ashutoshchaudhari » Knee Replacement

Knee Replacement

Knee arthritis and total knee replacement

knee replacement

knee replacement

What are the common causes of knee arthritis

Osteoarthritis (caused by wear and tear of the joint)
Rheumatoid arthritis (autoimmune disorder)
Post traumatic (occurs after a couple of years after an injury to the knee)

What are the symptoms of knee arthritis?

Pain associated with arthritis develops slowly over time rarely can be acute,the joint become sore,swollen,stiff making it difficult to bend and straighten the knee there can be a crackling sound perceived by the patient

When should you consider a knee replacement?

When your activities of daily living like brisk walking,negociating staircases are hampered due to pain

What is the ideal age for total knee replacement?

Ideal age for knee replacement is 55-65 years,but age is not the only criteria for deciding for surgery, surgery is now being offered in age group of 45-75 years

What can I do to delay the progression of my arthritis?

Loose weight, switch to swimming or brisk walking instead of jogging, do regular Knee exercises ,use knee supports ,in early stages can consider viscosuplementation

What is the lifespan of the artificial knees?

The average life of a knee replacement is 15 years but this is an average for some patients it can easily last their entire lifetime,. new technology is available where in new highly cross linked polyethylene is available which according to research should last longer than the above period this is especially useful in younger patients in their 40s requiring undergoing a knee replacement.

How many days of hospitalization are required?

On an average 5 days of hospitalization is required

After how many days after surgery can the patient walk?

The next day after surgery you will be able to walk with the help of a walker

What is a knee replacement?

The ends of the bones are removed and an artificial implant is put in its place generally there are 3 parts, the femoral component(which is generally metal) is applied on the thigh bone , tibial component (which is metal) is applied on the leg bone, in between the two polyethylene insert is introduced ,the patellar component is again polyethylene

Is knee replacement surgery very painful?

With recent advances like miniinciscion surgery the surgery is fairly painless

What are the advantages of a knee replacement?

More than 95 percent of the patients undergoing a knee replacement experience a dramatic reduction in the knee pain and a significant improvement in the ability to perform activities of daily living

Is knee replacement a major surgery?

Knee replacement is definitely not a minor surgery but can be considered an extremely safe procedure if done in the right set up ,equipped with laminar airflow theater

Recent advances

Gender specific knees

-a special knee is designed for the ladies

highly crosslinked polyethylene

-in a normal knee between the metal parts plastic is present this generally wears in 10-15 years with research new higlycrosslinked polyethylene is available which reduces the wear and in turn is expected to increase the life of the artificial knee

miniinciscion surgery

–earlier surgery was done with a incision(cut in the skin) of 8 -10 inches now surgery can be done through an incision of 4 -5inches, this reduces the pain associated with the surgery and shortens the recovery time

Getting ready for surgery

Getting ready for surgery

Stop blood thinners like asprin(ecosprin) and clopidrogel 1 week prior to surgery

Get a complete blood work up,urine examination,ecg ,chest x-ray

Hospitalisation

Get admitted to the hospital1 day prior to date of surgery preferably by 11 am so that any additional tests can be comfortably done. Carry all your investigations and x-rays with you
Blood will be sent for crossmatching
Anaesthetist will examine you and discuss the type of anaesthesia to be given
Take bath with medicated soap solution one night prior as well as morning of surgery ,this helps reduce the chances of infection
Do not take any food or water after12 midnight
You may be instructed to take your blood pressure medication and other specific medication( as advised by the anaesthetist ) at 6 am with a small sip of water

Surgery

You will be wheeled in the operation theater half an hour prior,the anaesthetist may give you complete anaesthesia(general) or may give you regional anaesthesia in which case your legs will be made numb
After cleaning and isolating your leg the knee will be exposed if any deformities exist they will be corrected,thebones will be cut,correct sizing is ensured then the final implants will be cemented
After surgery the anaesthetist will introduce a small catheter(femoral catheter) in your thigh so as to keep you comfortable and pain free

Recuperating in the hospital

Recuperating in the hospital

patient comfortably bending her knee with the help of a machine this photo was taken the next day after surgery
In the ward a cpm (continuous passive motion) machine will be applied to the knee and knee bending will be started You should move your feet from the ankles to reduce the chances of bloodclotting
Next day you will be made to walk with the walker your knee bending with cpm will be increased and the physiotherapist will teach you other exercises
Second day after surgery staircase negotiation will be taught your dressing may be changed
From the third day you can probably walk without the presence of the physiotherapist ,on your own
Most patients will be discharged the fourth day after surgery

CARE TO BE FOLLOWED AT HOME

CARE TO BE FOLLOWED AT HOME

Do your exercises regularly
Take your antibiotics regularly
Do not wet your dressing till suture removal
After suture removal if you have opted for high flexion option high flexion exercises can be initiated