Total Knee Replacement
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Knee Replacement Surgery
Knee Painful & Inflexible?
Treatments No Longer Working!
If your age is over 50 years and suffering from osteoarthritis and intense pain, you will want to consider knee replacement surgery.
Knee replacement surgery is the surgical procedure of replacing a damaged and diseased knee with an artificial joint.
Reasons for Knee Replacement Surgery
The most common cause for the surgery is osteoarthritis. A few conditions that lead to knee damage include:
- Rheumatoid arthritis
- Knee injury
A knee replacement is a major surgery, therefore it is generally advised when other treatments, like physiotherapy or steroid injections, haven’t aided in reducing pain or restore mobility.
Your surgeon will suggest the surgery if:
- You experience intense pain, swelling, and stiffness in your knee joint and reduced mobility.
- Day-to-day activities are difficult or impossible.
- Unable to work or have a normal sound life.
Who Can Have Knee Replacement Surgery?
Adults are often considered for knee replacement, but it’s usually advisable for older people because young, physically active people are more prone to wear the joint out.
The earlier the surgery, the greater the possibility you will at some point require additional surgery. But evidence suggests that replacing the knee joint before it gets very stiff results in a better outcome.
Nearly all total knee replacements are performed on individuals between the ages of 60 and 80. It is vital to be healthy enough to handle both major surgery and rehab later on.
Risks of the Surgery
Most individuals do not experience complications but like any other surgery, there are risks involved:
- Wound infection
- Bleeding into the knee joint
- Nerve, artery or ligament damage in the region of the knee joint
- Blood clots or deep vein thrombosis
- Persistent knee pain
- Occasionally, the new knee joint is not perfectly stable and additional surgery is usually required to fix it.
You will be admitted to the hospital on the day of your surgery. Your surgeon and anesthetist will come to see you and explain the procedure and answer any questions you may have.
Knee replacement surgery is generally conducted under general anesthesia or under spinal or epidural anesthesia.
The damaged ends of the bones in your knee joint are removed and replaced with metal and plastic parts which have been custom-made to fit.
You will have either a total or half-knee replacement surgery. This depends on how affected your knee is. Total knee replacements are much frequent.
Total Knee Replacement
In a total knee replacement, both of your knee joints are replaced. It usually takes 2 – 3 hours for the procedure to finish.
Your surgeon creates an incision in front of your knee exposing the knee cap. It is then moved to the side so the surgeon can access the knee joint behind it.
The useless ends of your thigh bone (femur) and shin bone (tibia) are removed with care. The ends are carefully measured and formed to match the custom-made prosthetic replacement. A test or dummy joint is placed to see if the joint is functioning properly. Changes are made, the ends of the bones are cleaned, and the final prosthesis is built in.
The end of your thigh bone is replaced by a curved piece of metal, and the end of your shin bone is replaced by a flat metal plate. These are positioned using special bone cement or are treated to promote fusing of the replacement parts and your bone. A plastic spacer is positioned between the pieces of metal which will function like a cartilage lessening friction as your joint moves. Please refer to the figure below.
The back of the kneecap might be replaced, based on the factors that promote replacement.
The wound is closed with stitches or clips and a dressing is applied to the wound.
In a few situations, a splint is employed to keep your leg immobile. However, you are advised to move your knee as soon as possible.
The replacement should last approximately 15 to 20 years.
Remember, you are still likely to have some trouble moving, specially bending your knee, and kneeling is possibly difficult due to the scar.