Knee Replacement For Seniors: What You Should Know
As you age, the cartilage in your knee joint wears down. This may cause activities you once enjoyed to become difficult to get through due to pain. Even taking a walk or carrying groceries upstairs may become difficult or inconvenient with knee pain. Your orthopedic doctor may talk to you about knee replacement surgery if you suffer from knee joint degeneration.
Heres what you need to know about knee replacement for seniors.
Knee Doctor In St Peters Or Ofallon Missouri
The orthopedic doctors at Advanced Bone & Joint specialize in treating conditions affecting the hip and knee, among others. We provide alternative therapies for pain relief and surgery for patients with damaged knee joints due to arthritis. We also provide rehabilitation services in our facility. Our orthopedic doctors are ready to see you in our orthopedic urgent care clinic.
If you would like to make an appointment, call 229-4222 or use our convenient online form. Our friendly and highly-qualified team of physicians and health care specialists looks forward to serving you in our clinic.
Understanding Why Some Joint Replacements Fail
Were also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome. This research has the potential to improve patient experience and increase the life of the joint replacement.
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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
Possible Benefits Of Total Knee Replacement Surgery
Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.
The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!
Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.
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What About Medicare And Medicaid
Medicare is a federal health insurance program for adults over the age of 65, as well as some other younger groups with specific chronic health conditions. People with Medicare often have either:
- Original Medicare .Part B is the outpatient medical insurance portion of original Medicare. It covers nonhospital based medical services that are considered necessary to diagnose or treat a specific condition.
- Medicare Advantage .Part C plans are offered by private insurance companies. Advantage plans are required to cover the same basic benefits as original Medicare but may also offer additional benefits.
Medicaid is a joint federal and state program that provides assistance with healthcare costs to those with lower incomes or resources. Eligibility and what exactly is covered varies from state to state.
Some research, both , has indicated that people with Medicare or Medicaid may have trouble accessing timely orthopedic care.
However, there are tools you can use to find doctors that accept these programs:
- For Medicare. Use the Physician Compare tool. This allows you to input a variety of information in order to find doctors in your area that accept Medicare.
- For Medicaid. Contact your states Medicaid office to find out which doctors in your state accept Medicaid.
What Kind Of Doctor Does Knee Replacement Surgery
After the operation, you can expect:
- Your knee is covered with a dressing and a drainage tube removes excess fluids from the wound.
- You are monitored by nursing staff who regularly check your vital signs .
- You are given antibiotics to reduce the risk of infection.
- You are given medications to thin your blood and reduce the risk of clots both during and after the operation.
- Strong pain relief can be given via an epidural or drip.
- You can start eating again on the second day after your operation.
- Nurses encourage you to move your feet and bend your other leg as soon as you can this helps to reduce the risk of clot formation.
- You are encouraged to walk around on the second day after surgery.
- Physiotherapists show you how to perform knee exercises.
- Occupational therapists advise you on how to best modify your home to make daily life easier during your recovery .
- Knee replacement surgery without complications usually involves a seven to 10 day hospital stay.
- Your stitches are removed about 10 days after surgery.
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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
More Surgical Experience Is Associated With Fewer Complications
The National Institute of Arthritis and Musculoskeletal and Skin Diseases4 cites a study that found complication rates to be inversely related to the number of total knee replacement procedures a surgeon or hospital performs each year. The study used data from more than 80,000 Medicare beneficiaries who underwent total knee replacement surgery and found:
- Surgeons who performed fewer than 12 knee replacements each year had an average medical complication rate of 4.0%, compared to 2.9% for surgeons who performed at least 50 knee replacements each year.5
- Hospitals that did fewer than 25 knee replacements each year had an average medical complication rate of 4.6%, compared to 3.0% for hospitals that did at least 200 knee replacements each year.6
Medical complications included post-surgical pneumonia, pulmonary embolism, heart attack, deep infection or death within the first three months after surgery. Other complications, such as the loosening of a prosthetic component in the knee, were not included in this study.
Factors that did not seem to affect complication rates in this study included:
- The number of years since the surgeons graduated medical school
- Whether the surgeries were performed in private or public hospitals, teaching or non-teaching hospitals, or urban or rural hospitals
Learn about how doctors such as Orthopedic Surgeons treat arthritis in Arthritis Treatment Specialists
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Patients Go Through Stages Before Accepting Knee Replacement Surgery
Patients pre-op and post-op experiences with knee replacement surgery were analyzed in a study from Kent State University. The researchers identified four stages that patients went through on their way to accepting that they needed knee replacement surgery. The four stages are:
- putting up and putting off
- waiting and worrying
Why Do I Need To See An Orthopedic Surgeon
An orthopedic surgeon treats any kind of musculoskeletal issue, such as a broken bone, sprain or strain, or arthritis. This type of doctor often has an area of expertise some may specialize in spine care, some treat the arms and shoulders, while others may focus on hip and knee replacement surgery.
Every orthopedic physician has had many years of specialized training, including medical school, residency, and usually also a fellowship. Whereas general surgeons handle all types of surgery as necessary, an orthopedist works on the musculoskeletal system and is deeply familiar with the intricacies of the bones and muscles.
The field of orthopedics is growing rapidly, and these surgeons know the latest techniques and technologies for treating these injuries. Some of the biggest reasons why you would want to see an orthopedic surgeon include sports injuries, overuse injuries, joint pain, and arthritis.
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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
How Does Knock Knees Differ From Bowed Legs
Bowleggedness, or genu varum, is a bone deformity where the knees are bowed outward. It is the opposite deformity of knock knees.
