What To Do If You Have Knee Pain
If you are suffering from knee pain, there is a wide variety of treatment options available to help relive the pain. Each patient and each problem should be treated individually, and should be evaluated by a specialist in knee pain.
With a focus on knee issues that range from simple sports medicine injuries to complex revision total knee replacements, Dr. Lindholm is committed to providing a complete spectrum of orthopaedic knee care for patients all over New Jersey. Dr. Lindholm completed his undergraduate work at the University of Michigan and received his medical degree from the University of Michigan Medical School in Ann Arbor, Michigan. Dr. Lindholm completed his residency in orthopaedic surgery at the University of California Davis Medical Center in Sacramento, California. His postgraduate training includes a fellowship in knee and hip reconstruction and sports medicine at the prestigious Insall Scott Kelly Institute at Lenox Hill Hospital in New York City. Dr. Lindholm continues to update his education and techniques with advanced postgraduate courses and seminars and is regularly referred complex knee and hip patients from the community.
Dr. Lindholm is consistently ranked as one of the top knee doctors in New Jersey by 201 Magazine, Bergen Magazine, Vitals.com and NJ Monthly.
Do I Have A Helper For My Recovery Period
If you opt for simultaneous replacement, you wont be able to use either of your legs normally for most of your recovery period. After a hospital stay of up to 10 days, you need assistance at home for up to six weeks. If a family member cant help out, you may need to hire a home health worker.
If you have your knees replaced in stages, your second operation isnt scheduled until about three months after your first operation. Your hospital stay is shorter per surgery and each recovery period is quicker, too. While you may need a helper for the first week, once youre released from the hospital with an assistance device such as a walker, crutches, or a cane you should be able to get around the house on your own without too much help during your 3-6 weeks of recovery
Having Both Knees Replaced At The Same Time: Pros And Cons
With todays improved technology in and out of the operating room, patients have the option of bilateral total knee replacement at the same time. This can be done by one surgical team doing both knees in the same operation. Or there can be two surgical teams working on both knees at the same time.
Patients who qualify for bilateral simultaneous TKRs have changed over the years. Surgeons still agree that patients older than 80 years of age should not have both knees done at the same time. The risk of serious complications is just too high in this group. The biggest change in patient selection is that older, sicker adults are approved for this procedure.
In this article, surgeons review the major complications, pros, and cons of having both knees replaced at the same time. They start out by saying there isnt one most common adverse event reported in the literature.
Cardiac, pulmonary, and neurologic complications are compared. The most serious complication is not any more likely after this procedure than in people of the same age dying of natural causes. Other problems that can occur include blood clots, the need for blood transfusion, and electrolyte imbalances. Gastrointestinal problems have also been reported.
Cardiac complications range from angina to heart attack, unstable heart rhythm, and heart failure. Heart attacks and heart arrhythmias top the list of most commonly reported cardiac problems.
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Pros And Cons Of Having Both Knees Replaced At The Same Time
It is essential to be aware of all pros and cons associated with simultaneous bilateral knee replacement surgery before considering it.
Though it finishes-off the work in one go, this type of surgery has its share of benefits and risks. You have to approach it cautiously and go ahead only after a thorough discussion with your doctor.
- More convenient as replacement surgery for both the knees takes place in a single procedure.
- You may need less time off from work. You dont have to repeat office leaves for two surgeries as in the case of staged bilateral surgery.
- The time for recovery after knee replacement surgery is single for both the knees. It means you dont have to wait to get one knee operated and healed and then wait again after the second one.
- You may also enjoy the benefits of reduced cost with a single surgery. Your cost savings can be anywhere between 18% to 26%.
How Common Is This Procedure
Mr Henry BourkeMr Kucheria and I have performed 30 of these procedures in a three-year period thus far. This equates to almost one per month. As far as we are aware, there are no other surgeons in the UK offering this procedure in the private sector and the NHS. There are surgeons that will however offer to do both knees in the same sitting but as mentioned before, this is usually one then the other with a prolonged anaesthetic time.
Mr Rakesh KucheriaSimultaneous knee replacement procedures are not as common as they could be in the UK, contrary to the third world where resources are limited, this procedure is quite common.
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Is There Anything Else You Can Tell Us About The Procedure Yourselves Or The Benefits That Would Be Of Interest To Our Readers
Mr Henry BourkeBoth Mr Kucheria and I are still learning. We have only been doing this for a few years and after each case we gain more experience. We have been following up the cases that we have done so far and are particularly interested in the feedback from our patients. One of the drawbacks of having a staged procedure is going through the operation and the recovery and then having to do it all over again. The patients that have been through bilateral simultaneous procedures have been very relieved that once it is all over, they do not have to go back into hospital again as you only do have two knees luckily! We have submitted our work to a number of specialist societies around the world and are hoping to present the data and our experiences to an international forum later on this year. Our philosophy is to try to improve patient experience as osteoarthritis of the knees is often a symmetrical disease, it seems logical to me to try to treat the disease in one go, which means operating on two knees and then in theory nothing further needs to be done after that.
