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.
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.
How Do I Prepare For Knee Arthroscopy
Your doctor or surgeon will advise you how to prepare for your surgery. Be sure to tell them about any prescriptions, over-the-counter medications, or supplements that youre currently taking. You may need to stop taking certain medicines, such as aspirin or ibuprofen, for weeks or days before the procedure.
You must also refrain from eating or drinking for six to 12 hours before the surgery. In some cases, your doctor may prescribe you a pain medication for any discomfort you experience after the surgery. You should fill this prescription ahead of time so that you have it ready after the procedure.
Your doctor will give you an anesthetic before your knee arthroscopy. This may be:
- local
- regional
- general
If youre awake, you may be able to watch the procedure on a monitor.
The surgeon will begin by making a few small incisions, or cuts, in your knee. Sterile salt water, or saline, will then pump in to expand your knee. This makes it easier for the surgeon to see inside the joint. The arthroscope enters one of the cuts and the surgeon will look around in your joint using the attached camera. The surgeon can see the images produced by the camera on the monitor in the operating room.
When the surgeon locates the problem in your knee, they may then insert small tools into the incisions to correct the issue. After the surgery, the surgeon drains the saline from your joint and closes your cuts with stitches.
There are also risks specific to a knee arthroscopy, such as:
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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
Have You Tried Other Options
Before recommending surgery, a doctor will usually recommend trying a number of other options first. These include losing weight, if necessary doing exercise and taking pain relief medication.
However, if your answer to some or most of the following questions is yes, maybe surgery is the right option.
- Does knee pain keep you up at night?
- Are you having trouble walking?
- Do you have pain when you stand up or get out of a car?
- Can you walk upstairs easily?
- Are over-the-counter medications not working?
However, surgery can be a major undertaking. If one doctor recommends the procedure, it may be worth seeking a second opinion.
Knee replacement surgery is a common procedure, and most people experience improvements in pain, mobility, and quality of life.
Here are some points to bear in mind:
Every year, over 700,000 people have knee replacement surgery in the US, and over 600,000 have a total knee replacement.
- In over 90% of people, pain levels and mobility improve significantly after surgery.
- Many people can return to the activities they enjoyed before having problems with their knee.
- Fewer than 2 percent of people experience severe complications.
If your doctor suggests surgery, be sure to ask plenty of questions. Click here for some ideas about what to ask.
Learn more about the timeline for recovery from knee surgery.
However, the speed of your recovery will depend on various factors, such as:
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When Knee Replacement Is Needed
If you are suffering from osteoarthritis, then you must need to go for knee surgery, however, if you have tried all the osteoarthritis treatments but none helped you then you surely need a knee replacement.
Note: If you are considering surgery and are a resident of Patna, Bihar, then do consult Dr. Ramakant Kumar the best knee replacement doctor in Patna.
Recovering From Knee Replacement Surgery
You’ll usually be in hospital for 3 to 5 days, but recovery times can vary.
Once you’re able to be discharged, your hospital will give you advice about looking after your knee at home. You’ll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your knee.
Most people can stop using walking aids around 6 weeks after surgery, and start driving after 6 to 8 weeks.
Full recovery can take up to 2 years as scar tissue heals and your muscles are restored by exercise. A very small amount of people will continue to have some pain after 2 years.
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Other Forms Of Treatment
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.
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.
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Why Imaging Isnt Always The Answer For Knee Pain
If youve been dealing with nagging pain that seemingly originated out of nowhere, imaging may not provide the enlightenment you are looking for. Injuries that have an insidious onset, meaning came on slowly without a specific traumatic event, rarely need imaging immediately, Richardson says. This type of knee pain is often knee pain that comes onafter long distance running or biking. These are usually wear and tear injuries that will improve with rest, stretching, and leg strengthening exercises.
Richardson notes that there are some specific cases that may merit more urgent imaging for non-traumatic knee pain elderly people, very young kids, and professional athletes, for example, may need immediate attention. But for most people, strictly sticking to a self-care routine should help alleviate nagging knee pain. Dont see a difference in your symptoms? Then it may be time to seek medical care. If there is no improvement in the pain after six weeks of physical therapy, then your doctor may order imaging to see if there is anything odd going on with your knee, Richardson says.
What Are The Risks
- An infection at the surgical site is possible. Blood clots are a risk as are injuries to a blood vessel or a nerve. These complications are quite rare.
- You may experience some knee joint stiffness.
- Late complications may include infection and a failure or loosening of the prosthesis, as well as continued pain.
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Dental Work And Knee Replacement
Can a tooth infection create a problem for you after knee replacement surgery?
Lets find out.
If you develop an infection in and around your knee after knee replacement, it can be one of the worst complications to occur. Because doctors want to avoid infections, youll probably be advised to avoid dental work immediately after your TKR.
