Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended worldwide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.
Modern technological advances have made computer-assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. Perfect alignment and balance are achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.
There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.
In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred to as prosthesis. The design of these highly flexible implants replicates knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.
Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. The post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.
Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced by artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.
When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of people over 50 years when having pain, swelling and deformity fail to respond to medicines, physiotherapy, injections and rest.
Aim of the surgery-
Correct the deformity: Relieve the pain and give near full movements almost immediately after the procedure. Details including techniques and safety, it is a safe, rewarding surgery with a success rate of as high as 99.5% when done by an able and experienced professional.
Anesthesia: Usually it is the spinal cord epidural where one is rendered numb for 3 to 4 hours waist down. Sometimes general anesthesia is given. A 4 to 5 inches cut is made in front of the knee and all the damaged cartilages, bones, loose bodies are removed from the lower end of the thigh, upper end of the tibia (usually of few millimetres) and the surface re-crafted to match the size and shape of the artificial joint (it is usually imported). They are fixed with bone cement. The ligaments and muscles are reattached and the parts closed.
Recovery: Stand up and walk a few steps with a walker the day after the procedure i.e. in 24 hours. Physiotherapy in hospital for 5 to 7 days and/or walking. progressively longer walks and exercises over the following 15 days. Stitches are removed in 15 days. The patient can return back to normal activity in 4 to 8 weeks the surgery.
Activities: Normal walks of 3 to 5 km per day Climbing stairs, cycling, swimming, and driving can be performed with the new implant(s) now.
Avoid: Squatting/kneeling Prohibited: contact sports like football, cricket, tennis; jumping; adventure sports Longevity of joints: 15-35 years depending on the materials used.
Knee replacement surgery is a procedure that is used to replace a worn out knee joint with an artificial knee joint. Such surgery is advised if your knee is causing pain and limiting your daily activities, provided other treatments have failed to cause the desired impact.
Once the knee replacement surgery is completed, the focus shifts to the recovery phase.
The duration of the recovery depends on the type of surgery and the individual.
After the surgery, painkillers are administered to provide relief from the pain.
In some cases, oxygen is administered through various tubes if required.
A blood transfusion may also be required after a knee replacement surgery.
A drain will be attached to the wound to drain out the blood from it and prevent the accumulation of blood in the wound.
The dressing of the wound should be changed regularly.
Post- Surgery Care -
Post-surgery, you will need assistance to help you walk. If the surgery that you underwent was minimally invasive, then you should be able to walk on the very same day. Your physiotherapist will prescribe and show you some exercises to strengthen the knee. It is important that you follow his/her instructions to avoid complications.
A passive motion machine is sometimes prescribed as it helps to restore the movement of the knee. It helps in reducing the swelling by keeping your leg elevated and moving the knee when you are lying down.
Here are some knee replacement recovery tips:
Avoid doing any work that puts pressure on the knees.
Eat nutritious meals so that the body receives proper nourishment, thus allowing your leg to heal faster.
Avoid heavy exercises which can strain your knees.
Perform all the exercises prescribed by your physiotherapist to speed up the recovery process.
Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.
Knee replacement is mainly of two main types:
Procedure: In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.
In total knee replacement, four steps are performed:
After general or spinal anaesthesia, an incision of 8-12 inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material.
After Effects of the Procedure: After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.
There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.
Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all!
Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area.
Causes of Hip and Knee Pain
Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include:
● Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis.
● Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain.
● Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area.
● Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury.
● Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces.
Knee Replacement Procedure
● Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone.
● Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone.
● Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition.
● Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components.
Hip Replacement Procedure
● Metal stem replaces the damaged femoral head and positioned into the femur’s hollow center.
● On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head.
● The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place.
● A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface.
Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.
Knee replacement is a surgery wherein an artificial joint is used to replace a diseased, damaged or worn out knee. This surgery is common among people who fall in the age group of 60-80, but recent trends seem to suggest that younger people are opting for this surgery as well. The lifetime of the artificial knee joint is around 20 years, provided the knee is well cared for.
Why do you need Knee Replacement?
Most common reason is “high grade osteoarthritis” due to wear and tear of the knee joint. The pre-hospital study of the Knee joint is mandatory and would decide what kind of Replacement is suitable to the patient. If there is diabetes or hypertension associated with this, then it should be controlled well before undergoing surgery. Hemoglobin of at least 10 gm% is required.
If the mobility in your knee joint is reduced leading to impaired functioning of the knee joint, then you might need a knee replacement surgery. You may experience pain while walking, sitting and, in some cases, resting as well.
Some of the common reasons why you may opt for this particular surgery are:
Knee replacement surgery is classified into:
1. Partial Knee Replacement: In this surgery, only one part of the joint is replaced.
2. Total Knee Replacement: Total knee replacement surgery involves replacement of both sides of the knee joint.
The usual hospital stay period is around 2-3 days after the surgery is completed. Initially, you will require the help of crutches to walk for at least 2 months. You may also be asked to do gentle knee strengthening exercises. It may take up to two years to recover completely from a knee replacement surgery.
Human bones are continuously being removed and formed which is necessary for its proper maintenance. However, in certain cases, especially with aging, some bones and joints will be worn down to an extent where the body will not be able to reform them. This is especially true in the case of hips which may become worn due to age or other problems within the body.
When this happens, a hip replacement surgery can be performed to replace the original joints with a prosthesis or artificial hip which is usually made out of metal alloy or a specially formed composite material or even a combination of the two. Along with other parts, it replaces the natural hip with an artificial hip to restore mobility and other related functions.
Benefits of hip replacement surgery:
1. Lessening hip pain - This is one of the major factors as well as symptoms of requiring hip replacement surgery. Due to the grinding down of the bones, even the slightest movement causes pain and after the surgery and the recovery period, the pain is lessened.
2. Correction of bone deformity - When the bones grind down and are abnormally reformed, deformities may occur reducing mobility. Artificial hips will ensure that deformities are corrected and resulting problems are thus eliminated.
3. Return to normal activities and resumption of normal activities - This is possibly one of the primary advantages of this surgery, although it entails a long recovery period. However, most patients can get back to their normal activities and are able to resume a pain-free life.
4. Ability to have painless sleep - Many persons who have hip arthritis or AVN (avascular necrosis of femoral head) or other congenital hip anomalies are not able to sleep properly due to pain mainly at night (night cries). But after surgery and recovery period then can get rid of that night cries and have sound sleep.
5. Leg strength increase - Many patients tend to have an increase in their leg strength as one side of the hip tends to become very weak due to bone problems before surgery. After surgery and recovery, the same side tends to have an increased strength due to the implant.
6. In most cases, a lifelong solution to hip problems - As the hip prosthesis are made up of metal alloy and if surgery is done by proper technique by trained surgeon, it tends to last for life long, as it usually doesn’t tends to have any problems if all post operative instruction about life style changes given by the doctors is been followed properly.
Oa is a chronic progressive degenerative disease, medical cure of which is still not possible. The last and only resort to get rid of the severe knee pain and deformity is total knee replacement surgery.
Joint Replacement Surgery is a procedure where the damaged surface of the advanced arthritic joints are removed and replaced with artificial joints, such as metallic, plastic and ceramic joints.
These surfaces closely replicate the original anatomy.
When do you need a knee replacement?
When you suffer from severe pain or deformity in the joint (knee in this case), the pain or stiffness and deformity makes it difficult to perform simple tasks. Severe grade IV osteoarthritic knees of people over 50 years when have pain, swellingand deformity fail to respond to medicines, physiotherapy, injections and rest.
Aim of the surgery: