There are several different types of surgery offered to treat knee arthritis. Which surgery, if any, is recommended will depend on several factors, such as the patient’s age, anatomy, general health, lifestyle, and personal preferences, as well as the surgeon’s experience and preferences.

Total Knee Replacement Surgery (Total Knee Arthroplasty)

Undergoing Total Knee Replacement for Knee Arthritis

Total knee replacement surgery involves cutting the damaged ends of the tibia (shin bone) and femur (thighbone) and capping both with prostheses. Read Undergoing Total Knee Replacement for Knee Arthritis

Patients with moderate to severe knee arthritis who have exhausted non-surgical treatment options might consider replacing the entire knee joint. The surgery involves cutting the arthritically damaged ends of the tibia (shin bone) and femur (thighbone) and capping both with prostheses (like capping teeth).

The two prosthetic pieces are made of either metal or a durable plastic called polyethylene. These new surfaces move smoothly against one another, creating a functional knee joint. Partial recovery typically takes 4 to 6 weeks¹ and full recovery may take a few months to an entire year.

Total knee replacement surgery provides most patients with pain relief and improved knee joint function. However, a replacement knee is not as strong and durable as a healthy knee, and patients are strongly advised not to engage in high-impact activities (such as jogging) that may speed up the wear-and-tear of the new joint.

See Minimally Invasive Knee Replacement Surgery

Partial Knee Replacement Surgery (Unicompartmental Knee Arthroplasty)

Partial knee replacement, often called unicompartmental knee replacement, involves replacing only one of the knee’s three “compartments”:

• The medial compartment refers to the inner knee (where a person’s knees touch when the legs are together).
• The lateral compartment refers to the outer knee.
• The patellofemoral compartment is at the front of the knee, where the patella (kneecap) meets the femur (thighbone).

Partial knee replacement surgery treats the arthritically damaged compartment of the knee joint (typically the lateral or medial compartment) while preserving healthy areas. This surgery is appropriate for only a small number of people, and patients may be ineligible if their knees are not well aligned (e.g. bowlegged or knock-kneed), have severe knee stiffness, have ligament damage, or if they suffer from inflammatory arthritis, such as rheumatoid arthritis.

Compared to total knee replacement, partial knee replacement is less invasive, so it is usually less painful and requires less recovery time. However, partial knee replacement is not as reliable as total knee replacement for alleviating pain.

See Managing the Pain of Joint Replacement

Knee Osteotomy (Tibial Osteotomy or Femoral Osteotomy)

Knee Osteotomy Surgery

During a knee osteotomy, a small wedge of natural bone graft or artificial bone material is inserted in the bone to realign the joint. Read Knee Osteotomy Surgery

This surgery is appropriate for a limited number of younger (under age 60 or so), physically active people whose poor knee alignment has caused a great deal of wear-and-tear on just one side of the knee joint, a condition called unilateral knee arthritis or asymmetrical knee arthritis.

During knee osteotomy the surgeon cuts into the femur (thigh bone) or tibia (shin bone) and either:

• Removes a small wedge of bone, or
• Adds a small wedge of natural bone graft or artificial bone material.

Knee Osteoarthritis Video

Knee osteotomy re-aligns the joint to shift more pressure onto the “good” side of the knee joint and reduce wear and tear on the bad side. The goal is to reduce pain and perhaps slow down the progression of knee osteoarthritis. A successful knee osteotomy surgery can postpone the need for total knee replacement surgery up to 10 years.²

Unlike after total knee replacement, recovered knee osteotomy patients may participate in high-impact sports.³ This is a major surgery with potential risks and complications, and patients must be committed to extensive post-surgical physical therapy. A full recovery may take months or even an entire year.⁴

Read more about the procedure, risks, and recovery timeline for: Knee Osteotomy Surgery

Knee Arthroscopy

In arthroscopic surgery, the surgeon inserts a video camera and surgical tools through small incisions and can make an assessment of arthritic joint degeneration.

Arthroscopic surgery requires only small incisions through which the surgeon inserts a very small video camera and surgical tools. During knee arthroscopy, a surgeon can make an assessment of joint degeneration due to arthritis.

