Understanding Why Some Joint Replacements Fail
We’re also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome. This research has the potential to improve patient experience and increase the life of the joint replacement.
Dislocation Risk After Hip Replacement: Bending Over
Is bending over a dislocation risk after hip replacement surgery? In other words, can bending over at the waist cause a dislocation or the hip to come out of socket. Bending over at the waist is a risk, which really depends on the surgical approach.
Surgeries that are done through a posterior approach have a higher risk of dislocating from the back. Anterior hip replacements have a higher risk of dislocating from the front. Bending over at the waist could place you at risk for a posterior dislocation. During the first 3 months after surgery, the risk of a dislocation is the highest. After 3 months, your risk goes down and its safer to bend over and perform normal movements. Be very careful when bending over or moving past the 90 degree bend as this increases the possibility of dislocation .
Can Rehabilitation Be Done At Home
All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
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Falling In The Weeks After Knee Replacement Surgery
The first several weeks following knee arthroplasty is the worst time for a fall.
If you fall on your knee soon after surgery when your joint replacement is still healing, you may damage the prosthetic implant. In that case, you might end up needing revision surgery. Until your balance, flexibility and strength are improved, use your cane, crutches or walker and be extra careful when walking.
What Are The Risks
- An infection at the surgical site is possible. Blood clots are a risk as are injuries to a blood vessel or a nerve. These complications are quite rare.
- You may experience some knee joint stiffness.
- Late complications may include infection and a failure or loosening of the prosthesis, as well as continued pain.
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How Long Will The New Knee Joint Last
For 8090% of people who have total knee replacement, the new joint should last about 20 years, and it may well last longer.
If you’ve had a partial knee replacement, you’re more likely to need a repeat operation about 1 person in 10 needs further surgery after 10 years.
The chances of needing another operation is greater if you’re overweight and/or involved in heavy manual work.
Does Diabetes Raise Knee Replacement Risks
Learn more about studies exploring the relationship between diabetes and knee surgery outcomes for people who also have arthritis.
When arthritis makes it too painful to walk or climb stairs, knee replacement surgery could help make getting around more comfortable. Yet this surgery, like any other procedure, comes with risks that may be more pronounced if you also have diabetes.
Its an important issue to consider since about half of people with diabetes also have arthritis, and many may eventually need a new knee or two.
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Side Effects From Drugs
Corticosteroids reduce arthritis symptoms but use of these steroids can cause side effects, such as elevated pressure inside the eyes, known as glaucoma, fluid retention that causes swelling of the lower legs, high blood pressure, weight gain causing fat deposits in the abdomen, face and neck, along with mood, memory and behavior disorders. Long-term corticosteroid use can cause clouding of the lens in one or both eyes, high blood sugar that can trigger or worsen diabetes, thinning bones associated with osteoarthritis, and thin skin that heals slowly and is prone to bruising.
When Should I Seek Medical Attention After Knee Replacement
After you go home, call your healthcare provider right away if you develop any of the following symptoms:
- Chest pain and/or shortness of breath.
- Fever higher than 101 degrees Fahrenheit .
- Incision problems, like bleeding, leaking, swelling, redness or odor.
- Pain in your calf, ankle or foot that is new and gets worse.
A note from Cleveland Clinic
If you have severe knee pain but medications and therapy arent helping, knee replacement may provide the answer. This common and effective surgery can reduce pain and get you back to everyday activities. Talk to your healthcare provider or an orthopedic provider about whether knee arthroplasty is a good option for you.
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More Questions About Knee Replacement Risks Talk With An Orthopedist
Choosing to have knee replacement surgery is a big decision. And the truth is, there may be other non-surgical treatment options that can help heal your knee pain.
Whether youre wondering about individual knee replacement risks or want a second opinion, dont delay getting the care and answers you need. Make an appointment with an orthopedic doctor and take the first step toward healing your knee pain.
Recognizing The Signs Of A Blood Clot
Follow your orthopaedic surgeon’s instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. He or she may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.
Warning signs of blood clots. The warning signs of possible blood clots in your leg include:
- Increasing pain in your calf
- Tenderness or redness above or below your knee
- New or increasing swelling in your calf, ankle, and foot
Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:
- Sudden shortness of breath
- Sudden onset of chest pain
- Localized chest pain with coughing
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And If You Are Sensitive To Cobalt And Other Metals Then Why Get A Cobalt Replacement
If you have an allergy, imagine carrying that around in your knee.
