Recovering From Knee Replacement Surgery
You’ll usually be in hospital for 3 to 5 days, but recovery times can vary.
Once you’re able to be discharged, your hospital will give you advice about looking after your knee at home. You’ll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your knee.
Most people can stop using walking aids around 6 weeks after surgery, and start driving after 6 to 8 weeks.
Full recovery can take up to 2 years as scar tissue heals and your muscles are restored by exercise. A very small amount of people will continue to have some pain after 2 years.
Can I Avoid Or Postpone A Knee Replacement
The choice on whether to have surgery to address arthritis of the knee joint depends on multiple factors, including:
- the condition of the knee joint
- the patientâs age and activity level
In cases where the damage from arthritis is minimal, and/or if the patient does not have a very active lifestyle, nonsurgical treatments by be tried, including:
- physical therapy
- , such as ibuprofen
- weight loss to reduce pressure on the knee
Preparation Prior To The Knee Replacement Surgery
Before the patient undergoes a knee replacement surgery, the doctor will take them through a few things that need to be done in order to prepare for the treatment. Here is a quick look at how to prepare prior to the procedure.
- Extensive diagnostic tests will be conducted in order to evaluate the exact nature of knee damage and the type of treatment required
- The patient will be advised to stop the consumption of certain medicines before the surgery
- Patients will also be advised to avoid eating any food for a few hours prior to the surgery
- The doctor will sometimes discuss options of anaesthesia and help the patient reach a decision as to which one is preferable
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Repeated Courses Of Treatment With Hyaluronic Acid Are Safe And Are Associated With The Delay Of Total Knee Replacement For Up To 3 Years
A July 2018 study in the American Journal of Orthopedics recognized that for some people: Total knee replacement is a significant procedure with potential risk for serious complications and high costs. Alternative lower risk therapies that can delay or total knee replacement are valuable to those who are poor candidates for surgery or wish to avoid total knee replacement as long as possible.
Are Hyaluronic Acid Injections the answer? Here is what the study concluded:Repeated courses of treatment with Hyaluronic Acid are safe and are associated with the delay of total knee replacement for up to 3 years. So again, we have a three-year delay after repeated courses of Hyaluronic Acid injections supported in the research. But what about the study that says Hyaluronic Acid Injections that delay inevitable knee replacement are a waste of time, money, and resources?
Mayo Clinic And Yale University Studies On Your Own Bone Marrow Stem Cells
Doctors at the Mayo Clinic and Yale University published their research on the benefits of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis in the American Journal of Sports Medicine. Here is the summary of that research:
- In their single-blind, placebo-controlled trial, 25 patients with bilateral knee osteoarthritis were randomized to receive Bone marrow aspirate concentrate into one knee and saline placebo into the other. Early results show that Bone marrow aspirate concentrate is safe to use and is a reliable and viable cellular product. Study patients experienced a similar significant relief of pain in both bone marrow aspirate concentrate- and saline-treated arthritic knees.
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Types Of Knee Implants
Thinking about a total knee replacement? There are a few different kinds of knee implants that are used in this procedure. The different types are categorized by the materials that rub against each other when you flex your knee:
Metal on plastic. This is the most common type of implant. It features a metal femoral component that rides on a polyethylene plastic spacer attached to the tibial component. The metals commonly used include cobalt-chromium, titanium, zirconium, and nickel. Metal-on-plastic is the least expensive type of implant and has the longest track record for safety and implant life span. However, one problem that can happen with plastic implants is an immune reaction triggered by tiny particles that wear away from the spacer. This can cause bone to break down, leading to loosening and failure of the implant. Advances in manufacturing have greatly reduced the rate of wear in the plastic.
Ceramic on plastic. This type uses a ceramic femoral component instead of metal . It also rides on a plastic spacer. People who are sensitive to the nickel used in metal implants might get the ceramic type. Plastic particles from this type of implant also can lead to an immune reaction.
To learn more about your options for knee replacement surgery, read the Harvard Medical School guide Total Knee Replacement.
Prp Is Not A Single Shot Miracle Cure Effectiveness Of Prp Is In How Many Times The Treatment Is Given
PRP is not a single shot miracle cure. While for the rare patient a single shot may work for them, we have seen in our clinical experience, PRP not to be as effective as a stand-alone, single-shot treatment. When someone contacts our center with a question about PRP, they understand the concept and that it should have helped them. But it did not. Why?
PRP does not work for every patient. The two main reasons are that some knees are indeed too far gone. What is typically too far gone? A knee that does not bend anymore or there is significant structural changes like bone spurs that have fused the knee.
The second reason is that they did not allow the treatment a chance to work. Many people think they are supposed to get immediate relief. That is not how PRP works.
