Knee Joint Doctor/Total Knee Replacement Surgeon in New York City
Knee pain is extremely common. It can also be debilitating. The pain can become so severe that simple day-to-day tasks like climbing stairs or walking become agonizing chores. For some patients, conservative treatments such as pain medications, physical therapy, or steroid injections may help. In others, surgery is required. In fact, more than 700,000 total knee replacement surgeries are performed in the United States each year.
If you experience knee pain, finding a local knee joint doctor is the first step in addressing it. A knee joint doctor may be a rheumatologist or, in more advanced disease, a total knee replacement surgeon, such as an orthopedic surgeon. This knee joint doctor will evaluate the cause of your knee pain and determine the best course of treatment.
Several Conditions May Require Total Knee Replacement Surgery
Knee pain may be acute or chronic. Acute knee pain may resolve on its own, or it may require surgery. Acute knee pain that continues for more than three to six months is considered chronic knee pain. Chronic knee pain is not likely to resolve on its own.
Some forms of acute knee pain and most forms of chronic knee pain ultimately require at least one surgical procedure — many require total knee replacement surgery.
Osteoarthritis: The Most Common Reason to See a Total Knee Replacement Surgeon
The main indication for total knee replacement is osteoarthritis. Osteoarthritis is a degenerative condition of the joint surfaces that occurs when the protective ends of the bones and joints break down and wear away. Without cartilage cushions, the bones often rub painfully against one another. Most cases of osteoarthritis are progressive, meaning they get worse with time. Drugs and joint injections may delay surgery, but most patients with moderate to severe knee osteoarthritis will eventually need the services of a total knee replacement surgeon.
New York City, Staten Island, and Jersey City are home to many world-class knee joint doctors who specialize in the medical and surgical treatment of osteoarthritis.
Posttraumatic Arthritis: Osteoarthritis with a Specific Cause
Posttraumatic arthritis is a form of osteoarthritis that is caused by an injury to the knee joint, either one major trauma (like a car accident) or several minor traumas (like several years playing contact sports). Injuries such as bone fractures or tears of the knee ligaments can damage articular cartilage. The surface of the joint can become uneven from the damage, causing friction during movement. Over time, the joint breaks down, eventually leading to arthritis.
Posttraumatic arthritis tends to develop faster than typical osteoarthritis because the damaged joint deteriorates faster. People with a history of knee injury should be under the care of a knee joint doctor, such as a rheumatologist or orthopedic surgeon. When the time comes, posttraumatic arthritis may be treated with total knee replacement surgery.
Rheumatoid Arthritis: Can It Be Treated by a Total Knee Replacement Surgeon?
Total knee replacement surgery is considered a last resort for patients with rheumatoid arthritis, which is an inflammatory arthritis. This is because many medical knee joint doctors will first use various biologic agents to treat the disease.
Over time, however, rheumatoid arthritis can destroy joints to the point that they become non-functional, even with medical treatment. When this is the case, rheumatoid arthritis can and should be treated by a total knee replacement surgeon.
Could I Be a Candidate for Total Knee Replacement?
If you have longstanding osteoarthritis, rheumatoid arthritis, or posttraumatic arthritis, you could be a candidate for total knee replacement surgery. The symptoms that indicate the need for total knee replacement surgery include:
- Moderate or severe knee pain that does not respond to pain medicines or other treatment
- Pain that occurs during rest throughout the day or night
- Swelling and inflammation that rest and medication do not improve
- Mild deformity, like the bowing in or out of your knee
- Pain that interferes with daily activities
- Pain that interferes with mobility
Radiographic findings (X-ray, MRI) that indicate the need for total knee replacement surgery include:
- Narrowed space between the upper and lower leg bones
- Bone spurs and cysts in the knee joint
- Bone sclerosis (hardening of the joint surfaces)
- Squaring of the condyles (a certain change in shape of the leg bone near the knee)
If you have these signs and symptoms, do not have an active infection, and are healthy enough for surgery, a total knee replacement surgeon can help.
The Total Knee Replacement Procedure
Total Knee Replacement, also called total knee arthroplasty, is a complete replacement of the natural knee structures with an artificial knee joint. Working with an anesthesiologist, your total knee replacement surgeon will administer general, spinal, or epidural anesthesia prior to repairing your damaged knee. With general anesthesia, you are asleep during the procedure, but with spinal or epidural anesthesia, you are awake and feel no pain. You will receive antibiotics at the time of surgery to prevent infection.
Next, your total knee replacement surgeon will make an incision over your knee joint and remove damaged cartilage, as well as a small amount of bone. The site is prepared, and careful measurements and adjustments are made to ensure the new metal and plastic implants will be in perfect functional alignment with the upper and lower leg bones.
The surgeon then inserts the artificial implants into the prepared joint space, capping the bone surfaces with tibial and femoral components. They often apply bone cement to stabilize the new parts. Your surgeon will then place a plastic spacer onto the tibial section that allows the femoral component to glide naturally during movement. If necessary, they also cut and resurface the undersurface of the patella, known as the kneecap, with a plastic button.
The surgeon will make various measurements and perform functional tests to ensure the implants are placed properly. Soft tissue balancing is required to make sure the ligaments and tendons move smoothly and properly over the new implant.
You will need to remain in the hospital for two or more days after total knee replacement surgery. However, your surgeon will urge you to become active as soon as possible (within limits) to promote healing and prevent complications. Most patients will be able to bear weight on the leg within one to two days after surgery, and within three to six weeks you should be back to your normal daily activities.
When You Need a Total Knee Replacement Surgeon in New York City
If you are looking for a knee joint doctor or total knee replacement surgeon in NYC, Staten Island, or Jersey City, contact Regional Orthopedic today. Dr. Montalbano and his team stay on the cutting edge of technology through regular participation in national conferences, as well as affiliations with the Hospital for Joint Diseases and the New York University School of Medicine.
Our highly-specialized team will review your history and provide a thorough and comprehensive evaluation. When medical treatments are no longer helpful, contact the experts at Regional Orthopedic. We can provide total knee replacement surgery to relieve your knee pain and improve leg function and mobility.