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HomeExclusiveDo You Still Have An Acl After Knee Replacement

Do You Still Have An Acl After Knee Replacement

What Are The Risks And Benefits Of Total Knee Replacement

Pain after a Knee Replacement Surgery?

Are There Any Serious Risks Involved With Joint Replacement?

Are There Any Serious Risks Involved With Joint Replacement?

As with any surgery, there are risks. In general, if you are healthy and active the risks are LOW

You should discuss your overall health with your primary care provider prior to planning surgery. Your PCP can estimate and discuss your relative risk associated with a major surgery, and may want to perform further tests before granting you clearance for surgery.

Specific risks associated with the knee during and after surgery include:

To set up an appointment for further evaluation, please call 336-8250.

Preoperative Medial Knee Instability Is An Underestimated Risk Factor For Revision Aclr Failure

University medical researchers in Germany published a July 2020 study in the journal Knee Surgery, Sports Traumatology, Arthroscopy that warned their colleagues that a loose knee after ACL reconstruction is a leading cause for ACL reconstruction failure.

The researchers wrote: The most important finding of this study was that preoperative medial knee instability is a risk factor for revision ACLR

The most important finding of this study was that preoperative medial knee instability is a risk factor for revision ACL reconstruction and should be adequately addressed at the time of revision ACL reconstruction. This study demonstrates the largest revision ACL reconstruction patient group with pre-and postoperative clinical examination data and a follow-up of 2 years published to date and it indicates that preoperative knee instability is an important factor for the treatment strategy of revision ACL reconstruction. Medial knee instability, high-grade anterior knee instability, and increased posterior tibial slope are risk factors for failure of revision ACL reconstruction and should be addressed at the time of revision surgery.

Preoperative Laxity Of The Knee And Excessive Graft Laxity As A Cause Of Acl Surgery Failure

Lets go back to 2001 and a well-documented summary of ACL complications that can be found in the abstract of a classic lecture presentation from the Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh. This lecture was delivered in 2001.

From 2001: Many factors influence the overall success or failure of anterior cruciate ligament reconstruction, including the integrity of the secondary restraints , the collateral ligaments, the mid-third capsular ligaments, the meniscus, and the iliotibial band), the preoperative laxity of the knee, the status of the articular and meniscal cartilage. . .

As we noted in the research above untreated associated ligaments insufficiencies, in other words, the other knee ligaments were too weak to support the new ACL, which caused the failure.

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Similar Conditions That Affect The Knee

Meniscus tear

Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.

Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.

Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.

Knee Joint Infections

Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:

  • severe pain
  • fevers and

Again, a joint infection is a serious condition that requires immediate medical attention.

What Are Possible Side Effects Of The Surgery

Post Knee Replacement Surgery Care

Urquhart: All surgeries have a risk of complications. Less than 1% of healthy patients undergoing any type of surgery can experience a cardiovascular event, such as a heart attack or stroke. About 0.5% of knee replacement surgery patients develop an infection.

But an important side effect or outcome to talk about is this buyers remorse idea I brought up earlier. About 15 to 20% of patients that undergo total knee replacement surgery have buyers remorse because they still experience discomfort, clicking or a sensation of instability in their knee, making them regret having the procedure. That is exactly why we consider non-surgical options first and remind patients that they should not make the decision to have surgery without careful consideration.

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What Is A Knee Replacement Surgery

Knee replacement, also called knee arthroplasty or total knee replacement, is a surgical procedure toresurface a knee damaged by arthritis. Metal and plastic parts are used tocap the ends of the bones that form the knee joint, along with the kneecap.This surgery may be considered for someone who has severe arthritis or asevere knee injury.

Various types of arthritis may affect the knee joint. Osteoarthritis, adegenerative joint disease that affects mostly middle-aged and olderadults, may cause the breakdown of joint cartilage and adjacent bone in theknees. Rheumatoid arthritis, which causes inflammation of the synovialmembrane and results in excessive synovial fluid, can lead to pain andstiffness. Traumatic arthritis, arthritis due to injury, may cause damageto the cartilage of the knee.

The goal of knee replacement surgery is to resurface the parts of the kneejoint that have been damaged and to relieve knee pain that cannot becontrolled by other treatments.

What Is Partial Knee Replacement

A partial knee replacement is an alternative to total knee replacement for some people with osteoarthritis of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee. In a partial knee replacement, only the damaged part of the knee cartilage is replaced with a prosthesis.

