Q: What is total knee replacement (TKR)?A: TKR is a surgical procedure in which damaged joint surfaces are replaced with a prosthesis designed to restore pain-free knee function.
The replacement joint consists of a metal component attached to the end of the femur and a polyethylene component attached to the tibia. The components create new bearing surfaces that mimic normal move¬ment of the joint.
Q: Why has TKR been recommended for my dog?A: TKR is recommended because it is an option for alleviating the pain and/or disability associated with knee arthritis. Many dogs that do not respond to standard medical or surgical management can benefit from TKR.
To determine if TKR is the appropriate option, schedule a consultation with your veterinarian. This is a surgical procedure but, for the right patient, surgery can greatly improve quality of life.
Q: What does TKR surgery entail?A: The knee joint is exposed through an incision on the side of the knee. The joint surfaces are replaced, stability of the knee is ensured, and the surgeon verifies that the knee moves smoothly through a full range of motion. A light dressing is applied over the incision in the early post-operative period.
Q: What are the benefits of TKR?A: The primary goal of TKR surgery is to restore pain-free function. In most cases, it is possible to restore joint function to a level similar to that of a healthy knee joint. Dogs that have had successful TKR surgery do not require long-term medical management. In addition to significant cost savings, this will eliminate the potential problem of long-term complications associated with chronic use of anti-inflammatory drugs.
Q: What are the risks of TKR?A: The most significant risks associated with TKR surgery are anesthesia, implant loosening, and infection. Infection is a rare but potentially devastating complication of any surgical procedure. The risk of loosening is also rare. The risks associated with anesthesia are very low as a result of preoperative screening, modern drug use protocols, and intraoperative monitoring. Your veterinary team will do everything possible to minimize the risks.
Q: Are there reasons why my dog shouldn't have TKR surgery?A: If your dog’s arthritis is effectively controlled with drug therapy or other methods, TKR surgery is not likely to be recommended. It is important to recognize that TKR may be indicated if medical therapies eventually become ineffective.
Pre-existing infection is a contraindication to TKR surgery. Additional reasons why surgery may not be recommended include lameness associated with arthritis in other joints, neurological disease, and previous amputation of a forelimb or opposite hind limb. These conditions do not necessarily preclude TKR but the final decision is made on a case-by-case basis.