How the Normal Knee Works
- The knee is the largest joint in the body. Nearly normal knee function is needed to perform routine everyday activities. The knee is made up of the lower end of the thigh bone (femur), which rotates on the upper end of the shin bone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. Large ligaments attach to the femur and tibia to provide stability. The long thigh muscles give the knee strength.
- The joint surfaces where these three bones touch are covered with articular cartilage, a smooth substance that cushions the bones and enables them to move easily.
- All remaining surfaces of the knee are covered by a thin, smooth tissue liner called the synovial membrane. This membrane releases a special fluid that lubricates the knee, reducing friction to nearly zero in a healthy knee.
- Normally, all of these components work in harmony. But disease or injury can disrupt this harmony, resulting in pain, muscle weakness and less function of the knee.
Common Causes of Knee Pain and Loss of Knee Function
The most common cause of chronic knee pain and disability is arthritis.
- Osteoarthritis usually occurs after the age of 50 and often in an individual with a family history of arthritis. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
- Rheumatoid Arthritis is a disease in which the synovial membrane becomes thickened and inflamed, producing too much synovial fluid that over-fills the joint space. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain and stiffness.
- Traumatic Arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee's ligaments may damage the articular cartilage of the knee over time, causing knee pain and limiting knee function.
Realistic Expectations About Knee Replacement Surgery
- An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and can't do.
- More than 90 percent of individuals who undergo total knee replacement experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement won't make you a super-athlete or allow you to do more than you could before you developed arthritis.
- Following surgery, you will be advised to avoid some types of activity, including jogging and high-impact sports, for the rest of your life.
- With normal use and activity, every knee replacement develops some wear in its plastic cushion. Excessive activity or weight may accelerate this normal wear and cause the knee replacement to loosen and become painful. With appropriate activity modification, knee replacements can last for many years.