What is a Total Knee Replacement?
The knee is a hinge joint which provides motion at the point. The thighbone (or femur) abuts the big bone of the lower leg (tibia) at the knee joint. Depending on the state of the kneecap portion of the knee joint, a plastic “button” can also be added under the kneecap surface. The man-made parts of a complete knee replacement are referred to as the prosthesis.
The posterior cruciate ligament is a tissue that usually stabilizes each side of the knee joint to ensure the lower leg cannot slide backward in relation to the thighbone. In total knee replacement operation, this ligament is either retained, given, or replaced by a polyethylene post.
What patients should consider a complete knee replacement?
Total knee replacement surgery is considered for patients whose knee joints are damaged by either progressive arthritis, trauma, or other rare destructive diseases of the joint. The most common basis for knee replacement in the USA is severe osteoarthritis of the knees.
Whatever the reason for the damage to the joint, the resulting progressively growing pain and stiffness and day-to-day function that is decreasing lead the patient to consider total knee replacement. Decisions regarding whether or when to get knee replacement surgery are not easy. Patients should understand the risks as well as the benefits before making these selections.
When is a Total Knee Replacement helpful?
The most important reason behind surgery is pain that’s interfering with your quality of life and is not adequately controlled by other means (medication, injections, physiotherapy, activity adjustments etc). This can be a very individual decision and depends on your own societal requirements and activity demands.
Determined by the amount of preoperative stiffness, the measure of deformity and arthritis, and the size of your knee, you might be a candidate for MIS. This technique minimises surgical trauma and allows for faster healing of sometimes less pain, improved freedom in the first few weeks and strength. Your surgeon will discuss this option with you during your first consultation.
Knee Replacement Procedure and Surgery Alternatives
What happens on the day of your operation?
Undergoing a total knee replacement is a major surgery. You will require special tests (blood tests, ECG and other x-rays) and potential review by other practitioners to ensure you might be in optimum state before your operation. If you might have a pre existing condition (eg: heart disease or diabetes) you will need to be given the “all clear” by your treating orthopaeadic doctor before your operation.
You will be admitted to hospital usually the day of your operation. Your surgeon will visit you to mark the affected knee with an ink pen as well as to answer some other questions you may have regarding the operation.
After your anaesthetic was administered a tourniquet will be applied to your upper thigh and your leg will be painted with antiseptic solution. A draping that is routine will be performed with clean sheets to allow exposure only of the knee.
A vertical incision is made on the front of your knee allowing use of the knee joint itself. Bone cement is used to help stabilise the prosthesis to the bone. A plastic (polyethylene) insert is set between the femoral and tibial components and acts as an articulating shock absorbing surface.
Before completion of the procedure, the knee is assessed for alignment, stability and level of movement. Often, a small drain will be made after the surgery to remove unwanted blood in the knee for 24 hours. Dissolving stitches are used to close the wound, and the knee is subsequently wrapped in a well-padded sterile bandage.
After Your Procedure
You’ll wake up in the recovery ward where you will be closely monitored until you’re prepared to return to your ward. Here until you’re completely alert you’ll remain monitored.
You’ll spend the first post-operative day in the recovery rooms at hospital. A physiotherapist will visit you to give you breathing exercises to your chest together with exercises for the leg that can be performed in bed. An x-ray of your knee will be taken after surgery to confirm optimum placement of the prosthesis.
For the first 24 hours after the surgery, an inflatable sleeve will intermittently compress your calves to prevent stagnation of blood flow. You’ll receive intravenous antibiotics for 24 hours after the surgery to reduce the risk of infection.
48 hours will be changed after the surgery. Your knee will be swollen and may have regions of bruising. This really is ordinary. Until you’re discharged from hospital you will end up under the day-to-day supervision of a physiotherapist. The objectives of these visits are to optimise motion in the knee, recover ambulation, enhance muscle strength and management knee swelling (please consult with instruction booklet on Total Knee Replacement Rehabilitation).
Once you are mobilising have recovered motion that was proper and your pain is controlled by tablets you’ll be released home. Some patients require further in-patient care and are transferred to a rehabilitation unit.
Knee Replacement Recovery Time
What happens after you go home?
After you leave hospital to maintain and after that improve on what you have already achieved your rehabilitation will continue. This will take the kind of a home exercise plan and outpatient physiotherapy visits, which typically lasts 3-6 months.
An appointment will be made to see your surgeon after your operation. The aims of your knee replacement surgery are to be walking alone, have the ability to flex your knee to 100-120 degrees and be pain free.
Knee Replacement Problems and Complications
Nine out of 10 patients who have knee replacement surgery experience less pain and far greater mobility. However, be aware that you will need to have regular check-ups for the life of your artificial knee joint and ongoing rehabilitation such as physiotherapy and special exercise.
- Avoid any sporting activities for at least two months.
- Follow the suggestions given to you by medical staff on how to walk, climb stairs, and get in and out of chairs safely.
- Avoid jumping, jolting the knee joint or kneeling down.
Knee joint replacements have been performed for years and on a regular basis is being improved. As with all surgeries, however, you will find dangers. Since you will not be able to move around much at first, blood clots are a specific issue. Your doctor will give blood thinners to you to help prevent this.
As are the risks connected with using general anesthesia, infection and bleeding additionally are potential.
Nerves in the knee area may be injured from pressure or swelling and can cause some numbness.
Dislocation and Component Wear: The replacement parts may become loose or break.
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