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    Old 08-16-2011, 02:38 PM   #1
    Williesdad
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    Total Knee Replacement Question

    Hi all, I am a 50 year old male with a long history of knee surgeries. The long and the short of it is this...I have had 3 ligament re-constructions ACL, PCL and MCL. I was on holiday in Italy (last week) and fell tearing both my ACL and PCL. I have been on the knee replacement waiting list and this obviously poses a new dynamic....OK....the question.

    Can an orthopedic surgeon perform a total knee replacement when the ACL and the PCL ligaments both need to be either replaced or repaired...??? If so, are they done as separate procedures or are they done at the same time. If separate, which procedure is done first...the kneee replacment or the ligament reconstruction/replacement...???

    MY GP is a bit of a pin head and doesnt know the answer and I'm waiting to get in to see my Orthopedic surgeon...Any help or advice would be greatly appreciated.

    Cheers,

    Stu

     
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    Old 08-16-2011, 06:16 PM   #2
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    Re: Total Knee Replacement Question

    Welcome Stu to the board,
    Sorry to hear about your knee problems especially in one so young. Thinking about the knee anatomy, the anterior cruciate would have to be removed in any case so nothing lost here. Depending on the position of the posterior cruciate it may in some cases be saved but if yours is already ruptured it would be academic to repair it. The medial and lateral ligaments will remain intact. So I would think one operation and knowing several people who have had one, or in some cases two, all are happy that they had the operation.
    Just one word of advice, no tub racing until next year!
    James

    Last edited by james079; 08-16-2011 at 06:20 PM. Reason: missed a Y !

     
    Old 08-16-2011, 07:08 PM   #3
    Williesdad
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    Re: Total Knee Replacement Question

    Quote:
    Originally Posted by james079 View Post
    Welcome Stu to the board,
    Sorry to hear about your knee problems especially in one so young. Thinking about the knee anatomy, the anterior cruciate would have to be removed in any case so nothing lost here. Depending on the position of the posterior cruciate it may in some cases be saved but if yours is already ruptured it would be academic to repair it. The medial and lateral ligaments will remain intact. So I would think one operation and knowing several people who have had one, or in some cases two, all are happy that they had the operation.
    Just one word of advice, no tub racing until next year!
    James
    Hi James, Thanks for the reply...that was helpful. Clearly I haven't done enough research on the Total Knee Replacement (TKR) surgery itself. I wasn't aware that the ACL and PCL weren't needed after such a surgery. Thats good news not having to undergo two procedures. Having said that, do you know why the ACL and PCL aren't needed.

    What I thought was involved with the new knee was simply the replacement of the surfaces between the Femur, the tibia and the patella. I do know a fair bit about ligament function as I've had so many surgeries on them but I can't even begin to imagin what is used to stabilize the knee when they are gone.

    I didn't know they actually sacrificed the ACL anyway and the same for the PCL...Do you know if it depends on what type of knee appliance is used by the surgeon or is removing the ACL and PCL a routine part of such a surgery...???

    Thanks again James....

    Cheers....Stu

     
    Old 08-19-2011, 09:34 AM   #4
    james079
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    Re: Total Knee Replacement Question

    Stu, There is a Simon H Palmer who seems to be a bit of a medical historian and has written on such things as knee arthroplasty. Look him up, see what you think.
    James

     
    Old 11-13-2012, 07:48 PM   #5
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    Re: Total Knee Replacement Question

    I was reading your questions and answers regarding which ligaments are actually used in a TKR and it brought up a question for me. I am a 46 yr old female who has had surgery to both my MCL & ACL. Both are reconstructions. My doc is concerned about the possible weakness to my MCL if we do a TKR. He says if its not strong enough then we will have to use a hinged knee(constraint knee). Does anyone have any experience with that type of a knee. The one thing I do know is that it does not last long at all!

    Any help would be appreciated.

     
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