The surgeon can also perform knee debridement and lavage, which includes the following process:

• Remove loose pieces of cartilage or bone (loose osteophytes) suspected of causing irritation
• Trim or smooth out cartilage that has grown irregular and bumpy
• Remove inflamed synovial tissue
• Flush the joint with a saline solution, a process called lavage, to clean out materials known to cause irritation and swelling

Experts’ opinions differ on whether knee arthroscopy is a worthwhile treatment option for knee osteoarthritis. Some experts point to clinical studies that suggest knee arthroscopy does not provide benefit to knee osteoarthritis patients.^5,6 Others reason that because knee arthroscopy is less invasive and carries fewer risks it is worth trying before embarking on a more invasive surgery, such as total knee arthroplasty.⁷ (Most experts do agree arthroscopy is useful for treating other knee problems, such as repairing meniscal tears.) Knee arthroscopy is an outpatient procedure, but it is still surgery and it can take 6 to 8 weeks for the joint to fully recover.

Cartilage Repair and Cartilage Restoration

One way to stimulate cartilage growth is by making precise microfractures in the surrounding bone.
This procedure is called bone marrow stimulation.

Once damaged, cartilage does not heal well. Even if the joint is able to grow new cartilage, it tends to be rough and bumpy and therefore less able to facilitate smooth movement at the joint. There are a handful of surgeries that attempt to repair or encourage the growth of healthy cartilage:

• Bone marrow stimulation, which stimulates cartilage growth by making precise microfractures in the surrounding bone
• Osteochondral transplantation techniques (OATS), also referred to as “mosaicplasty,” which involves transplanting cartilage from one site to another
• Autologous chondrocyte implantation (ACI), which requires two surgeries. In the first, cartilage cells are harvested and then grown in a laboratory for several weeks. During the second surgery the cartilage cells are re-implanted.

These procedures may be appropriate for patients who have a relatively small and very isolated area of articular cartilage damage. Typically, these patients are younger and have damaged their cartilage through trauma (e.g. a sports injury) rather than over years of gradual wear and tear. Therefore, these surgeries are usually more appropriate for people trying to slow or prevent severe arthritis rather than alleviate it.

This article focuses on the most common types of knee surgery for arthritis. New types of surgery, less invasive surgical techniques, and new implant designs and materials are the subjects of ongoing research.

People suffering from knee arthritis should make a concerted effort to alleviate symptoms with non-surgical treatments. If non-surgical treatments do not provide satisfactory pain relief and improved knee function, then an orthopedic surgeon who specializes in knee surgery can determine whether surgery is an appropriate option.

Learn more about how doctors such as orthopedic surgeons treat arthritis in Arthritis Treatment Specialists

In addition to recommending a specific surgery or set of surgeries, the surgeon will explain the surgery’s potential benefits, expected recovery period, and potential risks and side effects, as well as alternatives to the surgery. Once fully informed, the patient can decide whether or not to have the surgery.

Disclaimer: This article has been taken from https://www.arthritis-health.com/ as it is. Click here to read the original article.

The posterior cruciate ligament (PCL) is the strongest ligament in the knee joint. Ligaments are thick, strong bands of tissue that connect bone to bone. The PCL runs along the back of the knee joint from the bottom of the thighbone (femur) to the top of the lower leg bone (tibia).

The PCL helps keep the knee joint stable, especially the back of the joint. An injury to the PCL could involve straining, spraining, or tearing any part of that ligament. The PCL is the least commonly injured ligament in the knee.

A PCL injury is sometimes referred to as an “overextended knee.”

What Causes a PCL Injury?

The main cause of PCL injury is severe trauma to the knee joint. Often, other ligaments in the knee are affected as well. One cause specific to PCL injury is hyperextension of the knee. This can occur during athletic movements like jumping.

PCL injuries can also result from a blow to the knee while it is flexed, or bent. This includes landing hard during sports or a fall, or from a car accident. Any trauma to the knee, whether minor or severe, can cause a knee ligament injury.

