If medication and physical therapy don’t relieve knee pain caused by osteoarthritis, orthopedic specialists at NYU Langone’s Joint Preservation and Arthritis Center may recommend a surgical procedure to relieve pain and stiffness, restore flexibility and range of motion, and help you remain active.
Surgeons perform these procedures using general or regional anesthesia and discuss these options with you prior to surgery to determine the best approach for you.
If cartilage damage from osteoarthritis is present on only one side of the knee, doctors may recommend a knee osteotomy. During this procedure, surgeons remove or insert a small wedge-shaped piece of bone at the end of either the femur or the tibia. This reshaping of the bone realigns the leg so that your body weight shifts off of the damaged part of the knee.
To perform an osteotomy, surgeons make an incision above the area of bone to be removed. First, they carefully measure the bone to determine the precise size of the piece of bone to be removed or inserted. Surgeons stabilize the area around the removed or inserted wedge with metal screws and plates. The incision is closed with stitches.
Sometimes, osteotomy is combined with other cartilage repair procedures to optimize care for your knee.
The length of hospital stay after an osteotomy varies according to each person’s needs. Our staff works with you to get you home as soon as our experts determine it is safe. Your doctor may recommend pain relief medication for one or two weeks to help you remain comfortable while you recover.
Our doctors recommend walking and starting physical therapy as soon as possible to maintain strength in your muscles and increase blood flow to the knee, helping you heal.
Doctors schedule a follow-up appointment two weeks after surgery to remove the stitches and check to make sure the bone is healing normally. Most people require crutches for an additional four or five weeks and continue semiweekly physical therapy for an additional two or three months.
Osteotomy may or may not completely cure your arthritis; sometimes, osteoarthritis progresses, and total joint replacement is needed.
If knee osteoarthritis has progressed so that joint damage and knee pain significantly affect your life, doctors may recommend knee replacement surgery, also called arthroplasty. Arthroplasty means “reforming” the joint to restore its mechanical functions.
This procedure involves replacing the damaged cartilage and bone in the knee joint with durable prosthetic parts, eliminating painful movement between the bones and relieving osteoarthritis pain and stiffness. The purpose of arthroplasty is to preserve joint function, and allows you to return to your normal daily activities without chronic pain.
To perform a knee replacement, surgeons make an incision over the knee to access the joint. Doctors then remove the damaged cartilage and bone tissue at the ends of the bones, and prepare the joint surfaces for their prosthetic parts. The ends of the bones are reshaped in a way that that straightens the leg and restores normal alignment. The surrounding ligaments and muscles are minimally affected by the procedure.
The ends of the femur and tibia are each replaced with a smooth piece of metal. Between these metal components, the surgeon inserts a piece of resilient and long-lasting plastic. This acts as a weight-bearing surface, and mimics the protective function of cartilage to permit full range of motion. After the new knee joint is in place, doctors close the incision with stitches or staples.
You should expect to remain in the hospital for a short period of time so that doctors can monitor your knee while it begins to heal. Most patients are discharged within 48 to 72 hours after surgery, or when they are able to move around independently.
While you are in the hospital, pain management specialists are available 24 hours a day to ensure that you recover comfortably. A physical therapist meets with you on the day of or the day after surgery to help you stand and walk with the help of a walker or crutches.
Our doctors recommend walking and starting physical therapy as soon as possible to maintain muscle strength and reduce the risk of complications, such as deep vein thrombosis, that may occur in people who remain immobile for an extended time after surgery.
After you are discharged, a nurse visits you at home to monitor the wound and your overall health as you recover. He or she removes the stitches or staples two weeks after surgery. Doctors schedule a follow-up appointment two to four weeks after surgery to make sure the knee is healing normally. Most people require crutches for a few weeks after surgery and continue semiweekly physical therapy for an additional two or three months.
New and more durable joint implants often last for 20 years or more, but prosthetic parts can wear out over time. Our doctors recommend biannual appointments after surgery so that our specialists can ensure your knee implant continues to perform well.
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