Doctors in Germany studied patients to determine the prevalence of sensitisation to chromium, cobalt, nickel, or a cement component in patients who received joint replacement surgery.
In this curious study, the doctors selected patients with a pre-operative known sensitisation to chromium, cobalt, nickel, or a cement component for a post-operative allergic reaction. All patients who received revision surgery because of a potential allergic reaction were followed up post revision surgery.
- Revision surgery was needed in 9.8 % of patients with sensitisation to one of the reviewed components. Potential allergens were strictly avoided in the replaced prosthesis.
- CONCLUSION: The allergic patient should be thoroughly informed about potential reactions resulting from implant choice.2
A Few Alternative Exercises I Prefer
I have been very active all of life and I continue to be active after knee replacement. I have been able to continue with some of my old activities but I have also found new activities that I can enjoy.
Until I was 55, I played softball and basketball on a regular basis. I still play catch now and then, shoot a few baskets, and make a trip to the batting cages but I no longer engage in competitive play.
Pickle-ball has taken the place of softball and basketball. I play doubles and the reflex reactions and cardio workout keep me fit and sharp.
I can choose to play recreationally or I can opt for more competitive games. Pickle-ball was a great way to meet new friends when I moved to a new area.
Occasional games of golf and ping-pong also help to fill the gap left by basketball and softball. Before knee replacement I walked, hiked, swam and cycled.
All four are enjoyable ways to get outside and build up the muscles in my legs and get some cardio benefit as well.
Swimming as become one of my favorite exercises because I am able to get a full body workout. Continue to work out 3 to 4 times in the gym .
Have your physical therapist develop a workout program for you once you complete formal physical therapy.
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Helping Patients To Make Informed Decisions
We’re funding research to improve patient experience before, during and after knee replacement surgery. This includes a project based at the University of Sheffield which aims to help patients make informed decisions about their surgery. The research team will use the UK National Joint Registry dataset to develop and validate a personalised, web-based decision aid to help patients considering knee joint replacement to make informed choices about their treatment.
Five Reasons Why Knee Replacements Fail
Wear and loosening
Properly functioning implants depend on their appropriate fixation to the bone. Fixation is usually achieved by cementing the implant onto the bone. Some surgeons prefer instead to use biologic fixation, meaning no cement placed between the implant and the bone.
Although implants are firmly fixed at the initial knee replacement surgery, they may become loose over time. The cause of loosening may not always be clear but high impact activities, excessive body weight and wear of the polyethylene component may all act as contributing factors. Friction caused by the joint surfaces rubbing against each other wears away the surfaces of the implant, creating tiny particles that accumulate around the joint. In a process called aseptic loosening, the bond of the implant to the bone is destroyed by the body’s attempt to digest these wear particles. During this process, normal, healthy bone is also digested , which can weaken or even fracture the bone.
When the prosthesis becomes loose, the patient may experience pain, change in alignment, or instability.
Revision surgery of the infected knee can take several forms. Depending on the degree of infection and damage, the surgeon will determine one of two basic courses of action:
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Complications After Total Knee Replacement Surgery
30 August 2013
Mr Abdul Waheed and Mr George Dowd outline the main complications after knee surgery and how to manage them in primary care.
Total knee replacement has become an effective method of treating severe arthritis of the knee. A range of early complications can occur after knee replacement.
This article discusses complications of total knee arthroplasty presented to GPs. Such complications include problems with wound healing, infection, bleeding, deep venous thrombosis, swelling, stiffness and persistent pain.
The rate of complications after total knee replacement is reported in most publications to range from 1.65 to 11.3%.1-2
What Is A Knee Revision
A knee revision is the replacement of prosthetic implants in a person who previously had a total knee replacement. In this surgery, known as a “reoperation,” an original prosthesis is removed and a new prosthesis put in place.
Some knee revisions may require the replacement of only one implant, while others require a complete exchange of all the prostheses that were implanted during the original knee replacement surgery . A complete revision of this type is a complex procedure that requires extensive preoperative planning, specialized implants and tools, prolonged operating times, and mastery of difficult surgical techniques.
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Trouble Sleeping After Joint Replacement Surgery
Trouble sleeping after joint replacement surgery? This is a common complaint for those recovering from surgery. Not being able to sleep is more than just frustrating. It can interfere with your mental and physical recovery. Another point of concern is finding comfortable sleeping positions that are safe. Sleeping on your surgical side after surgery can go against the hip or knee precautions your surgeon laid out.
