How Do I Get Ready For Total Knee Replacement
Ask your provider how you should plan to get ready for your surgery.
Tell your provider about any medicines you are taking, including:
All prescription medicines
Over-the-counter medicines such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Ask if there are any medicines you should stop taking ahead of time, like blood thinners.
If you smoke, try to quit before your surgery.
If you are overweight, your provider may advise you to try to lose weight before your surgery.
Donât eat or drink after midnight the night before your procedure.
You may want to make some changes to your house, to make your recovery smoother. This includes things like adding a handrail in your shower.
In some cases, your provider might want additional tests before you have your surgery. These might include:
X-rays, to get information about your hip
MRI, to get more detailed information about your hip
Electrocardiogram , to make sure your heart rhythm is normal
Follow any other instructions from your healthcare provider.
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.
What Is Replaced During Knee Arthroplasty
During the knee replacement intervention, the surgeon removes only those parts of the knee joint that are damaged. Then, the bones are shaped to hold the artificial joint, which is attached to the bones using special cement or another material that is compatible with the human body.
The artificial prosthesis can be made of plastic or metal, and it should restore the weight-bearing portion of the joint, relieving the pain and allowing the patient to move freely. The new joint should be kept in place not only by the bones and cement but also by the surrounding muscles and ligaments, so if those are also damaged, a more complex intervention may be required.
The knee arthroplasty procedure does not involve the replacement of the blood vessels that supply the joint with blood, and all the parts of the joint that are healthy and still functional will be kept there, so the doctor will only replace the damaged components.
For most patients this is enough and as long as the joint isnt put under too much stress or strain, the artificial prosthesis should last for 15-20 years. The procedure is carried out regularly in the U.S., more than 600,000 patients receiving new knee joints every year, so its a common and safe intervention.
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Types Of Knee Replacement Surgery
Knee replacement can be total or partial.
Total knee replacement : Surgery involves the replacement of both sides of the knee joint. It is the most common procedure.
Surgery lasts between 1 and 3 hours. The individual will have less pain and better mobility, but there will be scar tissue, which can make it difficult to move and bend the knees.
Partial knee replacement : Partial replacement replaces only one side of the knee joint. Less bone is removed, so the incision is smaller, but it does not last as long as a total replacement.
PKR is suitable for people with damage to only one part of the knee. Post-operative rehabilitation is more straightforward, there is less blood loss and a lower risk of infection and blood clots.
The hospital stay and recovery period are normally shorter, and there is a higher chance of more natural movement.
What Is Knee Replacement Surgery
Knee replacement surgery is a type of arthroplasty a surgical procedure to restore joint function by resurfacing damaged bone and replacing it with an artificial metal or plastic implant called a prosthesis. There are two types of knee replacement surgeries: total or partial. Total knee replacement involves replacing both sides of the knee joint, while partial replacement replaces only one side, removing less bone in the process.
According to , approximately 40% of the worlds population over 55 years old experience chronic knee pain at some point in their lifetime. The prevalence of knee replacement surgery has grown, with 2.6 million people opting for knee replacement surgery each year. With the advent of new technologies and techniques such as robotics and minimally invasive surgery, patients may benefit from reduced surgical trauma, and shortened operation and recovery times.
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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.
London Knee Osteotomy Centre
The London Knee Osteotomy Centre at The Wellington Hospital in London brings together world-renowned surgeons from across the UK and Europe.
The Centre is led by Professor Adrian Wilson who has a global reputation in carrying out knee realignment surgery. Collectively, the London Knee Osteotomy Centre team have performed more than 700 knee osteotomy procedures across the UK and Europe.
All consultants at The London Knee Osteotomy Centre are globally recognised leaders in their specialist field of medicine, with many managing departments and clinical teams in distinguished London teaching hospitals and centres of excellence across Europe.
They are supported by a multidisciplinary team of anaesthetists, radiologists, specialist physiotherapists and the very latest state-of-the-art diagnostic imaging technology, contributing to a fast and accurate diagnosis for patients.
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Here Are Some Of The Reasons You Might Need Knee Surgery:
- Stiffness in the joint and pain makes it difficult to walk, stand up, or climb stairs
- You often have swelling in the knee area
- Chronic pain bothers you when resting
- The pain is disrupting your sleep
- The knee has defects or is bowed
- Medication and physical therapy havent been effective in managing the pain
If you can relate to any of these symptoms, then its time to talk to a sports medicine doctor about your treatment options.
What Happens During Knee Arthroplasty
The day of surgery, you will receive anesthesia to prevent pain during the operation. You will have either a regional or general anesthetic. Your anesthesia team will decide what type of anesthesia is right for you.
Knee arthroplasty takes about an hour or two. The surgical team will:
- Make an incision in the knee area.
- Remove any damaged cartilage and bone.
- Place the knee implant and position it properly.
- Secure the implant into place using cement or without cement.
- Insert a piece of polyethylene that creates a smooth, gliding surface between the metal parts of the implant.
- Close the incision.
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What About Exercise Following A Knee Replacement
Exercise and sport are recommended after knee replacement, apart from contact sports, which may weaken the cement and lead to loosening of the joint components. Recreational sports including golf, tennis and skiing will gradually become possible depending on how fit and sporty you were before the operation. Cycling is a very good way of building up strength and mobility after knee surgery.
Exercising the main muscle groups around your knee is very important both before and after having a knee replacement. You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your knee. Try to perform these exercises regularly, for instance for 10 minutes six to eight times a day. However, its important to find a balance between rest and exercise so you dont overwork your knee. Its a good idea to get advice from your doctor or physiotherapist about specific exercises before you begin.
