What is a knee replacement?
Knee replacement surgery also known as knee arthroplasty (ARTH-row-plas-tee) can help relieve pain and restore function in severely diseased knee joints. The procedure involves cutting away damaged bone and cartilage from your thighbone, shinbone and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade plastics and polymers.
Causes of knee replacement
The most common purpose for knee replacement surgery is osteoarthritis.
When a knee replacement is required:
- Rheumatoid arthritis
- Disorders that cause unusual bone growth.
- Death of the knee bone thanks to blood supply problems.
- Knee injury.
- Knee irregularity with pain and loss of cartilage.
Symptoms and signs
Signs it’d be time for a knee replacement:
- Your pain persists or recurs over time.
- Your knee hurts during and after exercise.
- Medications and therefore the use of a cane doesn’t provide enough relief.
- Your knee stiffens from sitting during a car or movie.
- You are feeling pain when it rains.
- Pain keeps you from sleeping.
- Your knees are stiff or swollen.
- Has trouble walking or climbing stairs.
- Has difficulty sitting down and getting up from chairs and bathtubs.
- Feel a “grinding” within the joint.
Types of surgery in knee replacement
The four main sorts of knee replacement surgery are:
- Total knee arthroplasty
- Unicompartmental (partial) knee replacement.
- Patella replacement (patellofemoral arthroplasty)
- Complex or revision knee replacement.
There are several sorts of replacement knee joints, also as different surgical methods. Your doctor and an orthopaedic surgeon should assist you to choose the simplest option for you, taking into consideration the condition of your knee and your general health.
Total knee replacement
Most of your recovery and rehabilitation will be at home after you leave the hospital. Some people need home health care or assistance.
Your doctor will most likely prescribe physical therapy at a local clinic for continued rehabilitation. The physical therapist at this clinic will suggest exercises you can do at home.
Everyone recovers differently, but most people are allowed to return to driving by the end of 4 weeks.
Knee replacement surgery isn’t usually the primary option for treating knee pain. Treatments will vary, counting on the precise explanation for your knee pain.
Your doctor may prescribe medications to assist relieve pain and treat underlying conditions, like atrophic arthritis or gout.
Strengthening the muscles around the knee will make it more stable. Your doctor may recommend physiotherapy or differing types of strengthening exercises counting on the precise condition that’s causing your pain.
If you’re physically active or play a sport, you’ll need exercises to correct movement patterns that will be affecting your knees and to determine good technique during your sport or activity. Exercises to enhance your flexibility and balance also are important.
Arch supports, sometimes wedged on one side of the heel, can help deflect pressure on the side of the knee most suffering from osteoarthritis. Under certain conditions, differing types of braces are often wont to help protect and support the knee.
In some cases, your doctor may suggest that you simply inject medications or other substances directly into your joint. Examples include:
- Corticosteroids. Injections of a corticosteroid medicine into the knee can help reduce the symptoms of an arthritis flare and supply pain relief which will last for a couple of months. These injections aren’t effective in altogether cases.
- Hyaluronic acid. A thick liquid, almost like the fluid that naturally lubricates the joints, mucopolysaccharides are often injected into the knee to enhance mobility and relieve pain. Although study results are conflicting about the effectiveness of this treatment, relief from one or more injections can last up to 6 months.
- Platelet-rich plasma (PRP). PRP contains a degree of the many different growth factors that appear to scale back inflammation and promote healing. These sorts of injections tend to figure best for people whose knee pain is caused by tears, sprains, or injuries to the tendons.
If you’ve got an injury that will require surgery, it’s usually not necessary to possess it operated directly. Before making a choice, consider the pros and cons of non-surgical rehabilitation and surgical reconstruction about what’s most vital to you. If you select to possess surgery, your options may include:
- Arthroscopic surgery. counting on your injury, your doctor may examine and repair your joint damage employing a fiberoptic camera and long, narrow tools that are inserted through a couple of small incisions around the knee. Arthroscopy is often wont to remove loose bodies from the knee, remove or repair damaged cartilage (especially if it causes the knee to lock), and rebuild torn ligaments.
- Partial knee replacement surgery. during this procedure, your surgeon replaces only the foremost damaged part of your knee with parts made from metal and plastic. Surgery can usually be done through small incisions, so it’ll likely heal faster than surgery to exchange the whole knee.
- Total knee replacement. during this procedure, your surgeon cuts away the damaged bone and cartilage from the femur, tibia, and kneecap, and replaces them with a man-made joint made from metal alloys, high-quality plastics, and polymers.
Diagnosis in knee replacement
During the physical exam, your doctor will likely:
- Inspect your knee for visible swelling, pain, tenderness, warmth, and bruising.
- Check how far you’ll move your lower leg in several directions.
- Push or pull on the joint to assess the integrity of your knee structures.
In some cases, your doctor may suggest tests such as:
- Bone scan. Your doctor may first recommend that you simply have an X-ray, which may help detect bone fractures and degenerative joint disease.
- Computerized tomography (CT). CT scanners combine x-rays taken from many various angles to make cross-sectional images of the within of your body. CT scans can help diagnose bone difficulties and subtle fractures. A special sort of CT scan can accurately identify gout even when the joint isn’t inflamed.
- Ultrasound. This technology uses sound waves to supply real-time images of the soft tissue structures in and around the knee.
- Resonance imaging (MRI). An MRI uses radio waves and a strong magnet to make 3D images of the within of your knee. This test is especially useful for revealing soft tissue injuries like ligaments, tendons, cartilage, and muscles.
If your doctor suspects an infection or inflammation, they’re going to likely do blood tests and sometimes a procedure called arthrocentesis, during which a little amount of fluid is far away from inside the knee with a needle and it’s sent to a laboratory for analysis.
Risks in knee replacement
Knee replacement surgery carries risks. They include:
- Blood clots within the leg vein or lungs
- Heart attack
- Damage to the nerve
Signs of infection
Notify your doctor immediately if you notice:
- Fever over 100 F (37.8 C)
- Shaking chills
- Drainage of the surgical site
- Increased redness, tenderness, swelling, and pain within the knee.
An infected knee replacement generally requires surgery to get rid of the synthetic parts and antibiotics to kill bacteria. Once the infection is cleared, another surgery is performed to put in a replacement knee.
Most knee operations are unproblematic, but about 1 in 20 people may have complications. Most of those complications are minor and may be treated successfully.
The risk of complications developing will depend upon a variety of things including your age and general health. generally, a younger patient with no other medical problems will have a lower risk of complications.
It is important to recollect that any medications used during your hospital stay, for instance, anaesthetics or pain relievers, also can have side effects.
- Blood clots
- Pulmonary embolism
- Wound infection
- Damage to nerves and other tissues
- Bone fracture