By Medicover Hospitals / 25 March 2022

Knee Replacement

  • Knee replacement is commonly known as total knee replacement or knee arthroplasty. This is a surgical procedure that resurfaces a knee that has been damaged by arthritis, an injury or any other reason. The procedure involves treatment of damaged knee joints with metal or plastic implants. It is a common procedure that is very effective in reducing pain and stiffness from injury or arthritis. An orthopaedic surgeon evaluates the knee's strength, flexibility, stability, and strength to see if a knee replacement is correct for you. The damage can be evaluated with an X-Ray. Depending on the age, weight, activity level and knee size the doctor can choose from a variety of knee replacement prostheses and surgical approaches.

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    Advantages of Knee Replacement

  • Some patient may experience discomfort in the long run and may need to limit high-impact activity to protect the replaced joint. However, it can help you move more freely and get relief from the pain. More than 90% of people who receive complete knee replacements remain able to function normally even 15 years later. Some of the advantages of knee replacement are:
    • Pain Relief
    • Improved mobility
    • Better treatment response
    • High success and satisfaction rate

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    Who needs a Knee Replacement?


    Knee replacement surgery is most commonly performed to address severe pain caused by osteoarthritis. The most common reasons for the procedure are:
    Osteoarthritis: An age-related condition. It is caused due to inflammation or breakdown of cartilage in joints.
    Rheumatoid arthritis or inflammatory arthritis: It is a condition in which the membrane around the knee joint thickens and becomes inflamed.
    Post-traumatic arthritis: It emerges as a result of a severe knee injury. Knee cartilage is affected when the bones around the knee shatter or ligaments tear.

    What are the Alternatives to Knee Replacement?

  • Knee replacement surgery is rarely the first treatment option for knee pain. Various alternative treatments may be able to provide adequate relief. After alternative therapies for knee pain have failed, the doctor may recommend this surgery. If you're having trouble with your knees, talk to your doctor about less intrusive options.

  • The above options may include:
    • Strengthening the muscles around the joint with exercise or physical therapy to regain flexibility.
    • Knee arthroscopy for mechanical problems.
    • Medications such as NSAIDs and cortisone injections.
    • Walking aids or supports (for example, a cane or walker ) and braces.

    How Do I Know if I Need a Knee Replacement?

    The decision of surgery would be made by your consulting doctor. You must visit an experienced orthopedic surgeon or take second opinion before making your mind for the surgery.
    • Discuss about your symptoms, including the severity with your doctor. The surgeon may ask about the severity of symptoms or if symptoms interfere with your daily life.
    • The doctor would examine the movement, strength, and stability of the knee.
    • The patient may be asked to go for a X-Ray. The images can help the surgeon understand the damage and problem. In the case of an arthritic knee, advanced imaging (MRI) is rarely useful.

    Knee replacement procedure

    The procedure requies pre-surgical planning and post-surgical care. Below are the details of the procedure.

    Before Knee Replacement?


    The doctor may ask for:
    • Blood tests
    • EKG (Electrocardiogram)to make sure your heart is strong enough for surgery
    • Physical exam to make sure you are healthy enough for surgery

    During Knee Replacement?


    On the day of surgery, the patient will receive anesthesia to prevent pain during the operation. It takes about an hour or two for the anesthesia to react. The surgical team:
    • Make an incision (cut) in the knee area.
    • Remove any damaged cartilage and bone.
    • Place the knee implant.
    • Secure the implant in place with or without cement.
    • Insert a piece of polyethylene (plastic) that creates a smooth, sliding surface between the metal parts of the implant.
    • Close the incision.

    After Knee Replacement?

    After surgery, the patient will be transferred to a recovery room. The healthcare team will observe for a short time to make sure the patient wakes up from anesthesia without complications. They will also check the vital signs and pain level. The time spent in the hospital will be based on medical necessity.

    Risks or Possible Complications of Knee Replacement

    Although knee replacement is a very safe procedure, rare complications can occur:
    • Blood clots
    • Infection
    • Injury to the nerves or blood vessels around the knee
    • Problems with the implant, such as the device wearing out too soon or loosening
    • Scar tissue within the knee

    Recovery

  • Your doctor will give you specific instructions. But many people can return to normal activities within three to six weeks after surgery. The healthcare provider will give you specific instructions on recovery. The patient will gradually increase your activity, starting with a slow walking program. They will be encouraged to stand up, climb stairs, and do other normal household activities as soon as possible.
  • When to seek medical help after a knee replacement?

    After reaching home, call the doctor if you have any of the following symptoms:
    • Chest pain or shortness of breath.
    • Incision problems, such as bleeding, dripping, swelling, redness, or odour.
    • The new calf, ankle, or foot pain gets worse.

    Frequently Asked Questions:

    Knee replacement surgery takes about six months to heal, but it might take up to a year to fully return to physical activities.

    The patient will probably be able to walk on their own in 4 to 8 weeks. They have to go through months of physical rehabilitation (rehab) after a knee replacement. Rehabilitation will help you strengthen your knee muscles and help you regain movement.

    It is a major surgery, so it is usually only recommended if other treatments, such as physical therapy or steroid injections fail to reduce the pain or improve mobility.

    Possible disadvantages of surgery can include wear and tear on the replacement joints over time, difficulties with some movements, and numbness.

    Within 7-10 days after knee replacement, you should be able to place your knee completely straight & fully extended.

    While lying in bed, always keep your knees straight.
    Avoid sitting with your legs crossed.
    Avoid driving for 6-8 months.
    Start driving only when you are pain-free and have totally recovered.

    Surgery is done under general anesthesia, so you will not feel any pain. post -surgical pain would be there, but they can be relieved with the pain medications you doctor would advise. For any severe pain, you must inform your doctor.

    Applying warm or cold packs to the joint as directed by the doctor can help reduce knee stiffness after the surgery.

    Knee replacements can be performed on adults of any age, but the majority are performed on people between the ages of 60 and 80.

    It depends on the type of technique and equipment used, the choice of implant selected, the city and the hospital you choose.

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