Genu varum may be congenital or may be due to an underlying problem with the bone growth. When an infant is born with bowed legs it is called congenital genu varum and usually corrects itself when the child begins to walk at 12-18 months of age.
If the childs legs continue to bow beyond the age of two a doctor should be consulted as they may need further treatment to correct the mal-alignment. Overtime, if left uncorrected, genu varum can lead to early arthritis.
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Do I Need A Continuous Passive Motion Machine
In general, no. However, depending on the circumstances of your surgery, you may benefit from a CPM. If so, most patients will be started on the CPM on the first post-operative day.
The amount of bend will gradually increase while you are in the hospital. Typically, patients will use the machine for 1-2 hours at a time, 2-3 times a day. Except under rare circumstances, you will not need a CPM when you go home.
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Tips On Finding The Best Knee Doctor
When one or both of your knees are suddenly experiencing pain, or if they are not working the way they should, it is in your best interest to see a specialized knee doctor for an examination and possible treatment.
Knee pain and stiffness are two of the most common symptoms that knee doctors treat. The orthopedist will first consider conservative treatments, such as physical therapy and pain-relief injections if nonsurgical treatments do not work in relieving your knee pain, a minimally invasive surgical procedure may be considered and advised. Even total knee replacement surgery can now be performed in a minimally invasive manner.
Lets talk about how to sift through the various knee doctors in Palm Beach County, how to determine who performs what procedures the best and with the greatest results, and where you can go in Boynton Beach for world-class knee care by an orthopedic specialist.
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Protecting Your Knee Replacement
After surgery, make sure you also do the following:
- Participate in regular light exercise programs to maintain proper strength and mobility of your new knee.
- Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery.
- Make sure your dentist knows that you have a knee replacement. Talk with your orthopaedic surgeon about whether you need to take antibiotics prior to dental procedures.
- See your orthopaedic surgeon periodically for a routine follow-up examination and x-rays. Your surgeon will talk with you about the frequency and timing of these visits.
Signs Its Time To See A Doctor For Knee Pain
It may be time to visit an orthopedic doctor if you experience any of the following, especially after an incident like an injury following athletics:
- Redness, warmth, and tenderness in the knee
- Significant swelling
- Inability to bear weight on the affected leg
- Fever
- Physical deformity in the area
Chronic knee pain that is not severe enough to warrant a trip to the emergency room or urgent care may be a sign of a degenerative condition. Osteoarthritis is one of the most common conditions affecting the knee and is a result of age-related changes to the protective cartilage of joints. Osteoarthritis is progressive, meaning it will continue to get worse. If you have to take pain relievers more than a few times a month for knee pain, it is a sign that you should see a doctor.
Also seek medical attention for knee pain that is accompanied by stiffness, swelling, and a limited range of motion. These are signs that an injury or condition exists. Many people ignore such signs, especially as they get older because they think its a part of normal aging. People who are overweight also think its a normal symptom. However, nothing could be farther from the truth. Chronic knee pain, while very common, is not normal. Dont accept it as your fate. There are many treatment solutions available that can reduce or eliminate knee pain.
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A Cpm Machine May Be Used
You may find that you have been scheduled to have your repaired leg strapped into something resembling an old torture device, called a CPM machine. Be thankful. It keeps the joint from stiffening up, and makes getting up and your post-op physical therapy easier in the long run.
This device is a framework with a motor and hydraulic shaft and piston sliding on a track under a cloth covered cradle that supports your lower leg. As it runs, it gently pulls and pushes your leg from bent to extended in a repetitive cycle. I was put into it for two hours twice a day.
Inquire about having one rented for use when you get home if the doctor writes a prescription as medically necessary, most insurance, including Medicare, will pay for it. You must convince your doctor that YOU need the gizmo, and get him to write that prescription.
I neglected to mention this to my doctor, as I did not realize just how helpful it would be. You WILL need strong help at home to use it, thoughthe thing is heavyit always took two nurses to lift it on and off the bedeven guys.
Most Knee Pain Surgery Is Arthroscopic
Most knee surgeries are done by making a few small cuts in the knee. The surgeon inserts tools and a small camera into these cuts to observe what needs to be done. This method of looking at joints, like the knee joint, is called arthroscopy.
The most common types of knee pain surgery include:
- Meniscus surgeries
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Types Of Knee Pain Doctors
Knee pain doctors can come from various different fields of medicine such as anesthesiologists, physiatrists, neurosurgeons, podiatrists, neurologists, primary care physicians, or orthopedic surgeons.
However, broadly speaking, if you are wondering what kind of doctor for knee pain exists, there are three knee pain specialists palliative care specialists, interventional pain and spine specialists, and chronic pain specialists.
As you can see, there are a lot of options when it comes to what doctor to see for knee pain. But you should look for interventional pain specialists because theyre the only ones who can truly diagnose the root cause of your knee pain and provide long-term relief. An interventional pain specialist will use imaging tests like X-Rays, CT scans, and MRIs to determine the root cause of knee pain.
What Activities Will I Be Able To Engage In
Most patients require an assistive device for approximately 3 weeks after knee replacement surgery although this varies significantly from patient to patient.
You will also be able to do low-impact exercise such as riding a stationary bike, walking, and swimming after 68 weeks. Your physical therapist can advise you on introducing new activities during this time.
You should avoid running, jumping, as well as other high-impact activities.
Discuss with your orthopedic surgeon any questions concerning your activities.
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