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Operative Treatment

Arthroscopic procedure

Arthroscopic surgery is used to diagnose and treat many joint problems. This significant advance in joint care allows for a rapid return to improved activity. Most commonly used in knees, shoulders and ankles, the arthroscope can also be used for the spine, hips, wrists, and elbows. This animation uses the knee joint.

Partial Knee Resurfacing

Arthritis pain affects more than 40 million Americans.1 If you’re reading this website, you may be one of them. There are many causes of knee pain and there are a variety of treatment options. This website will review the causes and treatments of knee pain, highlighting more conservative knee treatment. Alleviating the pain and restoring mobility in your knee may allow you to do the simple things — from walking to gardening, even playing with your grandchildren, and most importantly, just enjoying life again. Information is the first step toward potential relief from joint pain.

Knee Anatomy and Function

The knee is the largest joint in the body and is central to nearly every routine activity. The knee joint is formed by the ends of 3 bones: the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the knee cap (patella). Thick, tough tissue bands called ligaments connect the bones and stabilize the joint. A smooth, plastic-like lining called cartilage covers the ends of the bones and prevents them from rubbing against each other, allowing for flexible and nearly frictionless movement. Cartilage also serves as a shock absorber, cushioning the bones from the forces between them. Finally, a soft tissue called synovium lines the joint and produces a lubricating fluid that reduces friction and wear.

What Causes My Joint Pain?

Normally, all of the parts of the knee joint work together and the joint moves easily and without pain. However, diseases or injury can disturb the normal functioning of the joint resulting in:

  • Pain
  • Muscle weakness
  • Limited movement

Osteoarthritis (OA)

One of the most common causes of knee pain and loss of mobility is the wearing away of the joint’s cartilage lining. When this happens, the bones rub against each other, causing significant pain and swelling — a condition known as osteoarthritis. Trauma or direct injury to the knee can also cause osteoarthritis. Additionally, without cartilage there is no shock absorption between the bones in the joint, allowing stress to build up in the bones and contributing to pain.

Osteoarthritis is probably the most common joint disorder in the United States, affecting approximately 20 million people.1

Treatment Options for Arthritis

Following an orthopaedic evaluation, your orthopaedic specialist will review and discuss the results with you. Your treatment options may include:

  • Medication
  • Physical therapy
  • Knee joint fluid supplements
  • Arthroscopy
  • Knee joint resurfacing

If non-invasive treatment options are not giving you satisfactory pain relief, knee surgery may become necessary. However, a total knee replacement (TKR) may not be necessary — alternate types of knee implants are available.

Partial Knee Resurfacing (PKR)

There are three compartments to the knee: the medial (inside) compartment, the lateral (outside) compartment and the patellofemoral (kneecap) compartment. Depending on where the arthritis affects your knee, partial knee resurfacing may be an option for you. PKR is a growing procedure. There are approximately 70,000 partial knee resurfacing procedures done in the U.S. each year.2

Partial knee resurfacing (PKR) is a surgical procedure for relieving arthritis in one compartment of the knee. With PKR, only the damaged surface of the knee joint is replaced, helping to minimize trauma to healthy bone and tissue. The surgeon removes only damaged bone in the affected knee and fits the implant to that bone. Because the PKR artificial joints are smaller than total knee implants, the surgical incision may be smaller as well.

Since most of the knee joint is unaffected and the basic knee structure remains intact, post-operative pain may be reduced and the recovery period may be shorter than total knee replacement.3

Triathlon® Partial Knee Resurfacing

Triathlon® PKR was developed with patient needs in mind. The implant is anatomically shaped and helps enable surgeons to use the latest minimally invasive surgical techniques. With this procedure, only the affected compartment of the arthritic femur and the tibia are resurfaced with artificial implants.

Potential Benefits of PKR

X3® Technology

The bearing surface is defined as the two parts of the knee implant that glide together throughout motion. Triathlon® PKR utilizes Stryker’s advanced bearing technology, called X3®, which has demonstrated up to 96% decrease in wear in laboratory testing compared to competitive premium bearing surfaces in TKRs.4 Triathlon® PKR is the only unicompartmental knee with this technology.

