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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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During knee joint replacement surgery, the damaged parts of the knee joint are removed and artificial pieces (prosthesis) are then placed in the knee. The three areas involved are

• lower end of the thighbone (femur),
• upper end of the shinbone (tibia),
• behind you your kneecap (patella).

The prosthesis will have both metal and plastic parts. Some newer prostheses now are made of metal on metal, ceramic on ceramic, or ceramic on plastic.

The surgery lasts about two hours and involves an incision over your knee. The thighbone and shinbone will be cut to prepare them for the new pieces. The patella will be moved at the beginning of the procedure, and later a bone cement will be utilized to fasten the prosthesis to it. This is the traditional way the procedure has been performed. Several modifications to the procedure can be made and partial knee replacements are options as well.

During the procedure, you will either have general anesthesia (you are fully asleep) or a regional block (spinal or epidural) that numbs your legs combined with an intravenous medication that will sedate you during the procedure. Your surgeon and anesthesiologist will discuss the advantages and disadvantages of both techniques.

You will usually leave the hospital within a few days of the procedure and go to a rehabilitation facility that will help you get used to your new knee and help you return to all your activities and hopefully many that you gave up due to pain or inability of your "old" knee to handle.

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