Once partial knee replacement was reserved for older patients who were involved in few activities. Now partial knee replacement is often done in younger people as their recovery is quicker and usually less painful. About 5% to 6% of people with arthritic knees are estimated to be eligible for partial knee replacement.

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Mako/ Partial Knee Resurfacing

Mako Robotic-Arm Assisted Technology provides you with a personalized surgical plan based on your unique anatomy. First, a CT scan of the diseased knee joint is taken. This CT scan is uploaded into the Mako System software, where a 3D model of your knee is created. This 3D model is used to pre-plan and assist your surgeon in performing your partial knee replacement.

Answers To Questions About Knee Replacement Surgery

Are you still having knee pain after surgery? Learn how to do a self assessment and fix it.

Knee replacement surgery shouldnt be taken lightly. One orthopaedic surgeon explains what you need to know about the procedure.

When cartilage inside the knee joint starts to break down, a person may begin to experience pain.

If you were to look inside a healthy knee joint youd see a thick cushioning of cartilage that covers and protects the ends of your bones, as well as another type of cartilage, called the meniscus, that acts like a shock absorber between the bones, says Andrew Urquhart, M.D., a professor of orthopaedic surgery at Michigan Medicines Comprehensive Musculoskeletal Center.

The meniscus keeps the knee joint stable and helps evenly spread out the weight the knee joint bears, but when a persons knee cartilage is deteriorating, the bones rub together and they may experience pain when walking or weight bearing.

To treat a painful knee, Urquhart mentions there are a few options.

I think many patients jump to surgical options, but we recommend every patient start with diet and exercise or physical therapy before considering knee replacement surgery, he says.

Total knee replacement surgery involves capping off the thigh bone and shin bone with metal and inserting a plastic bearing, or artificial joint, in between the bones where cartilage would normally exist. In some patients, a plastic cap is inserted over the kneecap .

Urquhart notes that the surgery shouldnt be taken lightly.

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The Regenerative Approach To Knee Ligament Weakness And Degenerative Injury

Throughout this article, we demonstrated research from the surgical community that discusses the problems of knee instability following an ACL reconstruction surgery. These problems can be severe enough that a second or even third surgery may be suggested. We have also demonstrated that these revision surgeries are, for the most part, less successful than the patient expects.

The problem of knee instability is a problem of damaged, untreated degenerative structures. This includes the three other main stabilizing ligaments in the knee the MCL, PLC, and LCL.

In the case of an overstretched or partially torn ligament, a treatment approach to strengthen and heal the injured ligament should be utilized. The treatment that stimulates ligament healing and regeneration is Prolotherapy.

In this video, Danielle R. Steilen-Matias, MMS, PA-C, of Caring Medical demonstrates how we treat a patient with a primary complaint of knee osteoarthritis.

When Was The First Knee Replacement

The first knee replacement was performed in 1968. Numerous advancements through the years have significantly improved how the procedure is performed as well as the results.

With advanced knee replacements, the new knee has a better chance of obtaining a full range of motion. It feels more like a natural knee.

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What Is A Total Knee Replacement

A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint that provides motion at the point where the thigh meets the lower leg. The thighbone abuts the large bone of the lower leg at the knee joint.

During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic “button” may also be added under the kneecap surface. The artificial components of a total knee replacement are referred to as the prosthesis.

The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thighbone. In total knee replacement surgery, this ligament is either retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its own particular benefits and risks.

I Just Had Knee Surgery And Have Been Advised To Wear Compression Stockings Should I Wear Them During The Day Or At Night

ACL Reconstruction

Also, they are beginning to cause bruising and pain. Should I continue to wear them? I am 10 days post op from a total knee replacement.

Please call your treating physician for post-op instructions.

Please call your treating physician for post-op instructions.

You should be able to stop wearing the compression stockings now, but check with your surgeon.

You should be able to stop wearing the compression stockings now, but check with your surgeon.

Compression socks help when you are upright or the leg is dependent. So, the only reason to wear the stocking at night is if you are wearing them continuously because of difficulty doffing and donning the stockings.

Compression socks help when you are upright or the leg is dependent. So, the only reason to wear the stocking at night is if you are wearing them continuously because of difficulty doffing and donning the stockings.

Compression stockings are really only needed during the daytime.

Compression stockings are really only needed during the daytime.

