Its Not My Knee Replacement That Is The Problem It Is My Other Knee Expanding On The Other Knee Problem
In Australia, doctors at the University of Wollongong, examining why patients who should be able to kneel after knee replacement, did not kneel, wrote in the Journal of Orthopaedics and Traumatology , about the problems of the other, non-replaced knee.
Here is what they found:
- Seventy-two percent of patients in this study could, or thought they could kneel at 12 months post knee replacement
- However, some did not because of the pain and discomfort they felt during kneeling.
- BUT, it was not the pain and discomfort in the replaced knee, 75 % of the patients in this study had other health concerns why they could not kneel including obesity, other health problems, but the number one reason was problems with the other knee.
They Rushed Into Surgery
There are times when getting stronger and exercising can help get rid of knee pain, but sometimes people jump into surgery when more conservative measures may have worked better for them, says Jasmine Marcus, a physical therapist with McCune and Murphy Physical Therapy.
What you can do: Marcus recommends exercising and building strength, enlisting the help of a physical therapist if necessary.
Even if you still end up needing surgery, getting stronger can help. Performing prehab exercises and getting the bodynot just the leg in questionas strong as possible tends to improve outcomes after surgery, says Tom Biggart, a physical therapist, athletic trainer, and strength and conditioning coach with EBM Fitness Solutions.
So What Does This Mean For Me And My Terrible Joint
When a hip or knee joint is “worn out” and conservative treatments arent helpful enough, there arent many good options. So, this new study wont necessarily change how often surgeries are performed or who gets them. On the other hand, having this information is valuable. And based on the numbers published in this new report, some people may decide to delay or even forego surgery.
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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
Will We Face A Shortage Of Artificial Joints In The Future
Unfortunately, the demand for joint replacement surgery may soon outpace the availability. There are plenty of artificial joints — no shortage there. But there may not be enough qualified surgeons to implant them. Fewer medical students and residents are going into orthopedic surgery, says Bostrom, and joint replacement is not that popular a subspecialty within the field. “Many people would rather go into spine and sports medicine, which are much more lucrative,” he says. “There’s clearly going to be a lack of qualified people doing joint replacements, there’s no doubt about that.”
A look back at the projected growth in joint replacement surgery backs him up. Another study presented at the 2006 American Academy of Orthopaedic Surgeons’ meeting compared the number of anticipated surgeries with the number of surgeons expected to be available in 2010, 2020, and 2030. In two years, it found, the mean annual caseload per surgeon will be about 52 surgeries annually. By 2030, the annual caseload should triple to 167.
But career paths often veer to meet a huge demand, and it’s possible interest in orthopaedic surgery will increase as demand grows. If not? Expect to plan your joint replacement a few months — or even a year — in advance.
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People Should Be Able To Kneel After Knee Replacement Why Arent They Research: It Has Nothing To Do With The Knee Replacement
Lets look at a January 2019 study in the Journal of Knee Surgery. It comes from the Department of Orthopaedic Surgery, Johns Hopkins University.
Here are the summary points:
- The ability to kneel is one of the many patient goals after total knee replacement.
- Given the altered biomechanics of the knee after total knee replacement, the various implant designs, and multiple surgical approaches, there is a need to further understand the patients kneeling ability after total knee replacement.
- In patients who do kneel after surgery, data show that increased range of motion promotes improved kneeling performance. Targeted interventions to encourage kneeling after total knee replacement, including preoperative education, have not shown an ability to increase the frequency with which patients kneel after total knee replacement.
- Reasons for patient avoidance of kneeling are multifaceted and complex. There is no biomechanical or clinical evidence contraindicating kneeling after total knee replacement. There are insufficient data to recommend particular prosthetic designs or surgical approaches to maximize kneeling ability after surgery. Musculoskeletal health care providers should continue to promote kneeling to allow patients to achieve maximum clinical benefit after total knee replacement.
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.
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.
Hip and Knee Replacement at Johns Hopkins
The Johns Hopkins Hip and Knee Replacement program features a team of orthopaedic specialists highly skilled in joint replacement procedures. Our team will guide you through every step, from presurgical education to postsurgical care and physical therapy. Our goal is to return you to your desired level of activity as soon as possible.
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Total Knee Replacement In Younger Active Patients
Total Knee Replacement in Younger Active Patients
In years past the typical joint replacement patient was quite elderly and sedentary. the goal was to relieve day to day pain, not to improve athletic activities. waiting until patients were older also reduced the chance of needing a revision in the patients lifetime. In recent years however, younger patients are undergoing elective knee replacement in higher numbers. About 50 percent of total knees being done in the US are now between the ages of 45 to 64, and this is the highest growth area. Younger patients are less satisfied with a sedentary life. They want more physical activity in their lives. They are seeing friends who have become active again after a knee replacement, and they want the same. Some people build their social life around tennis or golf. I have an large group of senior softball players, all with total knees, who love to play all week long during their active retirements. This is what gives these people pleasure in life so why not replace a painful joint that limits your abilities to enjoy!
Many young knee replacement patients started out with a knee injury years ago. A torn meniscus or torn ACL ligament led to one or more knee surgeries- each with a period of rehabilitation. Now 20 years later, the knee cartilage has been worn down, and areas inside the knee start to grind. This leads to swelling and pain with activities. Scoping the knee again just cant replace the missing cartilage surfaces.
How Can We Help These Problems The Often Overlooked And Ignored Cause Of Knee Instability And Possible Causes Of Inability To Kneel After Knee Replacement The Knee Ligaments
When a knee replacement is performed, the joint itself has to be stretched out so the surgeons can cut out bone and put it in the prosthesis. When the joint is stretched out, the knee ligaments and tendons that survive the operation will cause pain as they heal from the surgical damage. Sometimes the ligaments and tendons heal well. Sometimes they do not heal as well.