Quicker Recovery

Because the PKR artificial joints are smaller than total knee implants, the surgical incision may be smaller. A smaller incision may lead to a smaller scar. Other potential benefits to PKR include a quicker operation and a shorter hospital stay compared to a total knee replacement.3 Rehabilitation may also be more progressive.3 Because less bone is removed and there is less trauma to soft tissue during surgery, your knee may feel more natural than with a total knee replacement.3

Not all patients are candidates for Partial Knee Resurfacing. Depending on your condition, a total knee replacement may be recommended by your doctor.

Total Knee Replacement

Total Knee Replacement (TKR) may be necessary if more than one compartment of your knee is arthritic. In TKR, your surgeon will replace all 3 compartments of your knee using total knee components.

Risks Associated with PKR/TKR

As with any surgery, there is a risk of complications. Blood clots are the most common complication after surgery. Your doctor may prescribe one or more measures to help prevent blood clots from forming in your leg veins, such as special support hose and blood thinners. You may also receive antibiotics to help prevent infection. Your doctor can provide you with more information about other potential risks.

Risk factors relating to your anatomy, weight, prior joint surgeries and your personal health should also be addressed with your doctor.

You Don’t Have to Live with Severe Joint Pain

You don’t have to live with joint pain and the limitations it puts on your activities. Partial knee resurfacing with X3® technology may relieve your pain and restore the function in your knee. Talk to your doctor today about the treatment options that may provide the pain relief you long for and help enable you to return to your favorite activities.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Stryker, Triathlon and X3. All other trademarks are trademarks of their respective owners or holders.

References:

  1. National Institute of Arthritis and Musculoskeletal Diseases Website, November 2005.
  2. 2008 Projection, Millennium Research Group, 2005.
  3. Newman, John H., Unicompartmental Knee Replacement, The Knee, 7 (2000), pp. 63-70.
  4. Stryker Orthopaedics Test Report: 06-013.

Total Knee Joint Replacement

Are You Considering Knee Replacement Surgery?

Each patient is unique, but generally candidates for knee replacement surgery have:

  • Pain severe enough to restrict not only work and recreation, but also the routine activities of daily living
  • Pain that is not relieved by more conservative methods of treatment, such as reduced activity, medication or physical therapy
  • Significant joint stiffness and loss of mobility
  • X-rays that show advanced arthritis or other degenerative problems

The National Institutes of Health (NIH) has concluded that knee replacement surgery is "a safe and cost-effective treatment for alleviating pain and restoring function in patients who do not respond to non-surgical therapies."1 According to the American Academy of Orthopaedic Surgeons, knee replacement procedures have resulted in significant restoration of function and reduction of pain in about 90% of patients.2 As you read,make a note of anything you don't understand. Your doctor will be happy to answer your questions so that you'll feel comfortable and confident with your chosen treatment plan.

Knee Basics: What You Need to Know

Knee Anatomy and Function

The knee is the largest joint in the body and is central to nearly every routine activity. The knee joint is formed by the ends of 3 bones: the lower end of the thigh bone (femur), the upper end of the shin bone (tibia), and the kneecap (patella). Thick, tough tissue bands called ligaments connect the bones and stabilize the joint. A smooth, plastic like lining called cartilage covers the ends of the bones and prevents them from rubbing against each other, allowing for flexible and nearly frictionless movement. Cartilage also serves as a shock absorber, cushioning the bones from the forces between them. Finally, a soft tissue called synovium lines the joint and produces a lubricating fluid that reduces friction and wear.

 

Arthritis: The Leading Cause of Knee Pain

One of the most common causes of knee pain and loss of mobility is the wearing away of the joint's cartilage lining. When this happens, the bones rub against each other, causing significant pain and swelling — a condition known as osteoarthritis. Trauma or direct injury to the knee can also cause osteoarthritis. Without cartilage there is no shock absorption between the bones in the joint. This allows stress to build up in the bones and contributes to pain.