Why Come To Hss For Your Knee Replacement
I call knee replacement surgery a team sport. The two most central players are the surgeon and the patient, but there are many other people on the team who help make it successful. At HSS, our knee replacement surgeons are among the most skilled surgeons in the world. In addition to their deep expertise and extensive training, they have a singular focus on joint replacement surgery. This experience allows them to achieve very high success rates, avoid complications and help effectively relieve our patients pain.
Another advantage is that the knee replacement surgeons at HSS embrace the multidisciplinary aspects of orthopedic care. They work closely with anesthesiologists, rehabilitation specialists, nurses, dietitians, and many others to keep our patients safe and healthy so they can get back to what they love to do.
The fact that HSS is a specialty hospital focused solely on orthopedics and rheumatology is a great advantage. All our staff have great experience and a singular focus. Since we do not have to compete with other departments for resources, we can concentrate all our efforts on obtaining the best outcomes for our patients without any compromise.
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What Is The Recovery Period Like For Such A Procedure
Mr Henry BourkeWe have not noticed that the recovery is that much different to having one knee replacement. We tell our patients to clear their diaries for six weeks after the procedure. The majority of this time is spent at home although in the latter few weeks you can get out of the house and do a little a bit of walking just gently. Unfortunately, you cannot drive a car in this period. We also do not let any of our patients fly in this period due to the increased risk of deep vein thrombosis. Most patients are mobile by six weeks, walking independently or just with a single stick. A return to gentle sporting activities such as golf usually is possible by three months.
Mr Rakesh KucheriaThe recovery period for bilateral knee replacement is between 8-12 weeks but most patients are in hospital for about 5-7 days.
Reasons That You May Need A Knee Replacement
When your knees hurt on a daily basis and its starting to affect your life, it may be time for you to look into treatment. You may have tried many conservative treatments without much relief. But what could be causing you to have so much pain that youre considering a knee replacement?
The main culprit behind chronic knee issues is osteoarthritis. This condition causes the cartilage that cushions your joint to deteriorate, leading to inflammation and pain. This condition can become severe, causing daily problems with certain activities including:
- Climbing up a flight of stairs
- Difficulty walking even short distances
- Trouble getting up from a sitting position
- Pain even at rest
Osteoarthritis is a chronic condition, so there is no permanent cure. There are treatments that help with the symptoms, but the only way to repair your knee completely is with an artificial knee replacement.
If both of your knees have damage from arthritis, you’re probably curious if you can get them both fixed at the same time. The truth is that you can, but there are advantages and disadvantages to this procedure.
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Advantages Of Bilateral Knee Replacement Surgery
Although it may seem like a big undertaking, having both of your knees replaced at the same time does have its advantages. The biggest benefit is the obvious one: significantly less pain than before surgery. Some of the other benefits include:
- May shorten your rehabilitation
- Only one hospitalization for two conditions
- Recovery may be shorter
- Only one leave from your job
Another advantage of having both knees replaced at once is that you can get back to your normal activities much quicker. The rehab and physical therapy is usually much more intense for bilateral surgeries, making your recovery smoother and quicker in the long run.
These advantages are mostly dependent on you and your motivation for recovery. The other big factor is how healthy you are. The younger and healthier you are, the more likely a bilateral knee replacement will work out in your favor.
Should You Have Both Knees Replaced At The Same Time
When your knees are stiff, painful, and cant perform their job anymore due to arthritis, a complex fracture, or an injury that wont heal, you may need knee replacement surgery. If both knees are shot, you face a dilemma: Should you replace them at the same time and get the whole thing over with, or deal with one surgery at a time?
At Texas Orthopaedic Associates LLP with locations in the Dallas-Fort Worth and Plano, Texas, areas our expert orthopedists only recommend knee surgery when other, less-invasive options have failed. Knee replacement surgery removes damaged tissue, resurfaces the joint bones, and then separates the bones with a spacer so your knee can move freely and without pain again.
If you need to replace both knees, you can choose for either a simultaneous bilateral knee replacement or a staged bilateral knee replacement . To choose between simultaneous or staged surgeries, ask yourself the following questions:
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Benefits Of A Simultaneous Knee Replacement
One benefit of a simultaneous knee replacement is that two problems are solved at once. The overall rehabilitation time is shorter, and there is only one hospitalization and one round of anesthesia. This can be a better situation for people who would rather not be away from work for extended periods of time.
