Knee Meniscus Repair Surgery
Sometimes, a meniscus tear happens in a portion of the meniscus that has better blood supply. In this case, the doctor may choose to repair the torn meniscus with an arthroscopic procedure. .;
This may be more beneficial to the patient, as it could decrease their risk of future arthritis by not having to remove a portion of the meniscus, but the recovery is typically longer.;
Find The Best Knee Replacement Implant: Top Brands
There are more than a dozen manufacturers of artificial knee implants. However, like anything else, some knee implant manufacturers have a larger market share than others. In the US, the most popular knee replacement parts manufacturers are Zimmer , Stryker, DePuy and Smith & Nephew.
Here are the top brands and styles used by surgeons in the US.
Zimmer is the most popular manufacturer of knee replacements. In fact, according to Zimmer, more than 25% of knee replacements implanted worldwide are a Zimmer product. Thats a whole lotta implants!
Biomet, who has recently merged with Zimmer and is now called Zimmer Biomet, offers a nickel-free implant for those with allergies. They also offer an antioxidant polyethylene material insert component to pair with their tibial and femoral parts. In saything this, there is nothing to prove that antioxidant plastic holds any true benefit. Admittedly, it sounds pretty good though!
Among the most popular manufacturers in the US, Stryker offers total, partial, and revision knee replacement systems that are suitable to a wide variety of patients. Stryker implants are used in over 100 countries.
Smith & Nephew offers a wide range of replacement variations that fall under their Legion family. This includes replacements made from oxidized zirconium, a nickel-free metal thats suitable for patients with metal allergies.
Knee Replacement Alternatives To Consider
Crunching sounds as you climb stairs, chronic aching and swelling: Knee osteoarthritis is a real pain. If youre suffering with it, you may be considering surgery.
Getting a knee replacement is one approach, but you may not need surgery, at least not right away. ;And some patients cannot undergo knee replacement surgery for various reasons. Other people with knee pain are too young for a knee replacement the artificial knee is only likely to last 15 or 20 years, after which the person may need revision surgery.
There are several things you can try first, on your own or with a professionals help, that can help with knee pain and even delay the need for replacement, says Daniel Valaik, M.D., orthopaedic hip and knee specialist at Suburban Hospital in Bethesda, Maryland.
Arthritis doesnt go away, he explains. Of the thousands and thousands of patients Ive treated, Ive never seen anyones X-rays improve in terms of arthritis, unfortunately. But there are things you can do to lessen pain and stay more active.
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The National Joint Registry
The National Joint Registry collects details of knee replacements done in England, Wales, Northern Ireland and the Isle of Man. Although it’s voluntary, it’s worth registering. This enables the NJR to monitor knee replacements, so you can be identified if any problems emerge in the future.
The registry also gives you the chance to participate in a patient feedback survey.
It’s confidential and you have a right under the Data Protection Act to see what details are kept about you.
What Is Knee Replacement Surgery
Knee replacement is where portions of the bones that form the knee joint are removed and replaced with artificial implants. It is performed primarily to relieve knee pain and stiffness caused by .
Most people who get this surgery have advanced knee arthritis, in which the knee cartilage is worn away and the surface of the knee becomes pitted, eroded, and uneven. This causes pain, stiffness, instability and a change in body alignment. Knee replacement surgery can also help some people who have a weakened knee joint caused by an injury or other condition.
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Lose Weight To Lessen Stress On Your Knees
Number one on Valaiks list of ways to reduce;knee pain;and delay knee replacement: reaching and maintaining a healthy weight.
Extra weight puts pressure on the knees and increases stress on the joint, increasing pain and making it hard to exercise, Valaik explains.;Research;compiled by the;Johns Hopkins Arthritis Center;confirms that carrying extra pounds raises your risk of developing knee arthritis and speeds up the destruction of cartilage that cushions the joint.
I know its not easy, he says, but losing weight really helps, whether youre dealing with arthritis in one or both knees. If you are overweight or obese, consulting with a nutritionist or a bariatric specialist may be the right place to start.
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.
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What Is A Total Knee Replacement
Total knee replacement is a type of surgery to replace a damaged knee joint. A minimally invasive surgery uses a smaller cut than a traditional total knee replacement. This type of surgery typically requires special tools so that the surgery team can see and do the procedure through the smaller incision.
The knee has several parts: the lower end of the thigh bone , the upper end of the shin bone , and the kneecap . A smooth substance called cartilage caps the ends of these bones and keeps the bones from grinding together. When there is damage to the knee joint, these bones may scrape together abnormally and cause pain.
During minimally invasive total knee replacement, your surgeon makes an incision to access your shinbone and thigh bone. Next, he or she removes a portion of the bones that make up the knee joint. Your surgeon replaces these bone parts with metal components that recreate the joint surface. A layer of plastic is placed between the metal components for smooth gliding.
Minimally invasive total knee replacement often takes place under general or spinal anesthesia.
Knee Replacement Surgery | Q&A with Savya Thakkar, M.D.
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
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After Knee Surgery Can You Still Be An Athlete
Remember this saying: Once an athlete, always an athlete? Expect to modify your choice of sports and activities as well as modify your intensity of play.
Believe it or not, you can enjoy sports and activities that allow you to compete at a high level against good competition.
As far as I know, athletes dont get special knee replacements. But I do think that athletes understand the benefits of hard work and that they will have a distinct advantage when rehabbing their knee.
An athlete will remember all those training sessions and time spent in the weight room that paid dividends when they were younger.
I have a friend my age that has had two knee replacements and he still plays basketball 2 times a week.; Another acquaintance who has had two TKR surgeries plays 100 games a year of softball on a 65-years and older team.
I prefer to continue to swim, bike, and hike, play golf and pickle-ball . I prefer to watch the younger generation compete with more strenuous competition like running, football, basketball, soccer, and baseball.
Water Sports And Athletes
Will you be able to participate in water sports? You bet!
In fact, water sports might be your best option after TKR surgery. If youre a swimmer you should be able to use all the strokes .
Water therapy is great for the leg because very little pressure is placed on the joint. It helps with strength and stretching.
Athletes can expect to swim laps, snorkel, scuba dive, play water polo, water aerobics, and dive. Other sports like wakeboarding and water skiing put much more pressure on the legs and should be discussed with your doctor.
After TKR Im able to kick with or without a kickboard pain-free and, like the leg machines in the gym, I can feel the burn in my muscles around the knee.
Before TKR I was able to paddleboard in the bay near my house but I could not stand for long periods of time. Now I am more comfortable standing longer and I am able to spend more time paddle boarding.
The same is true for snorkeling and bogey boarding. Before TKR I was unable to use fins on my right knee because of the pain and crunching. Now I snorkel and swim using fins with no problem.
I have a friend who still surfs after having TKR on both knees. However, I dont think I could pop up to a standing position anymore so surfing is no longer on my list of activities.
Getting up on the paddleboard takes some work but I can do that slowly.;
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Types Of Knee Replacement Implants
According to;Dr. Trevor North;orthopedic surgeon, Most surgeons use one style of implant for a significant majority of knee replacement cases. Only about 10% of total cases may require a different style of implant. He adds, There are certain nuances and different tools for each implant. You want a surgeon who is very familiar with the style of replacement you are receiving.
The most common type of knee replacements is called a single radius knee. Its commonly accepted that this type of implant offers the greatest level of extension and flexion for majority of patients, regardless of age, gender, activity level and so forth.
Other variations in the type of replacement received are fixed bearing and mobile bearing. This has to do with how the plastic insert locks into the tibia component. Majority of replacements are fixed bearing, meaning that the plastic insert is locked into the metal tibial plate. In a mobile-bearing knee, the plastic insert in the tibial component can rotate inside the tibial tray. An overwhelming majority of the replacements produced by the various manufacturers are classified as single radius, fixed bearing implants.
Rising Number Of Knee Replacement Surgeries
When medications, therapies and other treatments dont work, surgery is the next step to reclaiming mobility. A total knee replacement can get a patient back to work or back to a better quality of life.
The amount of knee replacement surgeries continue to grow in the U.S. and are projected to near 3.5 million procedures each year by 2030. This significant increase, in large part, can be attributed to the growing number of baby boomers reaching retirement age when the chance of a worn-out joint is higher and a rise in obesity and an increased need for follow-up procedures .
Most patients who undergo total knee replacement are between 50 and 80, but recommendations for these procedures are based on a patients pain and disability, not age.
As the number of knee replacements has increased, so has the number of problems reported with knee implants. Manufacturers have issued nearly 1,000 knee replacement recalls since 2003. But not all defective implants were included in those recalls.
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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
Looking For Alternatives To Total Knee Replacements
We’re also funding research which is investigating alternative approaches to total knee replacement. For example, total knee replacement is not recommended for many young people. This study aims to develop a new method called ToKa®, which uses images of;the patient’s joint and specially designed software to design a patient specific implant that will be made via 3D printing. If successful, this technique could prevent osteoarthritis patients from needing total joint replacement.
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Care After The Operation
Please give some thought as to how you will be looked after once you have had the operation, well in advance. Most people like to be independent, but you are going to need support with day-to-day activities for a while. If you have an able-bodied partner, this might fall to them, but otherwise you may need a friend or relative to come to stay with you for a while. Some people may arrange to stay in a care home until they have their mobility and independence back.
Types Of Knee Surgery For Arthritis Treatment
There are several different types of surgery offered to treat knee arthritis. Which surgery, if any, is recommended will depend on several factors, such as the patients age, anatomy, general health, lifestyle, and personal preferences, as well as the surgeons experience and preferences.
Total knee replacement surgery involves cutting the damaged ends of the tibia and femur and capping both with prostheses. ReadUndergoing Total Knee Replacement for Knee Arthritis
Patients with moderate to severe knee arthritis who have exhausted non-surgical treatment options might consider replacing the entire knee joint. The surgery involves cutting the arthritically damaged ends of the tibia and femur and capping both with prostheses .
The two prosthetic pieces are made of either metal or a durable plastic called polyethylene. These new surfaces move smoothly against one another, creating a functional knee joint. Partial recovery typically takes 4 to 6 weeks1 and full recovery may take a few months to an entire year.
Total knee replacement surgery provides most patients with pain relief and improved knee joint function. However, a replacement knee is not as strong and durable as a healthy knee, and patients are strongly advised not to engage in high-impact activities that may speed up the wear-and-tear of the new joint.
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Titanium And Titanium Cobalt
Pure titanium is not used nearly as commonly as titanium cobalt. Titanium joint replacement is used as frequently as cobalt-chromium alloys. Titanium alloys are biocompatible, will not corrode, nor change inside the body. Titanium cobalt is more elastic and favorable to the natural bone surrounding the implant. Since this metal is softer, it tends to make up the tibial part of the replacement where the plastic inserts lock-in. In the tibial component, the metal choice is less important since there is little traction or rubbing during movement.
Who Might Need A Knee Replacement
Knee surgery may be suitable for patients who experience:
- Severe knee pain or stiffness that prevents them from carrying out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair
- Moderate but continuous knee pain that continues while sleeping or resting
- Chronic knee inflammation and swelling that does not improve after taking medications or resting
- Knee deformity, where there is a noticeable arch on the inside or outside of the knee
- Depression, resulting from an inability to carry out daily or social activities
If the other available treatment options have not worked, surgery may be the best option.
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When Its Time For Knee Replacement Surgery
Knee arthritis can get worse in spite of treatment. If youve tried these methods and are still dealing with pain, it might be time to discuss knee replacement with an experienced orthopaedic surgeon. Total knee replacement is a major procedure, but it can offer better quality of life and improved mobility that last for many years.
A total knee replacement is more of a resurfacing of the bones in the knee: the end of the femur , the top of the tibia and the inward facing surface of the patella, or kneecap. The surgeon removes the bony surfaces and replaces them with metal and plastic implants. The plastic serves the same purpose as the cartilage, helping the implants glide against each other smoothly.
Valaik notes that there are constant innovations in the field of knee replacement. For instance, more surgeons are using regional anesthesia for the procedure, which can mean a shorter hospital stay compared with when general anesthesia is used.
New multimodal pain approaches, surgical techniques and physical therapy after these surgeries are all improving a patients knee replacement experience, he says.
Hip and Knee Replacement at Johns Hopkins