Knee Replacement Surgery Steps
Mild Knee Replacement Complications
All of us will experience some mild knee replacement complications after surgery. Your recovery will be a time of adjustment and each persons body adjusts to their new knee differently.
Complications can include bruising, swelling, tenderness and pain during the healing process. In most cases, these minor complications will last only a short time .
Knee stiffness may develop after surgery, especially if you remain sedentary. Physical therapy will help with many of these mild complications.
Some mild complications may persist and need further attention from your physician. Ill mention the more serious complications below.
Always follow your doctors instructions to reduce your risk of developing complications.
How Does Partial Knee Replacement Differ From Total Knee Replacement
Most arthroplasties target the entire knee joint, an operation called a total knee replacement. But some people choose to have a partial knee replacement.
To understand the difference, it helps to know the knees compartments, or sections. It has three:
- Inside .
- Outside .
- Under the kneecap .
The partial approach fixes a single section. So healthcare providers call it unicompartmental replacement. A total knee replacement addresses all three sections. Generally, only younger adults with symptoms in one knee section benefit from partial replacement.
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What Is Unicompartmental Knee Arthritis
Unicompartmental osteoarthritis of the knee is a condition in which degenerative arthritis affects only one part of the knee joint, most often the medial compartment, while the other compartments remain healthy or not significantly damaged.
may occur in any one of the three compartments that make up the knee joint. The inner or medial compartment of the knee and the outer or lateral compartment of the knee are formed by the articulation of the lowest part of the thighbone and the highest part of the shinbone . The third compartment of the knee is formed by the kneecap and the front part of the femur. This is referred to as the patellofemoral joint.
The medial compartment is the most frequent site of of the knee, with the disease occurring less frequently in the lateral compartment.
Figures: Illustration and X-ray image of medial compartment osteoarthritis of the knee
Tips To Reduce Swelling After Knee Replacement:
Elevate the leg with your foot above the level of your heart
Elevating the leg with your foot above the level of your heart is one of the best methods to reduce swelling. Keep 2-3 pillows below the affected leg. Make sure the position is such that it maintains the leg at a 45-degree or greater angle from the body.
Stay in that position as long as you can. But take the normal position if you start experiencing throbbing pain.
Wear compression socks
Compression stockings, which promote better circulation and reduce swelling, are also available on the market. You can simply ask your doctor about them. After surgery, the doctor suggests patients have them because they are important for promoting better circulation and reducing swelling.
As instructed by the surgeon, wear the stockings accordingly. Make sure to purchase the stocking according to your knee size. The small, or bog, stockings will not be helpful in providing relief.
Use an ice pack
Using an ice pack can also help you reduce swelling after knee surgery. When you are resting for a while, take an ice pack and put it on the affected area. If you do it for 10 to 20 minutes, 3 to 4 times a day, it will give you visible results.
But be sure not to put an ice pack directly on the skin because it may lead to a frostbite condition and skin damage may take place.
Do not put pressure on the knee
Keep the surgery site neat and clean
Maintaining your weight
Consult your doctor
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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.
Length of total knee replacement surgery
Pain and pain management
Implanting The Tibial Component
The bottom portion of the implant, called the tibial tray, is fitted to the tibia and secured into place using bone cement. Once the tray is in place, the surgeon will snap in a polyethylene insert to sit between the tibial tray and the femoral component, and act as a kind of buffer. This insert will provide support for your body as you bend and flex your knee.
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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.
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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Common And Serious Complications Of Knee Replacement
While knee implants give many recipients a second chance at walking and living a more normal life, complications do occur.
Most problematic is a loosening of the implant, which can be caused by a defective implant or poor positioning at the time of surgery. Implant loosening is a primary cause for revision surgery.
Although rare, metallosis is possible after knee replacement surgery. Metallosis, also known as metal poisoning, can occur when metal implant pieces rub against each other and release tiny metal particles into the knee joint and bloodstream.
Common complications from knee surgery include:
- Swelling and stiffness
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.
