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Knee replacement surgery

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Knee replacement surgery

Orthopedics & Joint Replacement | by Dr. Golam Hashib | Published on 01/04/2020

A knee replacement surgery or medically known as total knee arthroplasty is a surgical procedure that involves relieving pain and restoring the normal functionality in a severely ailing knee joint. Knee replacement surgery is one of the most common and extremely safe medical procedures. The surgery involves separating the affected bone and cartilage from the thighbone, shinbone, and kneecap, then replacing it with an artificial joint formed of metal and plastic – called a prosthesis.


The surgery is needed by patients, whose knee joints have been damaged or weakened by injury, trauma, or arthritis, causing immense pain and restriction in functioning. A knee replacement surgery is best suited for people who experience extreme pain in knee joints, due to weakening, wear-tear, injury, trauma, etc. of the bone and cartilage forming the joint. A painful knee joint causes a lot of problems such as difficulty in movement, including climbing stairs, walking, sitting, or lying. A knee replacement surgery is advised by the doctor, in case other treatment options such as medication, physical therapy, or (mobility aids including walkers, sticks, etc.) fail to restore healthy functionality and relieve pain. The surgery is safe, has minimum complications, and aims to correct a problematic knee joint and leg deformity. 


Even though knee replacement surgery is a highly safe surgical procedure, yet in-depth assessment and careful consideration must be done before taking the final call. All alternative methods of treatment should be evaluated; moreover, complications, risks, recovery, and precautions must be clearly understood before making the final decision. On the other hand, to assess the suitability of the patient for the surgery, the orthopedic surgeon will conduct a physical examination (to know the ability, stability, strength, flexibility, structure, etc. of the knee joint) to understand symptoms, and also perform several tests such as X-rays to evaluate the damage and current condition; blood and urine test; and an electrocardiogram to be aware of any heart problems beforehand. Also, the surgeon will consider the age, weight, physical activity, and overall health of the patient while deciding on the surgical method and prosthetics. Moreover, the surgeon will ensure that the expectations of the patient from the surgery are realistic. 


 Who needs knee replacement surgery?


A knee replacement surgery is ideal for patients who have been suffering extreme pain or have trouble in taking normal functioning from the knee joint because of reasons such as injury, osteoarthritis, age, trauma, etc. An ailing knee joint can cause severe pain and can make even simple activities such as walking, sitting, lying, climbing, standing and sitting, etc. 


What types of arthritis affect the knee?


Arthritis is a major factor that affects the mobility and strength of the knee joint. Some specific types of arthritis that cause damage to the joint are:


Osteoarthritis: A type of degenerative arthritis that causes a breakdown of joint cartilage and corresponding knee bone. This mostly occurs in middle-aged and older adults.


Rheumatoid Arthritis: This type of arthritis causes pain and stiffness in the knee joint because of excess synovial fluid which is caused due to inflammation of the synovial membrane.


Traumatic arthritis: A type of arthritis that occurs because of injury and causes heavy damage to the knee joint.


What are the risks involved in knee replacement surgery?


With the medical advancements today, a knee replacement surgery or a total knee arthroplasty is considered one of the safest medical procedures in the world. The surgery has effective results and minimum risks like ordinary surgery. Some common risks associated with knee replacement surgery include:


  • Blood clotting in legs or lungs
  • Stroke
  • Heart attack or heart damage
  • Infection
  • Nerve or blood vessel damage
  • Infection 
  • Implant problems
  • Continued pain after surgery


However, two important complications that can arise post-knee replacement surgery include:


  • Infection after the surgery is characterized by high fever, chills, swelling, leakage from the surgical area, tenderness, extensive joint pain, and redness. 
  • Exhaustion and wear down of the imitation joint that was placed in the knee to replace the original knee joint. This complication or problem does not arise immediately but occurs over a period of time due to wear-tear of the knee joint majorly because of rigorous physical activities, such as weight lifting and others.


How to prepare for knee replacement surgery?


Pre-operative consultations and tests begin a month before the scheduled surgery to assess the condition and the course of treatment in-depth. 


Pre-operative tests: An orthopedic will do some tests, including a blood and urine test to determine the blood count, blood clots, heart condition, etc. This will help the surgeon determine if surgery is the best.


A doctor will conduct several tests to assess the blood count, existing blood clots, and heart health (through electrocardiograms (ECGs)). You may also be asked to take a urine test.


Food and medications: To prepare for the surgery, the doctor might suggest you avoid certain medications or supplements. Also, the doctor may ask you to not eat anything post-midnight on the day of the surgery.


Post-surgery preparations: Post the total knee arthroplasty, one might need to use crutches or a walker or even take some rest. Make sure to make all arrangements before in hand to ensure a smooth recovery process. Make arrangements such that you avoid taking the stairs, have safety bars and handrails for support in the washroom, keep your leg elevated while sitting, sit while taking a shower, take a higher toilet seat, etc.


The recovery from a total knee arthroplasty is slow but effective. In most cases, it relieves pain and improves mobility while enhancing the quality of life. A knee replacement can last for as long as 15 years if proper care is taken. A person can resume everyday activities almost after three to six weeks post the total knee replacement surgery. More strenuous activities such as swimming, golfing, and biking, can be engaged post full recovery. Although activities such as jogging, jumping, skiing, tennis, sports, etc. You must consult your doctor before undertaking any activity which might involve stress on the replaced knee.


During the recovery period and post the recovery, the doctor might advise you to undergo some physical therapy to strengthen the replaced joints and maintain smooth movement of the replaced knee. Depending on case-to-case, special recommendations for diet, physical activity, the recovery process, follow-ups, may be made. Total knee arthroplasty is a collective decision and one that must be made will full consideration of the current condition, the need, as well as the after-effects. 


Recovery post a knee replacement surgery


A knee replacement surgery is a major surgical procedure, and it will take some time for the new knee joint to recover and assume normal functionality. A knee replacement surgery is a boon for people suffering from lack of mobility and functioning or excessive pain; the surgery enhances the quality of life and can even last for more than 15 years, providing care is taken. In general cases, a patient can resume normal routine activities almost after three to six weeks after the knee replacement surgery. However, it is advisable to refrain from rigorous activities such as swimming, golfing, biking, etc. which can be undertaken once complete recovery and a go-ahead from the doctor are acquired. Although activities such as jogging, jumping, skiing, tennis, sports, etc. can be resumed slowly. It is important to keep the doctor involved in the undertaking of any new physical activity that might stress the newly replaced knee joint.


Moreover, the patient may be advised to undergo some physical therapy, which is essential for the strengthening of the replaced joints and maintenance of the smooth movement of the replaced knee joint. Also, special diets, physical exercises, follow-up appointments, and tests, might be suggested by the doctor to fasten the process of recovery.


In all, knee replacement surgery is a shared decision and one that must be made after careful analyses of the current condition of the knee, the need for the surgery, the intensity of symptoms and problems, as well as the after-effects of the surgery.