Knee Replacement

Knee replacement is a surgical procedure — performed in the U.S. since the 1960s — in which a diseased or damaged joint is replaced with an artificial joint called a prosthesis.Made of metal alloys and high-grade plastics (to better match the function of bone and cartilage, respectively), the prosthesis is designed to move just like a healthy human joint. Over the years, knee replacement techniques and instrumentation have undergone countless improvements. Today, knee replacement is one of the safest and most successful types of major surgery; in about 90% of cases it is complication-free and results in significant pain relief and restoration of mobility.1

Knee Implants That Promote Easier Motion1,2,3

Stryker knee replacements are different than traditional knee replacements because they are designed to work with the body to promote easier motion,1,2,3 and a study has shown a more rapid return to functional activities after surgery.2 This is due to the single radius design of the knee implant. Single radius means that as your knee flexes, the radius is the same, similar to a circle, requiring less effort from your quadriceps muscle.1,4,6

Because the thigh muscle (the quadriceps) is attached to your knee, it is unavoidably involved in the surgery. Therefore, the quadriceps muscle can become a source of discomfort or pain during your recovery period. The quadriceps muscle plays an important role in your ability to move your legs so it also has a major impact on your recovery and how quickly you can get back to living your life.2

Knee implants designed to last longer5

Several factors influence how long an implant will continue to perform. Stryker knees are designed to resist wear in many ways — they use advanced bearing surfaces; they're balanced to help avoid excessive stress in any one spot; and, they're sized to better fit your personal anatomy. X3 Advanced Bearing Technology has demonstrated up to 96% decrease in wear in laboratory testing compared to competitive premium bearing technologies.5

What Typically Happens During the Surgery

To begin the surgery, the surgeon will make an incision on the front of your knee, cutting through the tissue surrounding the muscles and bone. The kneecap, or patella, is rotated to the outside of the knee, to help your doctor see the area where the implant will be placed. The surgeon will use special cutting instruments to measure and make precise cuts of the bone. The end of the femur (thigh bone) is cut into a shape that matches the corresponding surface of the metal femoral component. The femoral component is then placed on the end of the femur.

The tibia (shin bone) is prepared with a flat cut on the top. The exposed end of the bone is sized to fit the metal and plastic tibial components. The metal tibial component is inserted into the bone. Then a plastic insert is snapped into the tibial component. The femoral component will slide on this plastic as you bend your knee.

If needed, the patella (kneecap) is also cut flat, and fitted with a plastic patellar component. Bone cement may be used to help secure the implants onto your bone. Your surgeon will conduct several tests during the surgery to ensure the correct sized components are used to help you regain good balance and motion in your knee. Your surgeon will then close the wound in layers with stitches and/or staples.

Risks Associated with Knee Replacement

But as good as the results can be, knee replacement is major surgery, and as such, there are certain risks and expectations that must be recognized. As with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications, the vast majority of which can be successfully avoided or treated. In fact, the complication rate following joint replacement surgery is very low. Serious complications, such as joint infection, occur in less than 2% of patients.1 Other possible complications include blood clots and lung congestion, or pneumonia. Talk to your doctor for a complete assessment of the potential risks.

Life After Knee Replacement

The vast majority of individuals who have joint replacement surgery experience a dramatic reduction in joint pain and a significant improvement in their ability to participate in the activities of daily living. However, joint replacement surgery will not allow you to do more than you could before joint problems developed. Your doctor will recommend the most appropriate level of activity following joint replacement surgery.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Stryker and X3. All other trademarks are trademarks of their respective owners or holders.

Don't Let Knee Pain Slow You Down

Don't let severe knee pain limit your activities. If you haven't experienced adequate relief with medication and other conservative treatments, joint replacement may provide the pain relief you long for and enable you to return to your favorite activities. Remember, even if your doctor recommends knee replacement for you, it is still up to you to make the final decision. The ultimate goal is for you to be as comfortable as possible with your choice — and that always means making the best decision based on your own individual needs.

For more information visit AboutStryker.com and contact your doctor.

