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Who Does Knee Replacement Surgery

Walking Around After A Knee Replacement

Knee Replacement Surgery | What to Expect

To help make your recovery go as smoothly as possible, we need to start getting you active and mobile as soon as youre able. We understand you may be nervous about getting up for the first time, but well be there to help you whenever youre ready. Getting mobile is all about confidence, which is why we help you to progress through a range of walking aids until youre independent.

  • Day of surgery: A physiotherapist will give you some exercises to do while youre in bed to help your new knee joint move and strengthen the muscles around it. Then theyll help you to get out of bed and start taking your first steps with a frame this is to prevent stiffness and maintain a healthy circulation.
  • Day after surgery: Youll have an X-ray to check the position of your new knee, as well as some routine blood tests. If you havent started walking around yet, the physiotherapist will help you with this otherwise youll continue practicing to walk using a frame with your nurse until you can do so on your own.
  • Second and third day after surgery: An occupational therapist will give you some tips for washing, dressing and getting on and off the bed, chair and toilet. The physiotherapist will help you transfer to crutches or a walking stick, before giving you some more exercises to increase your movement.

What Are The Major Complications

Total knee replacement is primarily a pain relieving procedure however it may not relieve all pain with possible residual stiffness and swelling. Although complications are relatively rare , patients may experience a complication in the postoperative period. These include very serious and possibly life threatening complications such as heart attack, stroke, pulmonary embolism and kidney failure. Stiffness or loss of motion can also occur. Infection is one of the most debilitating complications and often requires prolonged antibiotics with several additional surgeries to rid the infection. Blood clot in the leg is another possible complication requiring some type of blood thinner following surgery to reduce the incidence. The implants can also fail over time due to wear or loosening of the components. But this generally occurs many years after surgery.

Traditional Total Knee Replacement

In a traditional knee replacement, the surgeon cuts into the quadriceps tendon, which connects the quadriceps muscles on the front of the thigh to the kneecap. The orthopedic specialist then moves the kneecap aside to have clear access to the knee joint.

The orthopedic surgeon removes damaged bone and cartilage from your thighbone, shinbone and kneecap, then replaces it with an artificial joint made of metal and wear-resistant plastic.

Most people can walk without crutches or a cane six weeks after surgery. But it may take up to three months for pain and swelling to completely subside. Recovery of full strength is gradual and may take up to 12 months.

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Medical Issues To Consider

Prior to the operation, you will need to discuss a range of issues with your doctor or surgeon, including:

  • Thorough assessment of your knee joint, which may include x-rays and other imaging techniques.
  • Your medical history. If you are elderly, you will need to undergo tests to make sure you are fit for the operation. These tests may include an electrocardiogram and blood tests.
  • Inform your doctor about any drugs you may be regularly taking, particularly drugs that affect the bloods ability to clot such as aspirin or Warfarin.
  • Your expectations you need to understand that although the prosthesis is sophisticated, it cant replicate the full function of a healthy knee joint.Possible complications of surgery will also be discussed.

Other Forms Of Treatment

WATCH: A Total Knee Replacement Surgery Procedure

Without replacement surgery, a severely osteoarthritic knee joint may continue to deteriorate until it is impossible to go about your normal daily activities, such as standing up, walking or getting up from a seated position. Other forms of treatment include:

  • The use of walking aids, such as frames or walking sticks
  • Non-steroidal anti-inflammatory drugs
  • Corticosteroid injections
  • Other surgery, such as osteotomy an operation in which diseased bone is cut away in an attempt to properly align the malformed joint.

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Which Type Should I Have

Your surgeon will discuss this with you. It will depend on how much of your knee is affected by arthritis – it may not be possible to know this until your surgeon has started your operation.

If you have a partial knee replacement it is more likely that you will need to have it done again, than if you have a total knee replacement . Sometimes the reason for choosing to have a partial knee replacement is that it leaves the option to have a TKR at a later date. However it’s also more likely that you will need to have your total knee replacement re-done, if you had a partial knee replacement done before having your total knee replacement.

