Total knee replacement

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Most total knee replacement operations involve replacing the joint surface at the end of your thigh bone (femur) and the joint surface at the top of your shin bone (tibia). A total knee replacement may also involve replacing the surface of your kneecap (patella), although many surgeons prefer to leave it in its natural state because the natural patella is less likely to fracture. There should be less pain because the worn kneecap will be moving against a smooth metal surface. However, where the kneecap itself is causing a lot of pain then this surface may need replacing too. This involves removing the rough underside of your kneecap and replacing it with a smooth plastic dome.

If you’ve already had your kneecap removed (patellectomy), this won’t stop you having a knee replacement, but it may affect the type of replacement part (prosthesis) your surgeon uses.

The new parts are normally cemented in place, although cementless parts are also sometimes used. In cementless knee replacements the surface facing the bone is textured or coated to encourage bone to grow onto the component, forming a natural bond.

Another common technique is to use a plastic bearing which isn’t firmly fixed to the metal parts (a mobile bearing). This may help to reduce wear on your new joint, though it isn’t yet clear whether it provides better long-term results.

An artificial knee joint in place

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Joint surgery 'can lower heart disease risk for osteoarthritis patients'

Joint surgery 'can lower heart disease risk for osteoarthritis patients'

Scientists at the University of Toronto have suggested that osteoarthritis patients who undergo hip or knee replacement surgery are less likely to suffer cardiovascular events than those who do not.

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Professor Sally Roberts

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