The co-payments and out-of-pocket expenses from insurance might be lower with one surgery and a single round of rehabilitation.
What To Expect After A Simultaneous Knee Replacement
After your bilateral knee replacement surgery, you should expect to be in the hospital for up to 10 days. The extended time is needed, in part, to ensure that you are mobile enough to return home safely.
Within six weeks of completing the surgery, your physical therapy will start and can last between six and 12 weeks. The program typically includes a walking plan and a variety of knee-strengthening exercises.
Most people, even over the age of 80, who undergo successful rehabilitation will experience marked improvement in mobility and pain relief. In many cases, complete restoration of knee mobility is possible.
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What Is The Bilateral Simultaneous Knee Replacement And How Does It Work
Mr Henry BourkeHistorically, knee replacements have been done one at a time. It is a reasonably big operation for the patient with a degree of blood loss sometimes requiring transfusion. Losing blood can stress the cardiovascular system somewhat and thus, up until recently, doing two procedures has not been safe for the patient. Better advances in anaesthesia and better surgical techniques have been able to minimise the risk to the patient and allow us to operate on both knees in the same sitting. Many surgeons around the world will offer patients two knee replacements in the same sitting but this involves replacing one knee, sewing up the skin and then starting on the other knee. This leads to a fairly prolonged anaesthetic time of 2.5-3 hours. Bilateral simultaneous knee replacement means two surgeons are operating at the same time, one on each knee. This means that both knees can be replaced inside one hour. The advantage of this is much less anaesthetic time which is in theory much safer for the patient leading to a quicker recovery in addition.
Mr Rakesh KucheriaBilateral knee replacements can be done either sequentially or simultaneously. Simultaneously, is when two surgeons are operating at the same time, which means within an hour to an hour and a half both knees are replaced. This reduces the time under anaesthesia, as well as exposure to the atmosphere, making it more beneficial for the patient.
Could A Nonsurgical Option Be Right For You
If youre having problems with knee pain and swelling due to osteoarthritis, there are a number of nonsurgical treatments you can try. Anti-inflammatory drugs such as ibuprofen, certain exercises to strengthen the muscles around the knee and injections offer relief for many people.
If these measures work for you, you dont need to have surgery. But if it gets to the point where youre staying home because it hurts too much to walk, or youre unable to do simple activities like climbing stairs, it may be time to seriously consider having knee replacement surgery.
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When Should I Consider A Total Knee Replacement
The best recommendation for your treatment can only be decided by you and your doctor. Whether or not you need surgery is a very personal decision that only you can make with the help of an orthopaedic specialists evaluation of your pain and its effects on your daily life. For example, experiencing knee pain day after day without relief can lead to staying off the joint which often weakens the muscles around it, so it becomes even more difficult to move.
The Advantages Of A Bilateral Knee Replacement
If youre physically fit and in good overall health, it can be tempting to have both knees replaced at the same time. Bilateral knee replacements offer several advantages, including:
- Less time off work
- Less time in the hospital
- Reduced medical costs, with estimated savings of 18-26%
Many men and women also opt for bilateral knee replacements because they only need one round of physical therapy. Once they recover, they dont face the prospect of needing additional surgery and rehab in the future.
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Pros And Cons Of Simultaneous Bilateral Knee Replacement
Traditional staged TKAs involve two surgeries, two episodes of anesthesia, two hospital stays, and two programs of rehabilitation over the course of a year or so. A key benefit of the simultaneous bilateral TKA is it exposes you to only one surgery and one episode of anesthesia, which can be safer and reduce the risk of infection in some people.
However, researchers have learned simultaneous bilateral TKA poses a higher post-operative risk of blood clots than the staged procedure. When a person has both knees replaced at once, you can imagine how difficult walking and rehabilitation become. Who wants to walk or participate in exercises with two swollen, painful, stiff knees, after all? This difficulty with walking and performing rehabilitation exercises causes double knee replacement patients to become more sedentary than their unilateral TKA counterparts.
When a person is sedentary after orthopedic surgery, their risk for developing , or DVT, rises. DVTs can cause to travel from the legs to the lungs and cause breathing problems, even sudden death. This complication is preventable in most patients.
If youre considering simultaneous bilateral knee replacement, you should discuss all of the risks and benefits with your doctor. Your overall health, co-existing medical conditions, and other factors might make simultaneous bilateral TKA a safer option for you than having two staged procedures. Or, you may find it better to go with the traditional staged process.