Total knee replacements are one of the most common surgical procedures in the country. In fact, the Agency for Healthcare Research and Quality expects that by 2030, about 11 million Americans will have had either a hip or knee replacement. In 2010 alone, approximately 7 million people underwent joint replacement surgery. And while many people may associate knee replacements with the elderly, patients of all ages undergo the procedure. This is due in part to the fact that car accidents can result in damage to the joint of the knee, and car accidents don't care how old you are.
The knee is made up of three bones - the lower end of the thigh bone known as the femur, the upper end of the shin bone known as the tibia, and the knee cap, also called the patella. Where these bones all meet is covered by protective cartilage. When the cartilage starts to wear away (either over time with old age, or sped up by a traumatic injury such as an automobile accident), this results in knee pain, also known as arthritis. According to the American Academy of Orthopedic Surgeons (AAOS), “damaging a joint raises your chances of developing arthritis sevenfold.” When unbearable pain, deformities of the knee, and loss of mobility are not being effectively treated by medication and/or physical therapy, a total knee replacement surgery is the final option.
Victims of automobile accidents who undergo total knee replacements are likely suffering from post-traumatic arthritis. According to the Cleveland Clinic, post-traumatic arthritis occurs when an intense force hits the knee, such as the impact from a car collision. This results in fracturing of the bone and damage to the surrounding cartilage, which alter how the joint moves and wears out the cartilage more quickly.
During a knee replacement surgery, the surface of the bone as well as the cartilage are replaced with an implant, creating a joint that glides much more smoothly than an arthritic joint does. The implant can be made out of metal, ceramic material, or plastic. According to the AAOS, there are 4 basic steps of a total knee replacement operation.
Steps of a Total Knee Replacement Operation
- Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
- Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts are cemented onto the bone.
- Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
- Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Patients are likely to experience some pain and discomfort directly after surgery. This is managed through medication and physical therapy. Health Care providers encourage the use of over-the-counter pain medications as much as possible, as opioids can have severe side effects, namely addiction. Physical therapy is used to help strengthen the muscle surrounding the knee, and restore range of motion. In the long term, total knee replacement patients experience a dramatic reduction of pain, and can enjoy low impact activities such as walking, swimming, and biking.
While overall quality of life is greatly improved for the vast majority of patients, doctors at the Cleveland Clinic are working to minimize pain and improve patient satisfaction in both the short and long term.
Research on Improving TKR Experience:
- Robotic Total Knee Replacement: Using robots can improve accuracy and precision during surgery. This leads to a more exact placement of the implant, resulting in better patient outcomes.
- Press-fit Implant Technology: This type of implant does not require cement to adhere it to the bone. This allows the bone of the knee to regrow better, allowing implants to last longer. This is especially beneficial for younger patients, who need their implants to last 20+ years.
- Customized 3D Implant Printing: Knee implants typically have one design that only varies in size, even though human anatomy varies tremendously. Custom printed 3D implants that more closely match the patient’s anatomy improve function and satisfaction.
- Neuromuscular Electrical Stimulation: This utilizes a brace that sends electrical stimulation to the muscles surrounding the knee. This causes the muscle to contract, strengthening the joint. These braces can be used before surgery, to make sure the joint is strong enough, and after surgery during recovery.
Accidents happen, so while there is no way to completely prevent needing a total knee replacement due to a car collision, there are other areas of your life in which you can take steps to minimize your risk. Maintaining a healthy weight so as not to put extra strain on the joint is what most doctors recommend. More so, be sure to wear the proper safety equipment, such as knee pads and shin guards, when playing high impact sports such as football or soccer. And who knows, since most car crashes are caused by human error, maybe with the future of autonomous vehicles we will be able to minimize the risk of knee injuries from automobile accidents. The good news is that total knee replacements are a relatively safe and effective procedure, should you find yourself needing one, and doctors and researchers are working to make the experience even better.
Knee injuries make the simplest things in life, such as anything involving walking or moving, difficult. The experienced attorneys at The Michigan Law Firm, PLLC understand that it is especially frustrating to have sustained a knee injury due to a motor vehicle accident, since medical treatment can be very expensive and auto insurance companies can be difficult to work with. If you have suffered any injury from a car accident, including a knee injury, call The Michigan Law Firm, PLLC at 844.4MI.FIRM for a free legal consultation. Let our attorneys handle your legal situation while you focus on recovery.