Orthopedics

Knee replacement

Description

Knee replacement is a surgical procedure to replace the surface of the knee damaged by arthritis where plastic and metal parts are used to cap the ends of the knee joint bones. It is considered as the most common treatment for knee diseases such as osteoarthritis, rheumatoid arthritis and psoriatic arthritis, which causes immense knee pain and impaired function.

People with advanced osteoarthritis and other severe knee damage that causes immense pain and trouble performing simple activities need this surgery where other treatments do not work.

Types of knee replacement are

  • Total knee replacement, which involves replacing the joint surfaces at the end of the femur and top of tibia.
  • Partial knee replacement involves a smaller cut as the arthritis affects only one side of the knee.
  • Kneecap replacement, where only the under-surface of the kneecap is replaced.
  • Complex knee replacement used for major bone loss, deformity or weak knee ligaments.

The doctor will first explain you the procedure where you can ask questions, if you have any. Complete medical examination needs to be done before the procedure to ensure you are in good shape. You can tell the doctor about your past or current medical condition and medications you are taking to avoid complications during the surgery.

Once all done, the knee replacement procedure will start in the hospital where you will be given general anesthesia to put you asleep. An 8-12 inch cut will be made into the knee through which the damaged joint is removed from the surface. The doctor will then resurface the knee joint with an artificial prosthesis made from plastic and metal. This joint is attached to the femur, knee cap and shin with cement or any other special material.

After they fit together, the prosthesis will part from the joints and rely on the muscles and ligaments for function. The whole procedure lasts for three to five days and most of the patient experience dramatic improvement soon after the surgery. The intense pain goes away and the person is able to walk and perform other activities within a month. The person may need crutches, cane or a walker for support after the surgery, but once the strength is restored, he can enjoy most of the activities.

Minimally invasive surgery has made knee replacement surgery incredibly easy and successful as it uses specialized techniques and instruments that does not require a large incision.

Complications

Complications of knee replacement surgical procedure may occur in a few cases, which are:

  • Infection
  • Bleeding
  • Blood clots
  • Fracture
  • Loosening of artificial prosthesis
  • Stiffness and pain
  • Deep vein thrombosis
  • Instability
  • Pulmonary embolism
  • Nerve or tissue damage

Post operative care

After the surgery, the patient need to spend some days in the hospital recovery room where his vital signs will be monitored frequently.

Pain medications are also given to relieve the pain.

The urine passage becomes difficult after the surgery, hence a catheter is inserted into the urethra to allow urine passage.

Physical therapy will be given by a continuous passive motion (CPM) machine and the patient will be given exercise plans to follow at home to recover the muscle strength.

After you reach home, keep the surgical site clean and dry. Avoid wetting the area while bathing as it can remove the stitches.

Notify the doctor if you experience fever, swelling and redness at the incision site, increased pain or any other health condition.

The patient will require crutches or walker after the surgery for support until his/her muscles develop enough strength.