There are over 150 different designs of knee replacement and some of the differences between all the different types and makes of knee replacement parts aren’t known, particularly how they perform in the long term. In many countries, registries have been set up so that anyone who has had a knee replacement is entered into the register. The information collected is used to monitor how their replacement is performing. In the UK, patients also enter information about their health and quality of life before and after their operation.

A study of over 500 patients with osteoarthritis of the inner part of their knee has compared the effectiveness of total and partial knee replacement. The two groups were followed up five years after surgery, and asked to complete questionnaires about pain, activity and day-to-day living.

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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Who Is Offered Knee Replacement Surgery

A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, have not reduced pain or improved mobility.

You may be offered knee replacement surgery if:

  • you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced
  • your knee pain is so severe that it interferes with your quality of life and sleep
  • everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
  • you’re feeling depressed because of the pain and lack of mobility
  • you cannot work or have a social life

You’ll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.

What Is A Knee Replacement Surgery

Why does my knee cap hurt after 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.

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Time Off Work After A Knee Replacement

Its important to take time off to rest, but getting back to your routine as soon as possible can help you recover faster. If you have a desk job, youll be able to return to work after around 8 weeks. If you job is more physically demanding, youll need to wait around 12 weeks. If youre not sure, check with your doctor.

What To Expect After Knee Replacement

Most people report feeling relatively comfortable immediately after the procedure and even better the next day. However, achiness and an uptick in pain may occur a few days later. Your care team should equip you with medications and techniques to get over the hump and effectively manage your pain level.

The recovery progresses from there:

  • Physical therapy: Usually, patients do physical therapy 2-3 times per week for 4-6 weeks.
  • Walking aids: Patients who had partial knee replacement may only need a walker or cane for a day or so after leaving the hospital, while full replacement patients may need one of these aids for a week or two.
  • Driving: Around three weeks, you can start driving , and six weeks after replacement, most patients can return to normal activity.
  • High impact activity: Patients often keep improving up to a year after the procedure, but you should plan to avoid high impact activities like running, basketball and skiing moguls.

Though there is some discomfort and work involved in the days and weeks after knee replacement, the vast majority of people find the lasting pain relief and ability to move better well worth it.

If youre not sure whether knee replacement is the right option for you, find an orthopedic expert to help answer your questions.

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What Is The Disability Rating For Knee Surgery

The VA rates knee replacements under 38 C.F.R. § 4.71a Code 5055. The rating criteria ranges from 100 percent to 30 percent disabling. The 30 percent rating is the minimum rating for a knee replacement, meaning if you had a knee replacement and it is service-connected, you will be rated at least at 30 percent.

What Are Knee Replacement Implants Made Of

Total Knee Replacement Surgery

The selection of knee replacement prosthesis design and materials depends on each individual patient. The main implant components are made of metal â usually titanium or chrome-cobalt alloys. The implants are fixated in place either with a cement bonding agent or by osseointegration, in which a porous metal stem extends into the tibia and the patient’s natural bone grows into it. A plastic platform or spacer will be inserted between the tibial and femoral implant surfaces. The spacer is made of polyethylene.

Most femoral components are made of metal alloys or metal-ceramic alloys . The patellar component is plastic . The tibial insert component is also plastic . The tibial tray component can be made of the following materials:

  • cobalt chromium

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Why Choose Jefferson For Knee Replacement Surgery In Philadelphia

Knee replacement surgeries at Jefferson are performed by orthopedic surgeons who set the standards of care for knee replacements. Our Joint Replacement Program is one of the nation’s most prestigious, reflected in an impressive volume of more than 6,700 joint replacement surgeries performed annually.

We are reimagining diversity and inclusion to promote and cultivate an inclusive environment that celebrates the differences and similarities of our patients, families, students, workforce and the communities we serve to achieve an equitable culture.