For instance, after hip replacement surgery lying on your surgical side can cause complications. Laying on your incision can cause fluid to collect. Its better to avoid this until past the 6 week mark. More loosely, your body should let you know when certain sleeping positions are comfortable or not. Simply, if it hurts or isnt comfortable, dont lay like that.
When trying to fall asleep and stay asleep, its important to put in extra effort to better your odds of resting well. This includes things like taking your medication on time, removing electronics from the bedroom, and engaging in relaxing reading or writing etc. Its important to avoid napping too much during the day, and to try and do as much physical activity as your body permits.
Characteristics Of Severe Arthritis Of The Knee
Pain is the most noticeable symptom of knee arthritis. In most patients the knee pain gradually gets worse over time but sometimes has more sudden flares where the symptoms get acutely severe. The pain is almost always worsened by weight-bearing and activity. In some patients the knee pain becomes severe enough to limit even routine daily activities.
Morning stiffness is present in certain types of arthritis. Patients with morning stiffness of the knee may notice some improvement in knee flexibility over the course of the day. Rheumatoid arthritis patients may experience more frequent morning stiffness than patients with osteoarthritis.
Swelling and warmth
Patients with arthritis sometimes will notice swelling and warmth of the knee. If the swelling and warmth are excessive and are associated with severe pain, inability to bend the knee, and difficulty with weight-bearing, those signs might represent an infection. Such severe symptoms require immediate medical attention. Joint infection of the knee is discussed below.
The knee joint has three compartments that can be involved with arthritis . Most patients have both symptoms and findings on X-rays that suggest involvement of two or more of these compartments for example, pain on the lateral side and beneath the kneecap . Patients who have arthritis in two or all three compartments, and who decide to get surgery, most often will undergo total knee replacement .
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How To Prevent Blood Clots:
A. We are shocked that you did not receive medicine to prevent blood clots prior to or immediately after your knee replacement. That is now considered standard practice.
A study published in JAMA Surgery demonstrated the importance of prevention when planning a knee replacement. The researchers tracked 41,537 Michigan patients who underwent knee replacement surgery . They all received some sort of anticoagulant treatment. It was administered either one day before surgery, the day of surgery or one day after surgery.
Heres What You Need To Know If Youre Over 80 And Wondering If Its Worth It To Have A Hip Or Knee Replacement Electively How Safe Is It
Its one thing if an 80-plus person absolutely has to have a total hip or knee replacement due to an acute injury such as from a fall or motor vehicle accident.
But what about people over age 80 who are plagued by the pain of osteoarthritis in their joints and are wondering about the mortality rates of a hip or knee replacement?
Studies seem to indicate that total joint replacement in the elderly, provided all factors regarding the patients health are similar, are really quite safe, says Barbara Bergin, MD, board certified orthopedic surgeon at and co-founder of Texas Orthopedics, Sports & Rehabilitation Associates.
There may be a slightly higher potential for post-operative complications, which would seem intuitively apparent, continues Dr. Bergin.
However, when compared to the benefits of improved quality of life, increased mobilization and reduced use of pain relievers, consideration of these operations in folks over 80 is becoming a reality.
One such study is in the Journal of Bone and Joint Surgery , affirming that these kinds of surgeries for people over 80 are generally safe.
This applies to patients with few to zero accompanying medical conditions.
It is especially important when we also consider the aging population, as well as the activity of the elderly now, as compared to decades in the past, says Dr. Bergin.
It is harder to recover from a total knee replacement than a total hip replacement.
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Mild Knee Replacement Complications
Many patients experience mild knee replacement complications after their procedure. These knee replacement complications typically include bruising or minor hematoma formation around the surgery site. Patients may also experience pain and redness in the knee, especially during the healing process. Swelling and tenderness may also occur. In many cases, these knee replacement complications resolve within a few weeks, after the area is healed.
Types Of Arthritis That Affect The Knee
This broad category includes a wide variety of diagnoses including rheumatoid arthritis, lupus, gout and many others. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage.
Patients with inflammatory arthritis of the knee usually have joint damage in all three compartments and therefore are not good candidates for partial knee replacement. However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. These patients often experience total, or near-total, pain relief following a well-performed joint replacement.
Osteoarthritis is also called OA or degenerative joint disease. OA patients represent the large majority of arthritis sufferers. OA may affect multiple joints or it may be localized to the involved knee. Activity limitations due to pain are the hallmarks of this disease.
OA patients who have symptoms limited to one compartment of the knee sometimes are good candidates for minimally-invasive partial knee replacement .
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