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What Conditions Does Knee Replacement Surgery Treat
Knee replacement surgery treats conditions that cause the cartilage of the knee joint to wear away. These include:
- Knee osteoarthritis. This is the most common reason for knee replacement surgery. It usually develops over time after an injury or with aging.
- Knee damage from other types of arthritis.
- Problems from knee joints that aren’t formed correctly.
When Is Total Knee Replacement Surgery Recommended
Osteoarthritis, rheumatoid arthritis, and other forms of arthritis can affect the knee. However, not everyone with knee arthritis is a candidate for total knee replacement surgery. Below are guidelines doctors use to decide when to recommend this surgery.
Who is eligible for total knee replacement surgery?Patients eligible for this surgery have:
- Knee pain that interferes with daily living and has not responded to appropriate nonsurgical treatments, such as exercise, weight loss, physical therapy, medications, steroid injections, and bracing.
- Moderate to severe arthritis in the knee that can be confirmed with medical imaging
Typical candidates for knee replacement will also have some combination of the following:
- Difficulty walking, going up stairs, and getting in and out of chairs
- Moderate to severe pain even while resting, which may affect sleep
- Knee deformity, such as bow-legs or knock-knees, that has resulted or been exacerbated by knee joint degeneration
- Knee swelling and inflammation that is chronic and not controlled with medication or rest
Sometimes a person may meet these criteria but knee replacement surgery is not recommended for other reasons.
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No 6 Walking Poles Or A Cane
Whether youre a young guy/gal or a senior like me, the early days after surgery will take a toll on you. Your balance will be slightly off as you manage the pain from TKR. The pain will gradually subside and your body should quickly adjust to its new knee. Even months after recovery youll want some support and thats why walking poles are a must-have item after knee replacement.
Even patients in top shape shouldnt be ashamed of using a little help. A cane in the weeks following surgery will help take some pressure off the knee although it will put more pressure on your arm.
Walking sticks can also be used while around the house or exercising outside. Unlike canes, walking poles come in a pair. Feel free to only use 1 or both depending on the situation.
> > read my review on the best walking poles
While walking/hiking they can help with shock absorption. Just as important, the might help you avoid a fall and further injury to your knee or hip.
Ive used walking poles for a number of years. They are lightweight so my arms dont fatigue when using them and I notice my knee is less sore the following day after Ive used them.
Knee Replacement Video Footage
If you are considering knee replacement surgery for your osteoarthritis , you are probably wondering what exactly happens once you get on the operating table. We scoured youtube for the best videos of knee replacement surgery to give you the birds-eye view of the operating table.
WARNING The following videos contain graphic content of real surgeries, viewer discretion is advised.
As you will see from the knee replacement videos, the procedure is fairly invasive. Over the course of two hours, an orthopedic surgeon will saw away bone and attach the prosthetic knee joint to your patella, femur, and tibia.
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What Does Knee Replacement Surgery Involve
The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.
Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.
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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Posterior Cruciate Ligament Retaining
The posterior cruciate ligament runs along the back of the knee, connecting the femur to the tibia. This design keeps the PCL intact, but it depends on several patient factors: good bone quality, few defects in the bones, intact soft tissue around the knee and a functional PCL.
There are two types of PCL implants: retaining and substituting. The difference between the two comes in part from how the PCL is affected by the implant surgery. A surgeon may remove the ligament to implant a PCL substituting implant. But if the ligaments are in good condition, the surgeon may want to preserve it. In that case, he or she will use a PCL retaining implant.
Preserving the ligament may not necessarily result in better post-operative knee function. A simple polyethylene bearing attaches to a metal component implanted in the tibia, and a metal implant in the femur hinges on the polyethylene. It is a minimal design dependent on the PCL to stabilize the implant but a tight PCL may lead to excessive wear on the bearing.
Less bone is removed with a PCL retaining implant. A PCL retaining implant is less likely than a PCL substituting version to result in a condition called patella clunk syndrome. This syndrome results from scar tissue forming near the implant and becoming caught in part of the device as the knee is fully extended.
Similar Conditions That Affect The Knee
Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.
Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.
Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.
Knee Joint Infections
Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:
- severe pain
- fevers and
Again, a joint infection is a serious condition that requires immediate medical attention.
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