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Understanding Arthritis & Knee Replacement

Joint deterioration can affect every aspect of a person’s life. In its early stages, it is common for people to ignore the symptoms of osteoarthritis, but as the disease progresses, activities like walking, driving & standing become challenging, painful & very difficult.

This short info will help you understand basic knee anatomy, arthritis & Knee replacement surgery.

This info is for educational purpose only & any questions or concerns you may have should be directed to your surgeon using the contact form.

THE KNEE

The knee is a complex joint consisting of bones & healthy cartilage. The end of your femur (thighbone) can be compared to a rocking chair. It has two distinct surfaces called compartments, which rest on the tibia (shinbone). A third compartment is found behind the patella (knee cap), and all three compartments are covered with cartilage to help cushion & lubricate the bones during movement.

ARTHRITIS

Osteoarthritis, the most common form of arthritis, is a wear and tear condition that affects joint cartilage, and it develops after years of constant motion and pressure in the joints. As the cartilage continues to wear away, the joint becomes increasingly painful & difficult to move. If conservative treatment options fail to provide relief, I may recommend you a total knee replacement surgery.

TOTAL KNEE REPLACEMENT

Total knee replacement can be an extremely successful surgical procedure. The first knee replacement procedure was performed more than 30yrs ago. Since then, millions of people have received knee replacements. Knee replacement surgery is a fairly routine procedure with more than 4,00,000 being performed every year in the United States alone.
Total Knee replacement, also called arthroplasty, involves removing the diseased bone and cartilage & resurfacing it with orthopaedic implants.

The word replacement makes one think that surgeons remove the entire knee. In truth, your surgeon only resurfaces damaged bone & cartilage at the ends of the bones in your joint.

During surgery, the joint is exposed by a midline incision.

I use a special technique to enter the knee without hampering the quadriceps muscle. This approach is called MID-VASTUS approach & the SUB-VASTUS approach as show below.

The advantages of these approaches are that the patient is able to walk on the same day of the surgery and muscle power is well maintained for better walking and climbing stairs.

The damaged bones are then resurfaced with components designed to re-create the natural contours of the bones in a healthy knee. The metal & polyethylene (plastic) implants allow the bones to smoothly glide against each other, much like natural cartilage.

Total knee replacement is performed while you are under anesthesia. There are various types of anesthesia like Spinal, Epidural, General, Femoral blocks etc which your physician and anesthetist will decide before surgery after examining you properly.

The length of surgery may be approximately 1 ½ - 2 hrs. Care before surgery & time spent in the recovery room can add additional 2-3hrs before you are back in your hospital room.

COMPLICATIONS

While uncommon, complications can occur during and after surgery. Some complications include, but are not limited to, infection, blood clots, implant breakage & premature wear, any of which can require additional surgery.
Although implant surgery is extremely successful in most cases, some patients still experience stiffness and pain. No implant will last forever and factors such as patient’s post surgery activities and weight can affect longevity. Be sure to discuss these and other risks with your operating surgeon.

There are many things that your surgeon may do to minimize the potential for complications. Your surgeon may have you see a medical physician before surgery to obtain tests. You may also need to have your dental work up to date and may also be shown how to prepare your home to avoid falls.

AFTER SURGERY

After surgery, you will receive pain medications and begin physiotherapy. It is important to start moving your new knee as soon as possible after surgery to promote blood flow, to regain knee motion, and to facilitate the recovery process. You may also be out of bed & walking with crutches or walker within 24hrs of your surgery.

You will be shown how to safely climb and descend stairs, how to get into & out of a seated position, & how to care for your knee once you return home. It is a good idea to enlist the help of friends or family to help you once you do return home.

Before you leave the hospital, your therapist will show you a variety of exercises designed to help you regain mobility and strength in your new knee. You should be able to perform these exercises at home.

Most people are ready to go home between 3-5days after surgery. When at home it is important to continue with your exercises as your surgeon has instructed.

RECOVERY

Exercise is necessary for proper healing and better results post the surgery. Diligent physical therapy, proper diet & a willingness to follow all of your surgeon’s recommendations will contribute to a more successful recovery.

Your surgeon will give follow up schedules to you. Complications can occur with any implants, so it is important to see your surgeon if you notice any unusual changes regarding your new joint

SUMMARY

I realize that the decision to have surgery is sometimes very difficult. Millions of others have made this choice, allowing them to return to more active lifestyles.

If any queries regarding KNEE REPLACEMENT SURGERY, kindly contact me.