But how is a new knee connected to your teeth?
In this article well find out why you should be aware of going to the dentist after surgery.
Above all, follow the recommendations of your surgeon and dentist. It may make a difference depending on the dental procedure you need.
A routine cleaning might receive different advice than a more invasive work like a root canal.
Your personal health status is important to consider too. Ifyou have a compromised immune system or you have an active infection in yourmouth you may be at greater risk.
Conditions That Can Be Treated With Knee Replacement
Knee replacement can be used to replace a knee joint affected by a range of conditions including:
- Severe osteoarthritis
- Ligament damage or infection that leads to severe osteoarthritis
- Rheumatoid arthritis
- Crystal deposition diseases such as gout and pseudogout
- Avascular necrosis death of bone following loss of blood supply
- Bone dysplasias disorders of the growth of bone.
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Have A Conversation With Your Doctor
Before you make up your mind about having your knee replaced, talk with your doctor about the possible risks of surgery. These can include infection, loosening of the knee replacement parts, and movement limitations. Also, talk about any health conditions you might have that could make the operation and your recovery more difficult.
Its also important to have realistic expectations for how quickly you will recover from the surgery. It can take several weeks to several months to feel back to normal after a knee replacement. Youll also need to commit to physical therapy and exercise. Your doctor can talk through the factors that can speed up or slow down recovery, and help you decide if the timing is right.
Under the right circumstances, a knee replacement can significantly boost your quality of life. More than 90% of people who get new knees are able to resume their normal activities shortly afterward and are happy with the results, according to the American Academy of Orthopaedic Surgeons. And pinpointing a good time to have a knee replacement is a key part of having success with the procedure.
Your Pain Prevents You From Doing Normal Activities Or Caring For Yourself
If you cant get relief from other treatments, your knee pain may start interfering with your daily life.
In general, the timing of a total knee replacement is determined by the impact the knee is having on your quality of life, says Jay Lieberman, MD, chief of orthopaedic surgery at Keck Medicine and chair and professor of orthopaedic surgery at the Keck School. If conservative treatments are not working and you have significant pain while walking, you may be a good candidate for 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
Types Of Arthritis That May Lead To Knee Replacement
Osteoarthritis occurs when cartilage on the gliding surface of the knee begins wearing away, causing pain and stiffness. When the cartilage wears away completely, the bones rub directly against each other causing decreased mobility and chronic pain. Osteoarthritis is most common in people 50 and older, but is also prevalent in those with a family history of arthritis or those with lifestyles that stress the joints, such as athletes and laborers.
Rheumatoid arthritis is actually an autoimmune disease in which the bodys immune system begins to attack the synovial membrane causing it to become inflamed and overproduce synovial fluid . More importantly, the process also causes damage and wear to the articular cartilage.
Traumatic arthritis results from a serious knee injury, such as a fracture, ligament damage or meniscus tear. The impact of the accident also causes mini trauma to the articular cartilage which over time, develops into osteoarthritis, causing knee pain and stiffness.
Abnormal formation or alignment of the knee can also create high stress on the joint, resulting in degeneration. This misalignment sometimes referred to colloquially as knock-knees or bowlegged creates an unnatural angle between the femur and tibia at the knee joint. After a substantial period of time, the cartilage will eventually and unevenly wear away.
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Nonsurgical Treatments Are No Longer Effective
If you have arthritis of the knee, youll probably start with more conservative measures such as medications, steroid injections or physical therapy to alleviate your symptoms. But, at some point, they may not be enough.
Anti-inflammatories, injections and physical therapy are temporary measures to provide pain relief, but they dont reverse the underlying cause of pain and dont allow cartilage to regenerate, Heckmann says. As time passes, these arthritic conditions tend to progress in severity, rendering these types of treatments less and less effective.
At that point, surgery may be an option.
Why Come To Hss For Your Knee Replacement
I call knee replacement surgery a team sport. The two most central players are the surgeon and the patient, but there are many other people on the team who help make it successful. At HSS, our knee replacement surgeons are among the most skilled surgeons in the world. In addition to their deep expertise and extensive training, they have a singular focus on joint replacement surgery. This experience allows them to achieve very high success rates, avoid complications and help effectively relieve our patients pain.
Another advantage is that the knee replacement surgeons at HSS embrace the multidisciplinary aspects of orthopedic care. They work closely with anesthesiologists, rehabilitation specialists, nurses, dietitians, and many others to keep our patients safe and healthy so they can get back to what they love to do.
The fact that HSS is a specialty hospital focused solely on orthopedics and rheumatology is a great advantage. All our staff have great experience and a singular focus. Since we do not have to compete with other departments for resources, we can concentrate all our efforts on obtaining the best outcomes for our patients without any compromise.
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