Procedure

Figure 2: Surgical Procedure [Collins and Pavlik, 2004]

ProsthesisProsthesis

Artificial ReplacementArtificial Replacement

Metal used for the femurMetal used for the femur

Plastic used for the tibiaPlastic used for the tibia

Figure 3: Knee Prosthesis [A Patients Guide to Total knee replacement surgery, 2004]

Conservative Methods of TreatmentConservative Methods of Treatment

NSAID- non steroidal anti-inflammatory NSAID- non steroidal anti-inflammatory medicationmedication– Aspirin, naprosyn, and ibuprofenAspirin, naprosyn, and ibuprofen

Physical TherapyPhysical Therapy– exercisesexercises

Reasons for Knee Replacement SurgeryReasons for Knee Replacement Surgery

Knee PainKnee Pain

Osteoarthritis Osteoarthritis (See figure)(See figure)

TumorsTumors

Figure 4: Before and After Knee replacement surgery of knees with osteoarthritis [Shiers, 1975]

Post Operative Treatment: Post Operative Treatment: Physical TherapyPhysical Therapy

GoalsGoals Increase flexibilityIncrease flexibility Increase coordinationIncrease coordination Increase movementIncrease movement Enhance endurance and daily activitiesEnhance endurance and daily activities Increase range of motionIncrease range of motion

Sample Exercises and PurposeSample Exercises and Purpose

Quadriceps setting –Quadriceps setting – increase muscle strengthincrease muscle strength

Heel slides - Heel slides - increase increase flexion and extensionflexion and extension

Terminal Knee Terminal Knee Extension- Extension- increase increase flexion and extensionflexion and extension

Figure 4: Quadriceps settings, heel slides Terminal Knee Extension Exercises [Muller and Webber Physical Therapy office, 2004]

Conclusion:Conclusion: Knee Replacement Knee Replacement Surgery over the YearsSurgery over the Years

One of the fastest growing surgeriesOne of the fastest growing surgeries

According to hospital database in Canada, According to hospital database in Canada, the number of knee replacement surgeries the number of knee replacement surgeries per year:per year:

– 1994 - 1995 = 15, 360 1994 - 1995 = 15, 360

– 2000 – 2001 = 23,1302000 – 2001 = 23,130

– 2001 – 2002 = 25,8152001 – 2002 = 25,815