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The Fact That Your Knee Is Moving Towards Inevitable Knee Replacement Should Tell You That Every Day Your Knee Is Getting Weaker

  • Researchers writing in the British Journal of Sports Medicine found that if you had to have a revision or secondary ACL reconstruction surgery you were at advanced risk for osteoarthritis, ligament damage and weakness, and loss of knee function.
  • In fact, doctors writing in the Journal of Bone and Joint Surgery wrote: Despite the success of restoring joint stability and improving early functional outcomes after anterior cruciate ligament reconstruction, the long-term risk of developing symptomatic osteoarthritis requiring total knee replacement is higher than that in the uninjured population.

Special Precautions To Take

  • Remember this is an artificial knee and must be treated with care.
  • In general, the more active you are the quicker your knee will wear out.
  • You can drive when you have regained muscle control, usually by 6 weeks.
  • Avoid situations where you might fall.
  • Your knee may go off in a metal detector at the airport. You can receive a note from our rooms to say you have had a joint replacement.
  • Prevention of infection is vital. If you have any infections anywhere make sure you see your local doctor straight away for treatment. If you get increasing pain in your joint and are sick and have temperatures you should go to hospital to get checked out.
  • USE OF ANTIBIOTICS Antibiotics should be prescribed if you have an infection anywhere in the body, if you have surgery in contaminated areas such as teeth, nose, bowel or bladder, podiatry treatment or urinary catheterisation.

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Should You Be Concerned About Bruising After Knee Surgery

There are many things for you to be concerned about besides bruising after TKR surgery. Above and beyond bruising, Id pay close attention to the following:

  • Pain management
  • Range of motion
  • Reducing swelling

Pain management and beginning your physical therapy should be at the top of your list.

The pain from my tourniquet took a few days to go away. The bruising eventually went away after 10 to 14 days.

Managing swelling could really help to reduce the appearance of bruising. In the early days after knee replacement surgery, I iced my knee to reduce swelling. I also elevated my leg to reduce the pooling of fluid in my leg .

Movement, although uncomfortable in the first few days after surgery, is a good way to increase circulation in your body and can help reduce bruising.

No matter what, your knee replacement surgery will result in at least some bruising. Depending on the individual, there may even be extensive bruising.

Understand that although bruising is unsightly, it is part of the healing process.

Revision Anterior Cruciate Ligament Reconstruction Restores Knee Laxity But Shows Inferior Functional Knee Outcome

Knee Pain After ACL Surgery

Here is a 2019 study from the Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden published in the journal Knee surgery, sports traumatology, arthroscopy . What the researchers found was that a revision ACL reconstruction laxity problem can be surgically fixed, but it could not fix problems with knee function in many patients.

The researchers wrote the final postoperative functional outcome is inferior

The findings of this study showed that anterior knee laxity is restored with revision bone-patellar tendon-bone autograft ACLR after failed primary hamstring tendons autograft ACLR, in the same cohort of patients. However, revision ACLR showed a significantly inferior functional knee outcome compared with primary ACLR. It is important for clinicians to inform and set realistic expectations for patients undergoing revision ACLR. Patients must be aware of the fact that having revision ACLR their knee function will not improve as much as with primary ACLR and the final postoperative functional outcome is inferior.

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How Far Ive Come And The Journey Ahead

Its pretty crazy to look at this list and think back to Weeks 1 through 4 or even those years pre knee replacement surgery. I really have come a long way! I am excited to see what the future holds for me and my bionic knee. I have some big plans for this knee of mine, including running some races, leading ultimately to a Disney Princess Half Marathon sometime in 2021 or 2022, depending on when they open everything back up!

Did you find out anything surprising? Are you at the 6-month mark and experiencing some of the same, or maybe some completely different easy activities or difficulties? Let me know by leaving a comment below or contacting me HERE.

Until the next part of this knee journey, take care!

Want to read to journey from the beginning? Click HERE

This content is not intended to be a substitute for professional medical advice. Always seek the advice of your physician.


Preparation For Total Knee Replacement Surgery

Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.

Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.

Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patient’s questions and concerns, as well as those of the family, are answered.


The surgeon’s office should provide a reasonable estimate of:

  • the surgeon’s fee
  • the degree to which these should be covered by the patient’s insurance.

Total Knee Replacement Surgical Team

The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.

Finding an experienced surgeon to perform your total knee replacement

Some questions to consider asking your knee surgeon:

  • Are you board certified in orthopedic surgery?
  • Have you done a fellowship in joint replacement surgery?
  • How many knee replacements do you do each year?

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