Total Knee Replacement

Total knee replacement surgery is recommended ideally for patients who have experienced severe destruction of the knee joint and undergo continual pain, which impairs knee functions. The total knee replacement surgery helps relieve pain in patients and enables them to do daily functions normally. Over the course of time, knee replacement surgery has emerged as one of the most mainstream procedures and has been performed on vast numbers of people who undergo knee pain for various reasons. In 2009, approximately 600,000 surgeries were performed. This figure was confirmed by the Agency of Research and Quality. It is also expected that this figure would rise by the year 2030.

What Is Total Knee Replacement?

Total knee replacement surgery is a safe and effective method to relieve knee pain. The first knee replacement surgery was performed back in 1968. Methods and technology have greatly evolved since then, making it a common and safely practiced operation.

In a knee replacement surgery, the weight bearing part of the knee is replaced by an artificial knee joint. The artificial knee is built step by step and with extreme caution by taking precise measurements of the knee bone and replacing the problematic parts.

Knee replacement surgery is recommended to patient with extreme knee pain. It is usually the last option when non-surgical treatments fail to relieve knee pain.

When Is Total Knee Replacement Recommended?

Knee replacement surgery is a complex procedure and should only be done after giving it some substantial amount of thought. Patients should undergo surgery only after discussing the risks associated with their doctors and orthopedic surgeons and after taking their family members' consent. Orthopedic surgeons may be in a better position to recommend surgery after careful examination.

Total knee replacement surgery is advised when patients have severe knee pain and have trouble performing normal everyday activities such as walking, sitting down or climbing the stairs. Often times the knee pain becomes so unbearable that patients have to walk using a support or a cane.

Knee replacement surgery is also recommended for people who have bowed knees due to severe pain, knee inflammation that is persistent and does not go away with medications, knee deformity that results in bowing of the knee or even moderate knee pain experienced while sitting or resting.

People of all ages can experience knee pain, but knee replacement procedures are usually performed on people between the ages of 50 to 80. There are no weight restrictions for this surgery and it is performed only if the patient is having pain that is not being reduced by nonsurgical methods.

How Is Total Knee Replacement Done?

For the knee replacement surgery to be carried out, patients are admitted into the hospital usually a day before. The senior surgeon and anesthetist come and discuss the patients’ queries to put him at ease. Surgery is normally carried out under general anesthesia by a senior level doctor. Junior surgeons assist the doctor while the surgery is being performed. It is imperative that the patient should inquire about who will be performing the procedure.

The following are the steps for the total knee replacement procedure:

Step 1: An incision, about 8 to 10 inches long, is made across the knee cap, also known as patella. This incision can be smaller in certain cases.

Step 2: After the incision is made, the knee cap is opened and rotated so that the surgeon can view where to perform the surgery.

Step 3: Thighbone, also known as femur will be the first bone that surgeons will resurface. After the knee cap is removed and knee joint is exposed, doctors will take careful measurements and cut away the damaged part of the knee from the femur. The end part of the femur is resurfaced to fit the other end of the artificial knee, known as the femoral component.

Step 4: The femoral component is firmly joined with the femur using bone cement.

Step 5: The next step that doctors perform is removing damaged cartilage from the top of the shinbone. The bone is then shaped so that it fits the metal and plastic components of the tibia.

Step 6: Tibial tray is the name given to the bottom portion of the knee implant. It is fitted firmly into the shinbone using bone cement and a special kind of plastic is inserted between the tibial tray and femoral component, which acts as a cushion.

Step 7: The patella is often flattened to fit with the rest of the knee implant and is then retuned back to its normal position.

Step 8: After all the steps have been carefully performed, the doctors flex and move the knee to ensure proper movement is taking place. They also check the alignment and positioning of the knee implant so the patient does not feel or go through future discomfort. The stiches are then closed and knee bandaged for recovery.

Risks of Knee Replacement Surgery

Knee replacement surgery, like other major operations, does carry risks that patients should be aware of. Although 90 percent of the patients experience no complications after the surgery, there is a small percentage that suffers from the undesirable effects. Knee replacement surgery may, instead of elevating pain, cause more consistent pain and knee stiffness. The surgery might lead to infection, permanent instability and blood clots in the knee area. It is also noted that some patients develop allergies to metal components after the surgery. Though these risks are present in a minor percentage of people, 99.96 percent people survive the total knee replacement surgeries.

Recovering from Total Knee Replacement

Patients who undergo knee replacement surgery see improvements within a few weeks. Since the pain is eradicated by putting a new metal gliding surface over the knee, patients can, with some assistance, move and walk the very next day of the surgery. It takes about six weeks for the knee to recover completely since muscles take time to restore strength. After the muscle tone has been improved, patients can walk and climb the stairs easily but cannot perform activities like running and jumping.

Planning Ahead for Recovery

Patients may need extra care after the surgery, so it is better they prepare beforehand. Crutches and walkers should be made available in the house, as assistance is needed after the operation. People often hire a caretaker or a servant to do the chores as performing daily activities soon after a surgery is not recommended.

The space inside the house should be cleared out a little to make way for easier walking. Handrails of the stairs should be secured, and safety bars should be installed in the shower and bath so that patients can hold onto them. It is advised to remove slippery carpets from the house to avoid slipping. Patients should also invest in a comfortable chair with a back and cushion and even a footstool, to help them elevate legs while sitting.

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