Knee Prosthesis FAQ

What is a knee prosthesis?

A knee prosthesis is a metal covering of the worn knee joint, on both the femur and tibia sides, with an interposed plastic component that allows for its gliding and functionality.

Knee: When is surgical intervention necessary?

Before discussing the need for surgical intervention, some important concepts must be understood. First, there is no ideal age for a knee replacement operation. This means a prosthesis may be necessary whether you are young or over 80; it simply depends on the joint's condition.

Furthermore, during the consultation, the surgeon may propose a unicompartmental knee prosthesis instead of a total knee prosthesis.

The rule is that the prosthesis is implanted when a person feels the need, perhaps to improve their quality of life. The parameters for deciding on the advisability of surgery are the pain and functional limitation caused by gonarthrosis.

Surgery may be necessary as early as age 30-40, although this is rare (e.g., patients with severe trauma or violent rheumatoid arthritis). Generally, however, a patient undergoing surgery for knee osteoarthritis is between 45 and 90 years old.

Before deciding on surgery, a consultation is essential where the surgeon will evaluate:

• Your general situation;
• Your state of health;
• Your knee's function (deficits in extension or flexion, significant varus or valgus deviations);

The surgeon may also ask to see previous examinations and may prescribe further ones.

When to proceed with a total knee prosthesis?

If your knee is severely damaged in all parts by osteoarthritis, making walking or climbing stairs difficult and causing constant pain even at rest, non-surgical treatments are no longer effective, and a total knee prosthesis should be considered. Total knee replacement surgery is safe, eliminates pain, and corrects leg deformities. After this procedure, you will be able to resume your usual life and normal activities.

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What is a knee prosthesis made of?

The knee prosthesis is made of metal alloys, primarily titanium. The materials are tested for biocompatibility, like dental implants.

Between the metal surfaces is a high-strength polyethylene plastic component that facilitates the gliding of the bone heads, preventing premature wear. Attempts to create prostheses without this component resulted in early failures and were abandoned.

What are the main causes of failure of a prosthesis?

Causes of prosthesis failure can depend on both the surgeon and the patient. Inadequate surgical technique (suboptimal bone resections, inadequate ligament balancing, insufficient stability, or patellar instability) can create pain, instability, and difficulties with articulation and walking.

Patient factors increasing the risk of failure are osteoporosis, overweight/obesity (increasing wear and loosening and infection risk), and excessively heavy use (high-impact sports).

Is it true that pain persists after a knee prosthesis?

Persistent pain is usually related to a problem with the prosthesis or the patient. A correctly implanted prosthesis usually allows for functional recovery with minimal or no pain after a few months. Recovery time and pain reduction vary. Pre-operative inflammation and suffering generally lengthen recovery.

Can there be rejection due to an allergy to the knee prosthesis?

In a small percentage of cases, patients may have intolerance to the prosthesis materials. Tests before surgery can verify this predisposition. Hypoallergenic implants are available.

Is it also possible to play sports with a knee prosthesis?

Yes, even demanding sports like tennis and running are possible, but not recommended due to premature wear. Walking, light trekking, swimming, cycling, and skiing (for experienced skiers) are generally fine. High-impact sports (running, tennis, football) can lead to premature wear/failure and are not recommended.

Does a knee prosthesis require revision?

If revision is needed, consult an experienced surgeon. It's not an easy procedure. Even during revision, correct surgical execution of the prosthetic implant (likely a semi-invasive prosthesis offering greater stability) is essential, especially in cases of significant bone wear or ligament damage.

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