Nathaniel Stewart, MD

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

There’s Good News and Better News!

If you’re reading this website, chances are you’re considering or preparing for knee replacement surgery. That’s good news — because knee replacement has been proven over four decades to relieve severe knee pain and restore knee function in the vast majority of patients. In fact, the National Institutes of Health recently 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

Not all knee replacements are the same. Advances in total knee design have resulted in knee implants that will help you feel like yourself again.

The new Triathlon® knee implant is designed for natural knee movement, helping to relieve pain and restore motion.

As you read, make a note of anything you don’t understand. Your orthopaedic surgeon will be happy to answer your questions so that you’ll feel comfortable and confident with your chosen treatment plan.

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

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 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.

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.) 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.

Standard Treatment Options

Conservative Treatments
Conservative treatments, such as steroidal and nonsteroidal anti-inflammatory drugs, physical therapy, bracing and cortisone injections may effectively relieve pain and restore mobility for some patients, for some period of time. But more severe conditions may not respond adequately to these approaches. In these cases, the orthopaedic surgeon may recommend knee replacement surgery.

Knee Replacement
Knee replacement is a surgical procedure — performed in the US 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 mimic 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 well over 90% of cases it is complication-free and results in significant pain relief and restoration of mobility.¹

The Triathlon® Knee System

The Triathlon® Knee System represents the contributions of over 30 years of clinical success in orthopaedic implants. Triathlon® utilizes the latest in knee technology to help replicate the natural bending and rotating of the knee.

The Triathlon® Knee is designed for patients who want to get back to being themselves. It is designed for natural knee movement, helping to relieve pain and restore independence.

The Triathlon® Knee System is designed to offer patients more natural movement and the potential for greater implant longevity (based on laboratory wear testing).^2,3

What Typically Happens During the Surgery

In knee surgery, the knee is flexed and the leg suspended. One muscle is separated to expose the femur (thigh bone); later, the tibia (shin bone) is exposed. The damaged surfaces at the end of the thigh bone are trimmed to shape it to fit inside the total knee prosthesis. The shin bone is cut flat across the top and a hole is created in the center to hold the stem of the tibial component. If needed, the kneecap is trimmed and the patellar component attached.

At various points during surgery, the alignment, function and stability of the knee joint are evaluated and required adjustments are made. The prosthesis components are cemented into place, any contracted ligaments are released, the mid-vastus muscle is reconstructed and the incision is closed.

Risks Associated with Knee Replacement

But as good as the results are, 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.⁴ (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. Each patient’s physician will recommend the most appropriate level of activity following joint replacement surgery.

Patient Testimonials

“Knee replacement has given my kids their dad back.”
“At age 47, I was in constant pain. I have two lovely children, ages 9 and 13 and they play a lot of sports. I try to volunteer to be a coach for some of the teams. I just couldn’t do it, so it was very difficult to sort of sit on the sidelines and watch the children out there playing but not be able to go out there and join them or coach them.

“After surgery, I was able to play 18 holes of golf, carrying my clubs and walking the golf course with all my other friends. My children are rapidly growing, so it was nice to get out there, play with them and be able to enjoy them completely. And with the Stryker Knee, I don’t even know the knee’s in there, which is a great benefit.”

— Jeff Gill, 47
Stryker Knee Replacement
2005

“Right after the operation, I knew that it had been a success…I have my life back again. I’m living a full-time life.”
“The pain was so severe, I really could not continue my life as I had known it before. I felt like I was living a part-time life. I have six grandchildren, and my husband and I do a lot of traveling…and we had to stop that.

“Right after the operation I knew that it had been a success, and my progress was just so wonderful, and the physical therapy, although it was a little difficult, just went beautifully. And I have my life back again. I’m living a full-time life. It’s given me my life back.”

— Cindy Goodfellow, 64
Stryker Knee Replacement
2005

You Don’t Have to Live with Severe Knee Pain

You don’t have to live with severe knee pain and the limitations it puts on 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 contact your doctor.

References:

1. National Institutes of Health Consensus Development Conference Statement: Total Knee Replacement 12/10/03. 
2. Stryker Test Report: RD-04-110. 
3. Stryker Test Report: RD-03-038. 
4. 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.