The Web site for Thomas Jefferson University Hospitals, its contents and programs, is provided for informational and educational purposes only and is not intended as medical advice nor, is it intended to create any physician-patient relationship. Please remember that this information should not substitute for a visit or a consultation with a healthcare provider. The views or opinions expressed in the resources provided do not necessarily reflect those of Thomas Jefferson University Hospitals, Thomas Jefferson University or their staffs. By using this Web site, you accept these terms of use. Please read our online privacy statement. Please read our privacy practices.

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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Understanding Total Knee Replacement

The knee is a hinge-like joint. It is formed where the thighbone , shinbone , and kneecap meet. It is supported by muscles, tendons, and ligaments. It is also lined with cushioning cartilage. Over time, cartilage can wear away. As it does, the knee becomes stiff and painful. A knee prosthesis can replace the painful joint and restore movement.

Recognizing The Signs Of A Blood Clot

How long does the pain last after a knee replacement?

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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A Lot Of Physiotherapy Is Needed Afterwards

Physiotherapy is certainly needed afterwards, usually 6-8 sessions, but well performed surgery makes the physiotherapists job much easier as movement is regained quickly and strengthening of muscles occurs more quickly.

It is important that your surgeon also partners with you in your rehabilitation and recovery. This should involve reviewing your progress and identifying what is amiss if things are going more slowly than usual to help you get back on track. Liaison with your physiotherapist as necessary is also important.

When movement is not regained as quickly as necessary it is sometimes necessary to manipulate the knee under a brief anaesthetic. This should not be needed very often. As a guide, Mr Sood manipulates on average one of his knee replacements a year . High rates of manipulation are more common with knee replacements that are performed by non-specialised Orthopaedic surgeons.

Ial Vs Total Knee Replacement Surgery: What You Need To Know

Are you part of the .2%? Each year, thousands of people in the United States have knee replacement surgery about 600,000 to be exact, according to the Agency for Healthcare Research and Quality. Robert L. DeMaagd, MD, specialist with the Total Joint Center at Orthopaedic Associates of Michigan, sees his fair share. I do close to 300 knee replacements each year, says Dr. DeMaagd. That includes both partial and total replacements.

Who is a candidate for knee replacement? According to Dr. DeMaagd, most knee replacement patients are between 55-75 years old. Typically knee replacement surgery is done for chronic osteoarthritis of the knee joint that has not been successfully treated with non-operative means like medication, bracing, injections, and physical therapy, he explains. Arthritis is an inherited trait, so for most people, its just a genetic wearing out of the joint.

Time to move on Many of these non-operative treatments can be good for mild to moderate arthritis, and you can go for years without joint replacement surgery, Dr. DeMaagd says. But after a while, those measures just dont work. You have to move on to something else. Thats when patients typically contact OAM. If the knee pain and stiffness are affecting a patients quality of life or getting in the way of normal daily activity, the patient is probably a good candidate for a knee replacement, says Dr. DeMaagd.

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How Well It Works

Most people have much less pain after knee replacement surgery and are able to do many of their daily activities more easily.

  • The knee will not bend as far as it did before you developed knee problems. But the surgery will allow you to stand and walk for longer periods without pain.
  • After surgery, you may be allowed to resume activities such as golfing, riding a bike, swimming, walking for exercise, dancing, or cross-country skiing .
  • Your doctor may discourage you from running, playing tennis, squatting, and doing other things that put a lot of stress on the joint.

The younger you are when you have the surgery and the more stress you put on the joint, the more likely it is that you will later need a second surgery to replace the first artificial joint. Over time, the components wear down or may loosen and need to be replaced.

Your artificial joint should last longer if you are not overweight and you do not do hard physical work or play sports that stress the joint.

People who have a partial knee replacement may have less pain. But in one study they were not as satisfied as people who had a total knee replacement.footnote 1

If you wait to have surgery until you have already lost a lot of your strength, flexibility, balance, endurance, and ability to be active, then after surgery you might have a harder time returning to your normal activities.footnote 1

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