Can This Injury Or Condition Be Prevented
If you have knee pain, you may be able to delay the need for surgery by working with a physical therapist to improve the strength and flexibility of the muscles that support and move the knee. This training could even help you avoid surgery altogether. Participating in an exercise program designed by a physical therapist can be one of your best protections against knee injury. And staying physically active in moderately intense physical activities and controlling your weight through proper diet might help reduce the risk of osteoarthritis of the knee getting worse.
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.
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.
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What Are Knee Replacement Implants Made Of
The selection of knee replacement prosthesis design and materials depends on each individual patient. The main implant components are made of metal â usually titanium or chrome-cobalt alloys. The implants are fixated in place either with a cement bonding agent or by osseointegration, in which a porous metal stem extends into the tibia and the patient’s natural bone grows into it. A plastic platform or spacer will be inserted between the tibial and femoral implant surfaces. The spacer is made of polyethylene.
Most femoral components are made of metal alloys or metal-ceramic alloys . The patellar component is plastic . The tibial insert component is also plastic . The tibial tray component can be made of the following materials:
- cobalt chromium
Know All Of Your Treatment Options
Your doctor may give you additional or alternate information regarding knee pain and total knee replacement surgery. If you have questions about treatment options, schedule an appointment to discuss whats right for you. Contact us today to learn more about NUsurface as a knee pain treatment option.
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When To Seek Emergency Care
Warning signs of a blood clot in the lungs include sudden shortness of breath, chest pain, and coughing. Signs of infection include fever, worsening redness or tenderness of the knee, and pus draining from the surgical wound. If you feel or see any of these symptoms after knee replacement, call your doctor immediately. Call 911 for chest pain or if you are having any trouble breathing.
Why Have Knee Replacement Surgery
There are three common reasons for the procedure:
Osteoarthritis: this type of arthritis is age related, caused by the normal wear and tear of the knee joint. It mostly affects patients aged over 50 years, but younger people may have it.
Osteoarthritis is caused by inflammation, breakdown, and the gradual and eventual loss of cartilage in the joints. Over time, the cartilage wears down and the bones rub together. To compensate, the bones often grow thicker, but this results in more friction and more pain.
Rheumatoid arthritis: also called inflammatory arthritis, the membrane around the knee joint to become thick and inflamed. Chronic inflammation damages the cartilage, causing soreness and stiffness.
Post-traumatic arthritis: this type of arthritis is due to a severe knee injury. When the bones around the knee break or the ligaments tear, this will affect the knee cartilage.
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When A Knee Replacement Is Needed
Knee replacement surgery is usually necessary when the knee joint is worn or damaged so that your mobility is reduced and you are in pain even while resting.
The most common reason for knee replacement surgery is osteoarthritis. Other health conditions that cause knee damage include:
- knee deformity with pain and loss of cartilage
The First Day After Surgery
Knee replacement recovery begins right after surgery. Typically, the day of knee replacement surgery, a physical therapist will ask you to stand up and take a few steps with a cane or walker.
If you walk or stand on your new knee quickly after surgery, you are more likely to recover faster and have less complications compared to those patients who do not stand up right away.
Most of my patients are up and taking a few steps four hours after surgery, says Dr. Frank Kolisek, a total joint specialist at OrthoIndy. Muscle sparing surgical approaches, periarticular pain medicine injections, advanced anesthetic techniques and short operating times of around 40 minutes, allow my patients to do this.
Your pain will be continually monitored and controlled with various pain-relief methods to make sure you are comfortable during your hospital stay. Most patients will be discharged when they have their pain under control and they are able to get in and out of bed and walk short distances.
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How Do I Know If I Need Knee Replacement Surgery
You may need surgery if:
- Your knees are stiff and swollen.
- There is pain throughout the day, even at rest.
- Walking, getting up or climbing stairs is difficult and painful.
- Medication and therapy do not offer enough relief.
- Knee cartilage is so damaged and worn away that you are walking “bone on bone,” in which the bones of the joint are scraping together.
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Technical Details Of Total Knee Replacement
Total knee replacement surgery begins by performing a sterile preparation of the skin over the knee to prevent infection. This is followed by inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incision–typically 6-7 in length though this varies with the patients size and the complexity of the knee problem–is made down the front of the knee and the knee joint is inspected.
Next, specialized alignment rods and cutting jigs are used to remove enough bone from the end of the femur , the top of the tibia , and the underside of the patella to allow placement of the joint replacement implants. Proper sizing and alignment of the implants, as well as balancing of the knee ligaments, all are critical for normal post-operative function and good pain relief. Again, these steps are complex and considerable experience in total knee replacement is required in order to make sure they are done reliably, case after case. Provisional implant components are placed without bone cement to make sure they fit well against the bones and are well aligned. At this time, good function–including full flexion , extension , and ligament balance–is verified.
Finally, the bone is cleaned using saline solution and the joint replacement components are cemented into place using polymethylmethacrylate bone cement. The surgical incision is closed using stitches and staples.
Anesthetic
Length of total knee replacement surgery
Pain and pain management
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Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
-
Bleeding
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Blood clots in the legs or lungs
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Loosening or wearing out of the prosthesis
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Fracture
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Continued pain or stiffness
The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.
Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
Extending The Life Of Your Knee Implant
Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following your orthopaedic surgeon’s instructions after surgery and taking care to protect your knee replacement and your general health are important ways you can contribute to the final success of your surgery.