References:

  1. National Institutes of Health Consensus Development Conference Statement: Total Knee Replacement 12/10/03.
  2. AAOS website, http://orthoinfo.aaos. org/topic.cfm?topic=A00385, accessed April 2011.
  1. AAOS website, http://orthoinfo.aaos. org/topic.cfm?topic=A00385, accessed April 2011.
  1. Ostermeier, S; Stukenborg-Colsman, C, Hannover Medical School (MHH) Hannover, Germany 'Quadriceps force after TKA — a comparison between single and multiple radius designs," Poster No. 2060 • 56th Annual Meeting of the Orthopaedic Research Society.
  2. Harwin, S.F., Hitt, K, Greene, K.A. Early Experience with a New Total Knee Implant: Maximizing Range of Motion and Function with Gender-Specific Sizing Orthopedic Surgery, Surgical Technology International, XVI. pgs 1-7.
  3. Greene, K.A. Range of Motion: Early Results from the Triathlon® Knee System, Stryker Literature Ref #LSA56., 2005.
  4. Wang, H., Simpson, K.J., Ferrary M.S., Chamnongkich, S., Kinsey, T, Mahoney, O.M., Biomechanical Differences Exhibited During Sit- To-Stand Between Total Knee Arthroplasty Designs of Varying Radii, JOA, Vol. 21, No. 8, 2006.
  5. Stryker Orthopaedics Test Report: 06-013.
  6. The effect of total knee arthroplasty design on extensor mechanism function, JOA, Vol. 17, Issue 4, June 2002, pp. 416-421.
  1. 1. Hanssen, A.D., et al., 'Evaluation and Treatment of Infection at the Site of a Total Hip or Knee Arthroplasty," JBJS, Vol.80-A, No. 6, June 1998, pp. 910-922.

Total Knee Implants Designed With Women in Mind

Total knee replacement is one of the safest and most successful types of surgery; in well over 90% of cases, it is complication-free and results in significant pain relief and restoration of mobility.1

Stryker’s Triathlon® Knee System represents the contribution of over 30 years of clinical success in orthopaedic implants. It utilizes the latest in knee technology to help increase the extent to which you will be able to restore motion in your knee after surgery. The Triathlon® Knee is designed for natural knee movement, helping to relieve your pain and restore your independence.

Over 60% of total knee replacements are performed on women.2 Triathlon® was designed with women in mind.3 It’s a complete knee system designed to increase motion, decrease wear and fit a woman’s anatomy.

Increased Knee Motion

Restoring motion in your knee is likely one of the reasons you are considering knee replacement. Motion, the bending (flexing), straightening (extension) and rotation of your knee, affects your ability to perform everyday activities. The Triathlon® Knee System allows for natural knee motion and up to 150° of flexion.

Better Fit for Women

There are over 300,000 knee replacements done each year in the US1 and over 60% of them are performed on women. Triathlon® is a total knee system designed with women in mind.

The design of Triathlon® offers a wide range of sizing options that closely match both the female and male anatomy. The smaller sizes are narrower, and a narrower implant accommodates the female bone structure, which improves fit and function for women.

Patient Testimonial

“Right after the operation, I felt that it had been a success…I have my life back again. I’m living a full-time life.”

— Cindy Goodfellow, 64
Stryker Knee Recipient 2005

Improved Wear Performance

Many things including patient weight, activity level as well as the implant’s bearing surface technology, can affect the longevity of the implant. The bearing surface is defined as the two parts of the knee that glide together throughout motion.

Stryker’s advanced bearing technology, called X3®, has demonstrated a 96% decrease in wear in laboratory testing compared to competitive premium bearing technologies.1 Based on this testing, X3® Technology may result in a longer lasting implant. This technology is particularly important for younger patients.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Stryker and X3. All other trademarks are trademarks of their respective owners or holders.

References:

  1. National Institutes of Health Consensus Development Conference Statement: Total Knee Replacement 12/10/03.
  2. American Academy of Orthopedic Surgeons
  3. Hitt, K., et al., “Anthropometric Measurement of the Human Knee: Correlation to the Sizing of Current Knee Arthroplasty Systems,” JBJS, Vol. 85-A, Supplement 4, 2003.
  1. National Institutes of Health Consensus Development Conference Statement: Total Knee Replacement 12/10/03.
  1. 1. Stryker Orthopaedics Test Report RD-06-013.