Symptoms of a PCL Injury

Symptoms of a PCL injury can be mild or severe, depending on the extent of the injury. Symptoms might be nonexistent if the ligament is mildly sprained. For a partial tear or complete tear of the ligament, common symptoms include:

• tenderness in the knee (specifically the back of the knee)
• instability in the knee joint
• pain in the knee joint
• swelling in the knee
• stiffness in the joint
• difficulty walking

Diagnosing a PCL Injury

To diagnose a PCL injury, your doctor will perform a variety of tests, including:

• moving the knee in various directions
• physical examination of the knee
• checking for fluid in the knee joint
• an MRI of the knee
• an X-ray of the knee joint to check for fractures

Preventing a PCL Injury

It’s difficult to prevent ligament injuries because they are often the result of an accident or unforeseen circumstance. However, preventive measures that can be taken to help minimize the risk of a knee ligament injury include:

• using proper technique and alignment when doing physical activities, including walking
• stretching regularly to maintain good range of motion in the joints
• strengthening the muscles of the upper and lower legs to help stabilize the joint
• using caution when playing sports in which knee injuries are common like football, skiing, and tennis

Treating PCL Injuries

The treatment for PCL injuries will depend on the severity of the injury and your lifestyle.

For minor injuries, treatment may include:

• splinting
• applying ice
• elevating the knee above the heart
• taking a pain reliever
• limiting physical activity until pain and swelling are gone
• using a brace or crutches to protect the knee
• physical therapy or rehabilitation to strengthen and regain range of motion

In more severe cases, treatment may also include:

• physical therapy or rehabilitation to strengthen and regain range of motion
• surgery to repair a torn ligament
• an arthroscope, a small fiber-optic camera that can be inserted into the joint

The major symptom of posterior cruciate ligament PCL injuries is joint instability. Many of the other symptoms, including pain and swelling, will go away with time, but instability may remain. In PCL injuries, this instability is often what leads people to elect surgery. Untreated instability in the joint may lead to arthritis.

Outlook for a PCL Injury

For minor injuries, the ligament may heal without complications. It’s important to note that if the ligament was stretched, it may never regain its prior stability. This means it’s more likely that the knee may be somewhat unstable and could be easily injured again. The joint could become swollen and sore simply from physical activity or minor injury.

For those with major injuries who don’t have surgery, the joint will most likely remain unstable and be easily reinjured. You will be less able to do physical activities and pain could result from even minor activities. You may have to wear a brace to protect the joint during physical activity.

For those who have surgery, the prognosis depends on the success of the surgery and of the associated injuries to the knee. Generally, you will have improved mobility and stability after the joint is repaired. You may need to wear a brace or limit physical activities in the future to help prevent reinjuring the knee.

For knee injuries involving more than just the posterior cruciate ligament PCL, treatment and prognosis may be different because those injuries maybe more severe

Disclaimer: This article has been taken from https://www.healthline.com// as it is. Click here to read the original article.

The posterior cruciate ligament (PCL), is one of four ligaments important to the stability of the knee joint. There many Posterior Cruciate Ligament Treatment. The anterior cruciate ligament (ACL), sits just in front of the PCL. The ACL is much better known, in part because ACL tears are much more commonly diagnosed than injuries to the PCL. Interestingly, it is thought that PCL injuries account for up to 20 percent of knee ligament injuries, however, the PCL is seldom talked about because these injuries are often left undiagnosed.1

The PCL is the ligament that prevents the tibia (shin bone) from sliding too far backward. Along with the ACL which keeps the tibia from sliding too far forward, the PCL helps to maintain the tibia in a position below the femur (thigh bone).

 

PCL Tears

The most common mechanism of injury of the PCL is the so-called “dashboard injury.”1 This occurs when the knee is bent, and an object forcefully strikes the shin backward. It is called a ‘dashboard injury’ because this can be seen in car collisions when the shin forcefully strikes the dashboard. The other common mechanism of injury is a sports injury when an athlete falls on the front of their knee. In this injury, the knee is hyper flexed (bent all the way back), with the foot held pointing downwards. These types of injuries stress the PCL, and if the force is high enough, a PCL tear can be the result.

