Michael Mayhew is a 59-year-old man with osteoarthritis of the knees. He has a history of bilateral knee injuries from college football as well as a 33-year career in construction. He has noticed a slow onset of symptoms, primarily over the past 10 years. His primary complaints were arthralgia and stiffness, especially first thing in the morning. Initial treatment was conservative and included rest, NSAIDs, physical therapy, and weight loss of 25 lb. In spite of these measures, Mr. Mayhew continued to experience worsening symptoms over the next few years. Eventually, he underwent bilateral TKRs. Follow-up note: Eight weeks after surgery, Mr. Mayhew stated he was pain free and had better use of his knees than he had in years.
Osteoarthritis, also known as degenerative joint disease (DJD), is the most common form of noninflammatory joint disease. The key feature of osteoarthritis is the wearing down and loss of cartilage in synovial joints. Osteoarthritis occurs most often after the age of 40, and involves joints that have had prior injuries or heavy chronic wear and tear. The most common joints involved are those of the hips, knees, hands, and spine. Pathological features include erosion of the articular cartilage, sclerosis of the bone beneath the cartilage, and formation of bone spurs. The primary symptom is joint pain on weight-bearing. Management of osteoarthritis includes rest, NSAIDs, glucosamine supplements, physical therapy, and weight loss (obesity is a common factor). If necessary, the patient may rely on a cane, crutches, or a walker. Surgery may eventually be necessary.
What type of surgery did Mr. Mayhew have?
a. Repair of both knee joints
b. Replacement of both knee joints
c. Fixation of both knee joints
d. Fusion of both knee joints