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1. When is Knee replacement necessary ?

You've taken the anti-inflammatory medications.

You’ve done the pain pills. 

You’ve even tried the hard-to-pronounce glucosamine and chondroitin sulfate, the alternative supplements for osteoarthritis.

You've stayed off your knee. 

Walked with a cane. 

Done the cortisone injections 

You have given physical therapy your best shot. 

You've even lost a few pounds to ease the pressure.

But your KNEE STILL HURTS a lot. 

You feel it before you get out of bed in the morning. 

Your knee stays swollen and has begun to bow. 

If any of these symptoms sound familiar, you may need knee replacement surger

2. What causes joint problems?

 The most common causes of the joints not working properly are OSTEOARTHRITIS and RHEUMATOID ARTHRITIS. While nobody is certain what causes arthritis, several things may contribute to joint weakening and lead to arthritis, including:

  • Heredity (runs in the family)
  • Problems with the development of the joint
  • Genetic (inherited) tendency to problems with the cartilage
  • Minor repetitive injures
  • Severe trauma to the joint cartilage (the cushioning tissue at the end of the bones)

While being overweight does not necessarily cause arthritis, it can contribute to early joint problems that can get worse quickly.

3. What tests need to be done before surgery?

 

Before the operation certain blood tests and radiological investigations need to be performed to ascertainthe patients physical fitness.

these commonly include blood and urine test, xray of the chest and ECG.

Any infection in the body, eg: urine, chest or teeth is also treated prior to the infection.

the patient is generally admitted a day before the operation. 

Blood test:

CBS (COMPLETE BLOOD COUNT)

LFT (LIVER FUNCTION TEST)

KFT (KIDNEY FUNCTION TEST)

BT CT (BLEEDING TIME, CLOTTING TIME)

PT INR (PROTHROMBIN TIME,INTERNATIONAL NORMALIZING RATIO)

RBS (RANDOM BLOOD SUGAR)

BLOOD GROUP

HIV

HBsAG

SERUM ELECRTOLYTES

URINE ROUTINE

What happens after the operation ?

 

After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Knee replacement surgery usually requires an in-hospital stay of 3 days for one knee and 5 days for bilateral knees if operated.

It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. A continuous passive motion (CPM) machine may be used to begin the physical therapy. This machine moves your new knee joint through its range of motion while you are resting in bed. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.

What are the advantages of operation ?

  • Pain relief
  • Improved mobility
  • Better treatment response
  • High satisfaction rates 

What are the risk of Knee Replacement surgery ?

 

  • Infection in the artificial joint
  • Neurovascular (i.e., nerve and/or blood vessels) damage
  • Wear and tear of prosthesis (i.e., the knee implant device) due to heavy use
  • Stiffness of the knee if scar tissue develops
  • Complications involving the lungs, heart, gastrointestinal, or neurological system
  • Failure to relieve knee pain
  • Loss of the leg due to blood clots

What are the long term results of this operation ?

The artificial joint that is implanted in the knee is made up of most advanced material. This is the reason that it will be able to last for years together. Sometimes due to misuse or even otherwise the joint can wear away quickly. but this occurs only in less than 5% of cases. 

What is Navigated Total Knee Replacement

Navigation was one of the most significant advances in instrumentation for total knee arthroplasty over the last decade. It provides surgeons with a precision tool for carrying out surgery, with the possibility of intraoperative simulation and objective control over various anatomical and surgical parameters and references. 

Advantages:

1. Increases accuracy of implant placement.

2. Small incision and lesser soft tissue dissection.

3. Adds to longevity of implant.

4. Minimizes risk of fat embolism as avoids drilling of intramedullary canal.

Cruciate retaining knee replacement

There are 2 types of knee prosthesis which are available for knee replacements

1. Cruciate retaining 

2. Posterior stabilizing

1. Cruciate retaining:

If this type of implant design is being used to replace the knee. then a ligament i.e posterior cruciate ligamnet (PCL) is retained during surgery.

Advantages being:

a. Less bone loss

b. PCL functions normally thus providing natural inherit kinematics of the knee.

c. Faster recovery as compared.