0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA Patient Page |

Knee Replacement FREE

Janet M. Torpy, MD, Writer; Cassio Lynm, MA, Illustrator; Robert M. Golub, MD, Editor
JAMA. 2011;305(8):844. doi:10.1001/jama.305.8.844.
Text Size: A A A
Published online

More than 500 000 persons in the United States have knee replacements each year. The most common reason for knee replacement is osteoarthritis. Osteoarthritis is destruction of the cartilage (supporting tissue between layers of a joint) and can occur at any joint in the body, but the knees are often the first site. Osteoarthritis causes pain, stiffness, limitation of motion, and swelling in the area of the joint that has arthritis. Rheumatoid arthritis, destruction of joint cartilage by an immune process, affects joints differently. Persons with rheumatoid arthritis often have deformities in the joints, along with pain, swelling, stiffness, and problems in other areas of their bodies. Referral to an orthopedic surgeon and evaluation for knee replacement may be offered when other treatments for osteoarthritis or rheumatoid arthritis fail. Orthopedic surgeons are doctors with specialized education in the diagnosis and treatment of bone and joint disorders.

TESTING BEFORE KNEE REPLACEMENT

Diagnostic x-rays of persons with osteoarthritis demonstrate collapse of the knee joint, indicating destruction of the cartilage and meniscus (fibrous tissue). Magnetic resonance imaging (MRI) may be used for evaluation of knee pain, in addition to x-rays. Knee arthroscopy, a surgical procedure, examines the inner surfaces of the knee joint. Knee arthroscopy allows for evaluation and treatment of the ligaments, tendons, and cartilage involved in the knee joint, as well as debridement (removing damaged tissues) within the joint. Patients have a medical evaluation by their primary doctor (or specialists, if needed for their specific medical conditions) before knee replacement, since joint replacements are major surgery. This may include cardiac (heart) testing, evaluation of lung function, or improving control of high blood pressure and diabetes in order to reduce the chance of complications.

TYPES OF KNEE REPLACEMENT SURGERY

  • Total knee replacement uses metal or plastic parts, or a combination (the prosthesis), to replace both surfaces of the knee joint and the kneecap (patella).

  • Partial (unicompartmental) knee replacement involves only one side of the knee joint.

  • Computer-assisted knee replacement relies on specialized digital technology to guide the procedure.

  • Minimally invasive knee replacement uses smaller skin incisions.

COMPLICATIONS OF KNEE REPLACEMENT

  • Infection after knee replacement can be serious. Antibiotics are given before the surgical procedure starts to protect against infection. In severe cases of infection, a person may need to be hospitalized to receive intravenous antibiotics or supportive care. Sometimes the prosthesis has to be removed and specialized antibiotic treatment given before a replacement (a revision) is considered.

  • Poor pain relief may occur, despite good surgical results.

  • Blood clots are a serious complication of joint replacement. Your surgeon will prescribe a blood thinner after the operation (and in some cases, before surgery) to reduce this risk. The use of pneumatic compression stockings and early ambulation (movement) also helps lessen the chance of blood clots.

  • Prosthesis malfunction may require another procedure to fix or replace the parts.

FOR MORE INFORMATION

INFORM YOURSELF

To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on knee pain was published in the April 18, 2007, issue, and one on osteoarthritis of the knee was published in the February 26, 2003, issue.

Sources: American Academy of Orthopaedic Surgeons; Arthritis Foundation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, World Health Organization

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

TOPIC: MUSCULOSKELETAL HEALTH

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Spanish Patient Pages
Supplemental Content

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles