Why You Might Say Nows The Time
Here are seven signs that the time might be right for a knee replacement:
Getting Back To Normal
It will be some weeks before you recover from your operation and start to feel the benefits of your new knee joint. Make sure you have no major commitments including long-haul air travel for the first six weeks after the operation.
Keeping up your exercises will make a big difference to your recovery time. Youll probably need painkillers as the exercise can be painful at first. Gradually youll be able to build up the exercises to strengthen your muscles so that you can move more easily.
These Questions Have Been Personally Answered By:
Dr. Vedant Vaksha
I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.
Please take a look at my profile page and don’t hesitate to come in and talk.
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Similar Conditions That Affect The Knee
Meniscus tear
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.
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
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Will I Need Knee Surgery For Osteoarthritis
Knee surgery can provide relief from osteoarthritis knee pain, but there are other osteoarthritis treatment options to explore before taking this step.
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More than a million people undergo surgery to replace a knee or hip every year, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. If you have painful knee osteoarthritis, you might be wondering if youll be one of them.
Knee surgery can bring relief for osteoarthritis knee pain, but there are other treatments you should try first that could delay your need for surgery.
Take On Household Chores
Over the next several weeks, the person youre caring for will likely be unable to do anything that involves standing for long periods of time, stretching, or bending.
They may have a hard time completing household chores, preparing meals, or performing other tasks that require them to move from room to room.
Although they may be able to do light chores, like dusting, they wont be able to do any heavy cleaning. This typically means that vacuuming and laundry are out of the question. If possible, take on some of these chores or arrange for outside help.
You may also need to assist with shopping and meal preparation for a while. Consider preparing frozen meals in advance, and asking other friends or family members to drop off meals during the first few weeks of recovery.
Its important that your loved one is eating nutritious foods, taking prescribed medications, and getting plenty of rest immediately after surgery.
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Physical Therapy Proves To Be Unsuccessful
Before recommending surgery, most physicians will first suggest trying physical therapy. It is the least invasive way to recover from a knee injury. The therapists main goal is to get you back on your feet as soon as possible. While physical therapy works for some people, others will ultimately need to have surgery.
Radiofrequency Ablation For Knee Pain
If all of these methods fail to control your knee pain from osteoarthritis, there are still options. Radiofrequency ablation controls pain in the knees by destroying the sensory nerves that carry the pain signal from the knee to the brain.
RFA is likely a temporary fix, as nerves will grow back in six months to two years, and the pain may return.
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Articles On Knee Osteoarthritis
Knee osteoarthritis can affect your every move: walking, climbing stairs, even sitting or lying down. Surgery can help bring relief, but doctors almost always advise trying other treatment options first. These include:
Medications you take by mouth. Over-the-counter options include acetaminophen as well as nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen . NSAIDs fight inflammation. Stronger NSAIDs are available by prescription.
Creams or ointments you rub onto the skin. Different forms are sold over the counter. You can get stronger versions with a prescription.
Medications injected into the joint. Corticosteroid injections, also called cortisone shots, fight inflammation and can offer fast pain relief that may last up to several months. Injections of hyaluronic acid boost the natural joint fluid that keeps knees moving smoothly. They may take up to a couple of months to have their full effect but can last up to 6 months or more.
Exercise and physical therapy. Exercise strengthens the muscles that support your knee. Physical therapy also helps. A physical therapist can design the program for you and see if you need supportive braces, splints, or canes. If you need to lose weight, diet and exercise can help you shed some pounds and take some of the pressure off your knees.
Use Pain Medications With Care
Except in very rare cases, the American Association of Hip and Knee Surgeons advises against using opioid medications for knee osteoarthritis. Opiate pain relievers, in addition to being addictive, are not proven to address knee pain over the long term any better than nonsteroidal, anti-inflammatory drugs .
Though safer than opioid drugs, NSAIDs arent for everyone, and Valaik advises caution in using them. Even over-the-counter drugs like naproxen and ibuprofen can have side effects, so check with your doctor, he says.
You can get an increase in blood pressure with NSAIDs. Larger studies have linked some of these pain relievers with a small increase in the risk of heart attack.
And the more you take, the more likely you are to have heartburn, stomach irritation or even bleeding ulcers, he notes.
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Your Knee Is Always Swollen
Swelling is another sign your knee is not responding to other treatments.