What Patients Should Consider A Total Knee Replacement
Total knee replacement surgery is considered for patients whose knee joints have been damaged by either progressive arthritis, trauma, or other rare destructive diseases of the joint. The most common reason for knee replacement in the United States is severe osteoarthritis of the knees.
Regardless of the cause of the damage to the joint, the resulting progressively increasing pain and stiffness and decreasing daily function lead the patient to consider total knee replacement. Decisions regarding whether or when to undergo knee replacement surgery are not easy. Patients should understand the risks as well as the benefits before making these decisions about knee replacement.
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Why Might I Need Knee Osteotomy Surgery
Knee osteotomy or knee realignment surgery is carried out on patients experiencing a range of knee conditions, including arthritis and sports-related injuries.
You might need this type of surgery if you are:
- Bow-legged this can result in damage from arthritis to the inner side of the knee joint. Alignment surgery is known as high tibial osteotomy where the top part of the shin bone is realigned. Around 80% of Adrians realignment procedures are for bow-legged patients.
- Knock-kneed this can result in damage from arthritis to the outer side of the knee joint. Alignment surgery is known as femoral osteotomy where the bottom part of the thigh bone is realigned.
Avoid Mistakes To Recover Faster
How long does it take to recover from total knee replacement? Will it be relatively easy or frustratingly hard, speedy or last over a year? This is the million dollar question. You can make a big difference in your recovery speed by avoiding the 5 biggest mistakes that most people make. Not doing any of your exercises would be the stupidest mistake but I am going to assume you are MUCH smarter than that after all you are here searching out and seeking the best answers to all your questions.
Here it is for all the wise ones. Listen up and take notes so that you too can avoid the 5 biggest mistakes that will shipwreck your recovery from a total knee replacement.
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How Your New Knee Is Different
Improvement of knee motion is a goal of total knee replacement, but restoration of full motion is uncommon. The motion of your knee replacement after surgery can be predicted by the range of motion you have in your knee before surgery. Most patients can expect to be able to almost fully straighten the replaced knee and to bend the knee sufficiently to climb stairs and get in and out of a car. Kneeling is sometimes uncomfortable, but it is not harmful.
Most people feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending activities.
Most people also feel or hear some clicking of the metal and plastic with knee bending or walking. This is a normal. These differences often diminish with time and most patients find them to be tolerable when compared with the pain and limited function they experienced prior to surgery.
Your new knee may activate metal detectors required for security in airports and some buildings. Tell the security agent about your knee replacement if the alarm is activated.
How Do You Know If You Need Knee Replacement Surgery
Each patient is unique, which is why it is essential to schedule an examination and testing with an experienced sports medicine doctor. Our team will determine a diagnosis before deciding if you need to schedule a date for surgery. The preference is always to use minimally-invasive treatments first before surgery is necessary.
But there are times when surgery is required. Whether the minimally-invasive treatments arent working, or youve had a severe injury, you might need to schedule surgery to achieve the recovery you desire.
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Surgical Treatment Of Knee Pain
Partial knee replacement: The surgeon replaces the damaged portions of the knee with plastic and metal parts.
Total knee replacement: In this procedure, the knee is replaced with an artificial joint. It requires a major surgery and hospitalization.
How Do I Determine If I Need A Knee Replacement
If youre considering knee replacement surgery, talk to an orthopedic surgeon. Orthopedic surgeons specialize in operations to fix joints and muscles.
Your orthopedic surgeon will:
- Ask about your symptoms, including how severe they are and how long youve had them. The surgeon may also ask whether anything makes symptoms better or worse, or whether symptoms interfere with your daily life.
- Take your medical history to learn about your overall health.
- Examine you to check knee motion, strength and stability.
- Order X-rays of your knee. The images can help the surgeon understand how much damage is in your knee. Advanced imaging is rarely helpful in the arthritic knee.
The orthopedic surgeon will then make a recommendation for surgery or another treatment option.
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Knee Replacement Recovery Time And Recuperation
Total knee replacement surgery generally takes about 60 to 90 minutes, but you should expect to be in the operating room for over two hours. Rehabilitation will begin within 24 hours of surgery.
After your surgery, the nursing staff will position you in bed and help you turn until you are able to move on your own. You may have a pillow between your legs if ordered by your surgeon.
Very soon after surgery, a physical therapist will come to your room to teach you appropriate exercises and review your progress. Gentle exercises to improve your range of motion can help prevent circulation problems as well as strengthen your muscles.
Your rehabilitation program will begin as soon as you are medically stable and there are orders from your doctor to begin postoperative mobility. All patients begin rehabilitation within 24 hours of their surgery. Your motivation and participation in your physical therapy program is key to the success of your surgery and recovery. The physical therapist will assist you in the following activities:
- sitting at bedside with your feet on the floor
- transferring in and out of bed safely
- walking with the aid of a device
- climbing stairs with aid of a device
Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
Blood clots in the legs or lungs
Loosening or wearing out of the prosthesis
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.
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Will I Be Able To Get Back To A Physical Active Lifestyle
Urquhart: Most patients about 80 to 85% feel their knee functions better than before they had surgery. These patients can get back to low-impact physical activity, such as walking, hiking, biking, playing golf or tennis and other light recreational activities. We discourage high-impact activities, such as basketball and running, as these can reinjure the knee.
To make a consultation appointment with our Comprehensive Musculoskeletal Center team, please visit the CMC website.
About St George Surgical Center
Located in sunny St. George, in southern Utah, SGSC is a multi-specialty surgical facility, physician-owned and operated.
- Board Certified Surgeon & Anesthesia Providers
- Prestigious AAAHC Accreditation
- Extremely low infection rate, 0.037%
- 11,000 sq ft with 4 state-of-the-art surgery suites
- 23-hour Overnight/Extended Stay facility
Competitive pricing and excellent customer service for our valued patients and their families.
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