PCL injuries are also commonly seen with severe trauma that can cause injury to many knee structures. PCL tears can be associated with other knee ligament injuries, including ACL tears, MCL tears, and LCL tears.2 They can also be found with complex ligament injury patterns such as posterolateral rotatory instability. In addition, PCL injuries may be associated with meniscus tears and cartilage damage. Often these more severe patterns of injury occur with a knee dislocation.

 

Symptoms of PCL Tears

The most common symptoms of a PCL tear are quite similar to the symptoms of an ACL tear. Knee pain, swelling and decreased motion are common with both injuries.1 Patients may have a sensation that their knee “popped” or gave out. Problems with knee instability in the weeks and months following PCL injury are not as common as instability following an ACL tear. When patients have instability after a PCL injury they usually state that they can’t “trust” their knee, or that it feels as though the knee may give out. If this complaint of instability is a problem after a PCL injury, it may be an indication to proceed with surgery.

The major factor in making the diagnosis of a PCL tear is by knowing how the injury happened. Knowing the story of the injury (for example, the position of the leg and the action taking place) will help in making the diagnosis. Specific maneuvers can test the function of the PCL. The most reliable is the posterior drawer test.2 With the knee bent, your doctor will push the tibia backward; this stresses the PCL. If the PCL is deficient or torn, the tibia will slide too far backward, and indicate an injury to the PCL.

X-rays and MRIs are also helpful in clarifying the diagnosis and detecting any other structures of the knee that may be injured. It is common to find other ligament injuries or cartilage damage when a PCL tear is found.

PCL tears are graded by the severity of the injury, grade I through grade III.2 The grade is determined by the extent of laxity measured during your examination. In general, grading of the injury corresponds to the following:

• Grade I: Partial tears of the PCL.
• Grade II: Isolated, complete tear to the PCL.
• Grade III: Tear of the PCL with other associated ligament injuries.

 

Treatment of a PCL Tear

Posterior Cruciate Ligament Treatment & tears is controversial, and, unlike the treatment of an ACL tear, there is little agreement about the optimal treatment for all patients.1 Initial treatment of the pain and swelling consists of the use of crutches, ice, and elevation. Once these symptoms have settled, physical therapy is beneficial to improve knee motion and strength. Nonoperative treatment is recommended for most grade I and grade II PCL tears.

Surgical reconstruction of the PCL is controversial, and usually only recommended for grade III PCL tears. Because of the technical difficulty of the surgery, some orthopedic surgeons do not see the benefit of PCL reconstruction. Others, however, believe PCL reconstruction can lead to improved knee stability and lower the likelihood of problems down the road.

Posterior Cruciate Ligament Treatment in surgery reconstruction is difficult in part because of the position of the PCL in the knee. Trying to place a new PCL graft in this position is difficult, and over time these grafts are notorious for stretching out and becoming less functional. Generally, surgical PCL reconstruction is reserved for patients who have injured several major knee ligaments, or for those who cannot do their usual activities because of persistent knee instability.

Disclaimer: This article has been taken from https://www.verywellhealth.com/ as it is. Click here to read the original article.

What Is It?

The posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL) are two tough bands of fibrous tissue that connect the thighbone (femur) and the large bone of the lower leg (tibia) at the knee joint. Together, the ACL and PCL bridge the inside of the knee joint, forming an “X” pattern that stabilizes the knee against front-to-back and back-to-front forces. In particular, the PCL prevents the lower leg from slipping too far back in relation to the upper leg, especially when the knee is flexed (bent).

Posterior Cruciate Ligament (PCL) Injuries includes a stretch or tear of the ligament. The Posterior Cruciate Ligament (PCL) Injuries most often occurred when the front of the knee hits the dashboard during an automobile accident. During sports activities, the PCL also can tear when an athlete falls forward and lands hard on a bent knee, which is common in football, basketball, soccer and especially rugby.

Disclaimer: This article has been taken from https://www.health.harvard.edu/ as it is. Click here to read the original article.