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Cartilage Repair And Cartilage Restoration
One way to stimulate cartilage growth is by making precise microfractures in the surrounding bone.This procedure is called bone marrow stimulation.
Once damaged, cartilage does not heal well. Even if the joint is able to grow new cartilage, it tends to be rough and bumpy and therefore less able to facilitate smooth movement at the joint. There are a handful of surgeries that attempt to repair or encourage the growth of healthy cartilage:
- Bone marrow stimulation, which stimulates cartilage growth by making precise microfractures in the surrounding bone
- Osteochondral transplantation techniques , also referred to as mosaicplasty, which involves transplanting cartilage from one site to another
- Autologous chondrocyte implantation , which requires two surgeries. In the first, cartilage cells are harvested and then grown in a laboratory for several weeks. During the second surgery the cartilage cells are re-implanted.
These procedures may be appropriate for patients who have a relatively small and very isolated area of articular cartilage damage. Typically, these patients are younger and have damaged their cartilage through trauma rather than over years of gradual wear and tear. Therefore, these surgeries are usually more appropriate for people trying to slow or prevent severe arthritis rather than alleviate it.
Learn more about how doctors such as orthopedic surgeons treat arthritis in Arthritis Treatment Specialists
Knee Doctors In San Antonio Tx
Our medical team at the Center for Orthopaedic Surgery and Sports Medicine is here to help you with your musculoskeletal condition, such as knee pain, hip pain, shoulder pain, and muscle problems. Our orthopedic specialists specialize in treating knee arthritis, knee ligament injuries, unstable kneecap, a torn meniscus, and other knee problems you may be experiencing.
If you have any questions or would like to schedule an appointment, call our office today at 692-7400. You can also fill out our convenient online appointment request form now. We look forward to serving you!
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What Is A Partial Knee Replacement
Total knee replacement involves all three compartments in human knee joints. Usually all three compartments are all worn out by arthritis, but in some knees, only one or two compartments may be arthritic. If so, the affected compartments can be replaced selectively, thereby preserving bone and minimizing surgery. Such knee replacements are called partial knee replacements.
Very few patients are proper candidates for partial replacements, despite the marketing claims of surgeons and manufacturers. If a partial replacement is done improperly, or in the wrong patient, premature repeat surgery is usually needed to put in a complete knee prosthesis, which likely should have been used in the first place.
Nerve And Other Tissue Damage
There’s a small risk that the ligaments, arteries or nerves will be damaged during surgery.
- Fewer than 1 in 100 patients have nerve damage and this usually improves gradually in time.
- About 1 in 100 have some ligament damage this is either repaired during the operation or protected by a brace while it heals.
- About 1 in 1,000 suffer damage to arteries that usually needs further surgery to repair.
- In about 1 in 5,000 cases blood flow in the muscles around the new joint is reduced . This usually also needs surgery to correct the problem.
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What Are The Different Types Of Knee Doctors
A specialized knee doctor can treat problems related to your knees such as arthritis, tears, or dislocations. If you are experiencing chronic knee pain, or if you have suffered a knee injury, you are probably looking for a doctor who specializes in the knee so the pain or injury can be addressed as quickly and effectively as possible.
There are different types of physicians who specialize in various kinds of knee conditions. Lets talk about the main types of knee doctors, and where you can go in San Antonio and South Texas for world-class knee pain treatment that works.
How To Encourage Healing
For anyone who has had knee surgery, it is essential to keep the wound as dry as possible until it has thoroughly healed. Covering the wound with a bandage will also help prevent irritation from support stockings and other clothing.
Having a healthful, balanced diet helps encourage healing, though a person may have a poor appetite for the first few days after their surgery.
The AAOS recommends exercising in the first few weeks after the operation. A physical therapist may recommend specific exercises that help restore movement and build strength in the knee, and a person may need to do these several times a day.
Otherwise, the best approach to aftercare largely depends on the type of surgery that a person has had.
Anyone who has undergone arthroscopy should exercise regularly. A doctor or physical therapist usually recommends 2030 minutes of exercise two or three times a day and walking for 30 minutes two or three times a day during early recovery.
A physical therapist may design a personalized activity program. This may involve gradually increasing the amount of walking and a timetable for resuming everyday activities, such as climbing stairs. They will also recommend rehabilitation exercises.
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Looking After Your Knee Replacement
Your new knee will continue to improve for as much as two years after your operation as the scar tissue heals and you exercise your muscles. You’ll need to look after yourself and pay attention to any of the following problems:
Stiffness Sometimes the knee can become very stiff in the weeks after the operation for no obvious reason. Try placing your foot on the first or second step of the stairs, hold on to the banister and lean into your knee. This should help to improve movement and flexibility in your knee. Its very important to continue with the exercises you were working on in the hospital.If the stiffness doesnt improve after about six weeks your surgeon may need to move or manipulate your knee. This will be done under anaesthetic.
