The most common knee damage, which occurs mainly in older adults, is cartilage degeneration, in which the cartilage cannot regrow. Between 10% and 15% of the population aged 60 and above experiences this erosion, and at age 80 and above, 80% of the population will have varying degrees of joint erosion.

Other causes of cartilage erosion are joint trauma, fractures, dislocation, tumors surrounding the joint, lack of blood supply to areas within the joint, and inflammatory diseases such as rheumatism and lupus, which severely affect most joints of the body.

Knee replacement is a last-resort surgery

Assuta orthopedists recommend knee replacement surgery only after all non-surgical procedures have been exhausted, including:

• Anti-inflammatory medications
• Joint injections (intra-articular injections) of steroids, hyaluronic acid, or platelet-rich plasma
  (PRP)
• Physical therapy
• Other treatments

It is very important for the patient to consider undergoing knee replacement surgery only after he/she has exhausted all non-surgical treatments.

Considerations for undergoing partial or complete knee replacement

Patients can develop degenerative changes in one or more parts of the knee, specifically: the inside (medial), the outside (lateral) or the kneecap (patellofemoral). When only one of the parts of the knee is
damaged, a partial replacement (unicondylar knee replacement) can be performed. The surgery is done through a smaller incision, and the rehabilitation is typically relatively short.

When two or three parts of the knee are involved, then a total knee replacement (TKR) is recommended.

The Assuta surgeon determines the type of replacement based on the patient’s clinical tests and imaging scans, sharing with the patient the considerations for selecting the type of surgery and explaining the procedure itself.

Total knee replacement surgery

When the bone or cartilage damage is degenerative, inflammation usually affects the thighbone (femur) and the knee socket.

These injuries require multiple repairs, affecting in all parts of the joint bones and, at times, the area behind the kneecap. In this operation, the damaged sections of the knee including the tip of the shinbone (tibia), the tip of the thighbone, and part of the kneecap are replaced with artificial implants that enable the joint to move without pain.

In a total knee replacement operation, the incision is larger than the partial replacement.

Partial knee replacement surgery

This surgery, which replaces only the injured parts of the knee (usually the inner part of the knee joint), has the potential to preserve about 75% more bone than full replacement surgery.

The procedure is typically performed using a minimally invasive approach (a small, minimal incision).

This state-of-the-art surgery performed at Assuta puts the latest computer imaging technology to use. In advance of the procedure, the patient undergoes an MRI imaging scan of the knee, which displays a
precise three-dimensional computerized diagram for the surgeon. Prior to the procedure, the surgeon plans the operation using the diagram and simulates the operation virtually. Based on the precise computer design, the surgical team produces surgical instruments customized to the patient's knee structure. The surgeon uses these instruments during surgery to personalize the surgery and perform it simply and accurately.

Partial replacement surgery helps the patient recover and rehabilitate quicker and promotes optimal range of motion.

This surgery is not suitable for all patients suffering from cartilage degeneration; a thorough examination by an expert orthopedist is required to determine whether the surgery is appropriate for the patient.

Every year, Assuta performs numerous knee replacement surgeries, which have become routine procedures to treat injuries, wear and tear, osteoarthritis, and other orthopedic conditions.