A knee that is consistently swollen despite the use of anti-inflammatory medications, steroid injections and physical therapy suggests degeneration of the cartilage and/or instability of the knee, which can be confirmed with an X-ray, Lieberman explains. This can make you a candidate for a total knee replacement, he says.
How Soon Will I Be Up And About
The staff will help you to get up and walk about as quickly as possible. If you have had minimally invasive surgery or are on an enhanced recovery programme, you may be able to walk on the same day as your operation. Generally, you will be helped to stand within 12-24 hours after your operation.
Walking with a frame or crutches is encouraged. Most people are able to walk independently with sticks after about a week but this can vary depending on the individual.
During your stay in hospital, a physiotherapist will teach you exercises to help strengthen your knee. You can usually begin these the day after your operation. It is important to follow the physiotherapist’s advice to avoid complications or dislocation of your new joint.
It is normal to experience initial discomfort while walking and exercising, and your legs and feet may be swollen.
You may be put on a passive motion machine to restore movement in your knee and leg. This support will slowly move your knee while you are in bed. It helps to decrease swelling by keeping your leg raised and helps improve your circulation.
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An Artificial Meniscus May Soon Be Available
If you are suffering from knee pain following meniscus surgery or are without viable treatment options, the NUsurface®Meniscus Implant may provide an alternative option, once it has approval from the U.S. Food and Drug Administration. NUsurfaces design mimics the function of the natural meniscus and redistributes weight across the knee joint. The implant is made from medical grade plastic and, as a result of its unique materials, composite structure, and design, does not require fixation to bone or soft tissues.
NUsurface can potentially address the treatment gap of those who are too old for meniscus repair and too young for total knee arthroplasty. U.S. clinical trials completed enrollment in June 2018, and the company expects to file for U.S. Food and Drug Administration approval soon.
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.
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What Is Recovery Like
You can start moving the knee the day of your surgery. Your knee function should return rapidly and with less pain than with total knee replacement. Youll work with a physical therapist to mobilize the knee while in the hospital and for two to four weeks after discharge. Youre usually discharged no later than one or two days after surgery.
Youll need medication to guard against formation of a blood clot while in the hospital and maybe for a period of time after youre discharged.
If all goes well, you should be back to full activity in about six to eight weeks. Impact exercises or jogging/running may not be recommended because the replacement includes a bearing surface that can wear. However, activities like tennis, skiing, and other sports are okay. This, of course, is why partial knee replacement is even being considered to return you to activities you enjoy.
Last reviewed by a Cleveland Clinic medical professional on 12/16/2020.
References
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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Providing Better After Care For Patients
We’re funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as ‘at risk’ by this approach. This study would enable us to deliver better and more streamlined after care for patients.
No 5 Post Surgery Pillow For Leg Elevation
Weve already mentioned the I and C of the acronym RICE in ice and compression. Lets take a look at the E elevation.
For elevation youll have a few options. The easiest option is to stack a few pillows from your bed and place your leg on top. This is effective but consider a few things.
Leg pillows for post-surgery are a common item purchased after knee replacement surgery. They are long enough for the whole leg, provide adequate cushion but more support than a traditional pillow, and best of all they are relatively inexpensive.
If you want to read more, I found the best wedge pillow for after knee replacement and wrote about it.
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Youre Ok With Avoiding Certain Activities Afterward
Patients should know what to expect after knee replacement surgery and understand that regular high-impact activities may not be advisable.
Total knee replacement is quite successful in enabling patients to return to an active lifestyle patients can perform all types of recreational activities, including hiking, bicycling, skiing, surfing, tennis and golf, Lieberman says. In general, we do not limit activities but suggest that patients avoid impact activities on a consistent basis to reduce wear of the prosthesis.
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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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.
What Is Partial Knee Replacement
A partial knee replacement is an alternative to total knee replacement for some people with osteoarthritis of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee. In a partial knee replacement, only the damaged part of the knee cartilage is replaced with a prosthesis.
Once partial knee replacement was reserved for older patients who were involved in few activities. Now partial knee replacement is often done in younger people as their recovery is quicker and usually less painful. About 5% to 6% of people with arthritic knees are estimated to be eligible for partial knee replacement.
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How Do I Know If I Need Knee Replacement Surgery
If you have a knee which is causing pain, instability or stiffness and these symptoms are affecting your everyday life it may be that you are a suitable candidate for knee replacement surgery.
In this blog, we will assess when knee replacement surgery can be the best treatment option and run through some of the key benefits of the procedure. But before we do that, well look at the main types of knee replacement surgery.