An artificial knee joint is one of the most frequently performed orthopedic surgeries worldwide. Although most patients experience significant pain relief and improved function after surgery, there are still a significant number of patients who report dissatisfaction after surgery. This blog will detail the most common reasons for this dissatisfaction and discuss strategies to improve patient satisfaction.

Properties of an artificial knee joint

An artificial knee joint typically consists of several components that have been carefully designed to mimic the function of the natural knee joint as closely as possible. Here are some essential features:

1. Components of an artificial knee joint

• Femoral component: This is made of metal and is attached to the lower end of the femur.
• Tibial component: This is attached to the upper end of the shin bone and is also made of metal, often combined with a plastic cushion for cushioning.
• Patella component: This replaces the back of the kneecap and is made of plastic.

2. Materials

The materials an artificial knee joint is made of are crucial to its function and longevity. High-strength metals such as titanium or cobalt-chrome alloys as well as durable plastics such as polyethylene are usually used. These materials are biocompatible, meaning they are well tolerated by the body and have a low rate of wear.

3. Movement mechanics

An artificial knee joint is intended to mimic the natural movements of the knee joint as closely as possible. Modern prostheses are designed to provide a full range of motion and allow for both flexion and extension of the knee. Some models are specifically designed to provide a specific type of movement or stability tailored to the patient's individual needs.

4. Lifespan

The lifespan of an artificial knee joint depends on various factors, including the patient's activity, his weight and the accuracy of the implantation. With optimal care and under normal circumstances, an artificial knee joint can last 15 to 20 years or longer.

Common reasons for dissatisfaction after an artificial knee joint

1. Pain after surgery

Pain after knee replacement surgery is one of the main reasons for dissatisfaction. Although pain is expected to decrease over time, some patients experience persistent or even chronic pain. These can be caused by various factors:

• Nerve Injuries: Nerves can be damaged during surgery, resulting in long-term pain.
• Misplacement of the implant: A poorly positioned artificial knee joint can cause unnatural stress and pain.
• Scar tissue and adhesions: These can limit the movement of the artificial knee joint and cause pain.

2. Functional limitations

Another common problem is that the artificial knee joint does not provide the expected functionality. Patients may be disappointed when they find that they are not completely pain-free or can no longer perform certain activities. The most common functional limitations include:

• Restrictions on movement: Some patients cannot fully bend or extend their artificial knee joint.
• Instability: A feeling of unsteadiness or instability may occur, particularly during activities such as climbing stairs.
• Loss of strength: Despite intensive physical therapy, some patients report a persistent loss of strength in the affected leg.

3. Psychosocial factors

Psychological and social factors play an important role in the perception of the success of the operation. Patients with pre-existing mental illnesses such as depression or anxiety disorders are at higher risk of postoperative dissatisfaction. Unrealistic expectations and lack of support from family and friends can also contribute to dissatisfaction.

4. Patient-specific factors

Certain patient groups are at increased risk of dissatisfaction after surgery:

• Younger patients: With increasing age, the risk of dissatisfaction and poorer results with an artificial knee joint decreases.
• Patients with comorbidities: Comorbidities such as diabetes and obesity can slow the healing process and increase the risk of complications.
• Patients with high levels of preoperative pain medication: Patients who required strong pain medications before surgery often have poorer pain control after surgery.

5. Implant-specific factors

The type and quality of the artificial knee joint used can also influence satisfaction:

• Implant wear: Over time, the artificial knee joint can wear out, causing pain and loss of function.
• Reactions to the material: Some patients may have an allergic reaction to the materials of the implant, causing inflammation and pain.

6. Surgical factors

The surgeon's experience and technique play a crucial role in the outcome of the operation. Technical errors such as incorrect alignment of the artificial knee joint or inadequate soft tissue balance can lead to pain and dysfunction.

Strategies to improve satisfaction

To improve patient satisfaction with an artificial knee joint, several strategies are necessary:

• Preoperative Education: Patients should have realistic expectations regarding the results of the knee replacement.
• Optimization of surgical technique: Careful planning and execution of the operation can minimize complications.
• Multimodal pain therapy: Effective pain treatment that combines different approaches can improve postoperative pain management.
• Rehabilitation and physiotherapy: Structured aftercare is crucial for restoring the functionality and strength of the artificial knee joint.
• Psychosocial support: Treating mental health conditions and providing support from family and friends can improve postoperative satisfaction.

Conclusion

An artificial knee joint offers many people a significant improvement in the quality of life by relieving pain and improving mobility. However, there are various reasons for postoperative dissatisfaction, ranging from pain to functional limitations to psychosocial factors. However, through comprehensive information, careful surgical technique and structured follow-up care, the results for patients with an artificial knee joint can be significantly improved.