Pain Pain caused by bruising from the operation is normal in the first two months, and you’ll probably still need to take painkillers at six weeks to help you sleep through the night. You may still have some pain for as long as six months. If you still have pain after this, speak to your physiotherapist or GP.
Infection You should speak to your GP or hospital if you notice any signs of infection, for example:
- breakdown of the wound with oozing/pus or sores
- increased pain
- redness and the affected area feeling warmer than usual or smelling unpleasant.
You should also look after your feet see a doctor or podiatrist if you notice any problems such as ingrown toenails that could become infected.
Personalized Sports Medicine Treatment
You dont have to live with chronic knee pain! If you are experiencing discomfort, pain, and swelling in the knee joint, then its time to talk to a sports medicine specialist for a diagnosis and treatment plan.
Call us at Orthopedic Associates to book an appointment to meet with a sports medicine doctor. We provide our patients with a full-service clinic, including a knowledgeable team that can help you find the right treatment solutions. Contact our office if youd like to book an appointment.
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How Do Knee Braces Fix Knee Pain Injury And Instability
Functional braces are designed to control your motion and stabilize your knees to prevent an injury from occurring again.
Their support is so beneficial that many athletes wear functional braces long after recovering from their knee injury.
Rehabilitative braces are commonly worn for a few weeks after a patient has undergone surgery or immediately after being injured. They allow for some movement while the patient is recovering while still keeping the knee stable.
If you are worried about pain, your doctor may suggest wearing unloader braces. Unloader braces are designed to reduce pain in patients who have arthritis. They shift weight from the affected region to a stronger knee component to relieve pain.
Hyaluronic Acid Injections Or Viscosupplementation For Knee Osteoarthritis: What To Expect When Getting Gel Injections In Knee
Much like cortisone, it is very likely that this knee injection treatment has been explained to you already by your orthopedist. It is a conservative care plan to help you try to manage along until you can get a knee surgery scheduled or you are trying to do everything you can to avoid the knee surgery.
Also like cortisone, you may have already had viscosupplementation and the effects and benefits have now worn off and you need to treat your knee differently. For some people, they may not even be reading this sentence because they have moved down the article to other treatments because this one is no longer an option for them.
What are Hyaluronic acid injections or Viscosupplementation?
The explanation that you may have been given is that hyaluronic acid injections will provide a gel-like cushion in your knee, getting between the shin and thigh bones to alleviate your bone-on-bone situation. The injections increase the volume of the protective synovial fluid in the knee.
- The treatment is therefore referred to as Viscosupplementation because you are supplementing the viscosity or the thick, sticky, gel-like properties of the synovial fluid. Hyaluronic acid is naturally occurring in the synovial fluid of the knee.
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Growth And Healing Factors In Prp This Is What Makes Prp Work
A paper in the journal Clinical Cases in Mineral and Bone Metabolism describes the growth, healing, and repair factors found in platelet-rich plasma. These are the healing factors and what they do:
- PDGF initiates connective tissue healing through the promotion of collagen and protein synthesis.
- The primary effect of PDGF seems to be its mitogenic activity to mesoderm-derived cells such as fibroblasts ,
- Vascular muscle cells .
- Glial cells and chondrocytes .
- The most important specific activity of PDGF is the creation of cartilage.
So the concept is here. These healing growth factors in your blood are taken and spun, to separate out a platelet-rich plasma solution filled with these healing and growth factors, and then the solution is injected into your knee.
Who Is Offered Knee Replacement Surgery
A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, have not reduced pain or improved mobility.
You may be offered knee replacement surgery if:
- you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced
- your knee pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you’re feeling depressed because of the pain and lack of mobility
- you cannot work or have a social life
You’ll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.
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Different Types Of Surgery
There are 5 main types of knee replacement surgery:
- Total knee replacement. This is the most common form. Your surgeon replaces the surfaces of the thigh bone and shin bone that connects to the knee.
- Partial knee replacement. If arthritis affects only one side of your knee, this surgery may be a possibility. However, itâs only right for you if you have strong knee ligaments and the rest of the cartilage in the knee is normal. Partial knee replacement can be performed through a smaller cut than is needed for total knee replacement.
- Patellofemoral replacement. This replaces only the under-surface of the kneecap and the groove the kneecap sits in. This can be very effective for people with chronic kneecap arthritis.
- Complex knee replacement. This procedure may be needed if you have very severe arthritis or if youâve already had two or three knee replacement surgeries.
- Cartilage restoration: Sometimes when the knee only has an isolated area of injury or wear this area can be replaced with a living cartilage graft or cells which grow into cartilage.