To assist doctors in the surgical management of osteoarthritis of the knee, the American Academy of Orthopaedic Surgeons has conducted research to provide some useful guidelines. These are recommendations only and may not apply to every case. For more information: Surgical Management of Osteoarthritis of the Knee – Clinical Practice Guideline | American Academy of Orthopaedic Surgeons
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Orthopedic Surgeons Located In Farmington Nm & Gallup Gallup Nm
Knee replacement surgery is one of the most successful procedures in modern medicine. Orthopedic surgeon Tyson Christensen, MD, and the team at Orthopedic Associates PA in Farmington, New Mexico, treat advanced arthritis and severe injuries with knee replacement surgery. They often perform knee replacement surgery as a same-day outpatient procedure at the local ambulatory surgery center. If youre considering having a knee replacement procedure, call the office or schedule an appointment online today.
- Request Appointment
How Long Is It Before I Can Walk After A Knee Replacement
Most patients progress to a straight cane, walker or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.
Patients are usually able to drive a car within three to six weeks after surgery and resume all other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take up to four months. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement
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What Is Involved With The Pre
Before surgery, the joints adjacent to the diseased knee are carefully evaluated. This is important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield a significant improvement in function as the nearby joint may become more painful if it is abnormal.
- Furthermore, all medications that the patient is taking are reviewed. Blood-thinning medications such as warfarin and anti-inflammatory medications such as aspirin may have to be adjusted or discontinued prior to knee replacement surgery.
- Routine blood tests of liver and kidney function and urine tests are evaluated for signs of anemia, infection, or abnormal metabolism.
- Chest X-ray and EKG are performed to exclude significant heart and lung disease that may preclude surgery or anesthesia.
- Finally, a knee replacement surgery is less likely to have a good long-term outcome if the patient’s weight is greater than 200 pounds. Excess body weight simply puts the replaced knee at an increased risk of loosening and/or dislocation and makes recovery more difficult.
Another risk is encountered in younger patients who may tend to be more active, thereby adding trauma to the replaced joint.
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.
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Ial Knee Replacement Overview
A is also known as unicompartmental knee arthroplasty or unicondylar knee arthroplasty. In this surgery, damaged cartilage and bone are removed and replaced only in one diseased compartment of the knee. This differs from a total knee replacement, in which bone and cartilage from the entire joint are replaced.
Partial knee replacement is suitable for people who experience arthritis only in one compartment of the knee joint, rather than throughout the joint. It can also provide relief from pain and stiffness in some people who have medical conditions that make them poor candidates for total knee replacement surgery.
What Is An Artificial Knee And How Does It Stay In Place
Artificial knee implants consist of metal and medical-grade plastic called polyethylene.
There are two ways of attaching the components to the bone. One is to use bone cement, which usually takes about 10 minutes to set. The other is a cement-free approach, in which the components have a porous coating that allows the bone to grow onto it.
In some cases, a surgeon may use both techniques during the same operation.
Any operation done with anesthesia has risks, although it is rare that severe complications result from any type of anesthesia.
The options for TKR include:
- general anesthesia
- spinal or epidural
- a regional nerve block anesthesia
An anesthesia team will decide on the most suitable options for you but most knee replacement surgery is done using a combination of the above.
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Total Knee Replacement Facts
- Patients with severe destruction of the knee joint associated with progressive pain and impaired function may be candidates for total knee replacement.
- Osteoarthritis is the most common reason for knee replacement operation in the U.S.
- Risks of total knee replacement surgery have been identified.
- Physical therapy is an essential part of rehabilitation after total knee replacement.
- Patients with artificial joints are recommended to take antibiotics before, during, and after any elective invasive procedures .
Who Needs Knee Revision Surgery
A knee revision may be necessary for anyone whose prosthetic knee implant fails due to injury or wear, or who gets an infection in the area around implant.
In elderly people who have a knee replacement, the artificial knee implants may last for life. But in younger patients, especially those who maintain an active lifestyle, knee prostheses may eventually fail, requiring a second replacement later in life.
The most common reasons people for knee revision are:
- Infection: The risk of infection from a total knee replacement is less than 1%, but when infections do occur, a knee revision of one kind or another is necessary.
- Instability: This occurs when the soft tissues around the knee are unable to provide the stability necessary for adequate function while standing or walking.
- Stiffness: In some patients, excessive scar tissue may build up around the knee and prevents the joint from moving fully.
- Wear and tear: This can include loosening or breakage of prosthesis components due to friction over time.
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When Can I Go Back To Work
How soon you can return from knee replacement recovery depends on the type of work you do. If you work at a sedentary job, you may be able to return to work four to six weeks after surgery.
If your job requires frequent lifting and standing or bending, you may return to work after six to eight weeks.
If you work at a more labor-intensive job, your total joint specialist will work with you on a customized estimate of when you might be able to go back. In some cases, the time frame might be up to three months.
Minimally Invasive Total Knee Replacement
Some medical centers perform minimally invasive surgery for a total knee replacement, also called min-incision joint replacement.
This surgery allows surgeons to cut less muscle and tissue, which leads to less blood loss, increased range of motion and a shorter hospital stay. Many patients go home the same day and the recovery process is usually much quicker than traditional total knee surgery.
However, minimally invasive knee replacement is not for everyone. In general, the best candidates for this kind of surgery are younger and in better health. Older patients, those who are overweight or patients who have undergone knee surgeries in the past may be less suitable for minimal incision procedures.
Because it uses a much smaller incision, minimally invasive knee replacements have a higher risk for poor implant placement compared to traditional total knee surgery. Other common complications include nerve and artery injuries, wound healing problems and infection.
Only specialized medical centers typically offer this surgical option. An orthopaedic surgeon should explain the complete process, the benefits and the potential risks to help the patient decide which surgical option is the best fit.
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