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Risks Of Knee Replacement Surgery
Knee replacement surgery is a common operation and most people do not have complications. However, as with any operation, there are risks as well as benefits.
Complications are rare but can include:
- stiffness of the knee
- infection of the joint replacement, needing further surgery
- unexpected bleeding into the knee joint
- ligament, artery or nerve damage in the area around the knee joint
- persistent pain in the knee
- a break in the bone around the knee replacement during or after the operation
In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.
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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What Happens During Knee Replacement Surgery
During the surgery, a surgeon removes damaged cartilage and some bone from the surfaces of your knee joint. Cartilage is tissue that covers your bones where they meet. Healthy cartilage is smooth and helps the bones glide over each other when you move. When cartilage becomes rough and wears away, the bones rub against each other, causing pain.
After removing the damaged knee cartilage and bone, the surgeon attaches the artificial parts to your bones. The artificial parts are made of metal and plastic. They will give your knee new, smooth surfaces.
Knee replacement surgery may replace all the damaged parts of your knee or just part of your knee . In a total knee replacement, the surgeon replaces 3 surfaces:
- The end of the shinbone
- The end of the thighbone
- The back of the kneecap
Added Health Benefits Of Knee Surgery
Knee replacement surgery doesnt only reduce pain and make it easier for you to get around.
Staying active is crucial for good health. A knee replacement may make it easier for you to get regular exercise. This can help manage or prevent obesity, cardiovascular disease, diabetes, osteoporosis, and many other health conditions.
Strong knees also offer more support and stability, so there is less chance of having a fall.
Most peoples insurance will cover the cost of knee surgery, as long as a doctor says it is necessary. If you are not sure, check with your insurance company.
Even with insurance, however, there may be other costs, such as:
- deductibles
- coinsurance or copays
You may also need to pay for transportation, care in the home, and other items.
Knee replacement surgery can be expensive if you dont have insurance, but prices vary. You may get a better deal in a different city, state, or medical center.
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Who Should Consider Total Knee Replacement Surgery
It is usually reasonable to try a number of non-operative interventions before considering knee replacement surgery of any type. Prior to surgery an orthopedic surgeon may offer medications knee injections or exercises. A surgeon may talk to patients about activity modification weight loss or use of a cane.
The decision to undergo the total knee replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of knee pain. When basic activities of daily life–like walking shopping or reasonable recreational pastimes–are inhibited or prevented by the knee pain it may be reasonable to consider the surgery.
Doctors Dont Know Who Can And Who Cant Kneel After Knee Replacement
A February 2021 study comes to us from the Australian National University. In this paper, the researchers suggest that despite patients desires to kneel after knee replacement, there is no evidence or guidelines to offer patients on which knee replacement hardware would be best for them. Here is what the researchers wrote in the journal Knee Surgery, Sports Traumatology, Arthroscopy.
Modern total knee replacement prostheses are designed to restore healthy kinematics including high flexion . Kneeling is a demanding high-flexion activity. There have been many studies of kneeling kinematics using a plethora of implant designs but no comprehensive comparisons. . .The aim of this systematic review was to determine whether there are any differences in the kinematics of kneeling as a function of total knee replacement design.
In this study, the researchers examined 26 previously published articles on different knee replacement implant designs. What they found were limited findings. Too many designs, too many differently conducted studies. What does this mean to the patient who asks their surgeon about their ability to kneel after knee replacement? The researchers concluded: There remains a need for high-quality prospective comparative studies to directly compare designs using a common method. In other words, we cant tell you for sure.
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How Long Will It Be Before I Feel Normal
You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery. However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear.
Your new knee will continue to recover up to 2 years after your operation. During this time, scar tissue will heal and muscles will be restored by exercise.
Even after you have recovered, it is best to avoid extreme movements or sports where there is a risk of falling, such as skiing or mountain biking. Your doctor or a physiotherapist can advise you.
What Happens After Knee Replacement Surgery
Some people go home the same day they have surgery. Other people will stay in the hospital a few days. To help prevent blood clots, you’ll most likely take blood thinners and wear special socks or coverings on your legs for a short time after surgery.
The success of your surgery depends a lot on what you do at home to help yourself recover. A physical therapist will teach you exercises to make your knee stronger and help it bend. It is important to do these exercises regularly. You may need to use a cane or walker for several weeks after the surgery. It will probably also be several weeks before you can drive. Your doctor will tell you when you can start driving again.
Most people who follow their recovery instructions can get back to nearly all of their normal daily activities within 3 to 6 weeks after surgery.
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Why You Might Say Nows The Time
Here are seven signs that the time might be right for a knee replacement:
New Hip And Knee Replacement Data
A recent study examined how long knee or hip replacements last, and how their durability is affected by the persons age at the time of surgery. As published in the April 2017 edition of the medical journal The Lancet, researchers found that:
- Among more than 60,000 people who had a hip replacement, only 4.4% required revision surgery in the first 10 years after surgery, but by the 20-year mark, 15% required revision.
- Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery by 20 years, 10.3% required revision.
- Age did matter. Of those over 70 having hip or knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%. But this risk was much greater in younger individuals, especially for men. Up to 35% of men in their early 50s required a second operation.
Some orthopedic surgeons might scoff at these findings and say, “My patients do better than those in in this study.” And that may be true. But increasingly, hospitals and surgeons are being required to make public their results, so if youre considering hip or knee replacement and your surgeons results are truly better, or worse, than average, hopefully youll be able to find out.
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