Please find the information prepared by us for the benefit of patients and relatives who wish to know about Total Knee Replacement. Please read, copy or print and use
INTRODUCTION
The knee
joint is among the strongest, largest and most complex joints of the body.
Whenever
You walk ,
sit, squat, turn around, drive or perform many other seemingly simple
movements,
You are
depending on the knee for support and mobility. When your knee is healthy, you
may
Take it for
granted, not giving a thought about the job it does for you. But once it starts
to
Become
painful, stiff, and you are forced to restrict certain activities, you may come
to realize
How much
freedom of movement means to you.
Fortunately,
today’s advanced medical technology makes it possible to replace the knee joint
With an
artificial one that reduces pain, allows you to strengthen your legs, and improves
your
quality of
life.
Knee
replacement is a procedure commonly performed throughout the world, and one
that
offers
an outstanding rate of success.
In this
brief, we will discuss how your knee works, how arthritis causes your pain,
and the
Knee
replacement surgery you will have. We will also help you can expect every step
of the way.
HOW YOUR KNEE JOINT FUNCTIONS.
The Healthy Knee. The healthy knee joint is a
remarkable mechanism. It is formed by the Bottom end of the femur (thigh bone),
the top end of the tibia(shin bone) and the patella
(knee cap) .
A healthy knee joint has cartilage between the bones that acts as padding. This
Padding
helps assure a gliding movement of the knee that is both effortless and smooth.
The healthy
knee joint also has a joint capsule which houses the synovial membrane. This
Membrane
produces lubricating fluid which contributes to the smooth movement of the
Knee.
The human
knee is designed to withstand a lifetime of stressful activity. However,
Sometimes
arthritis intrudes, interfering with the knee’s ability to cushion the body
from stress,
and
eventually causing the pain that dramatically
erodes your quality of life.
WHAT IS ARTHRITIS?
Arthritis is
not a symptom of “just getting old”. It is a degenerative or inflammatory
disease
Of the
joints that is not necessarily part of the normal aging process. Indeed, some
patients
With
arthritis present symptoms in their 20s and 30s.
Although
there are several types of arthritis, one of the most common is called
osteoarthritis.
If effects
million of people in the world today.
Arthritis
causes permanent deterioration of the cartilage layers that shield the joint
from
Impact.
Because cartilage cannot repair or replenish itself, it begins to crack, wear
away and
Eventually
disappear. The cushion your knee requires to absorb stress is gone, resulting
In
bone-on-bone contact. The bones in advanced cases may be so rough and pitted
from
Grinding
against each other that they form bone spurs, which often cause stiffness.
In the first
stages if osteoarthritis, your knee may feel stiff and swollen. Later, you may feel
Pain and may
be notice that one leg seems shorter or more crooked than the other.
Eventually,
your mobility may become limited and you may need to alter your lifestyle to
Accommodate
your sore, arthritic knee. If you are overweight or have a malalignment, the
Extra stress
on your knee can accelerate the damage.
Regardless
of your type of arthritis, you may have already had to curb or quit the
activities
You enjoy.
This is partly why arthritis can make people “feel” old, eventhough they are
still in the
prime of life. But there is hope-you have options.
HOW TO KNOW WHEN YOU ARE READY FOR
TOTAL KNEE REPLACEMENT SURGERY?
Total knee
replacement surgery is an elective procedure. Along with your doctor, you will
Decide when
the time is right for this surgery. Your doctor has more than likely treated
your
Condition
with plain medications, anti-inflammatory drugs or perhaps even minor surgery.
But now the
pain has become severe. Even staying off your feet doesn’t help. You cannot
Sleep at
night because of the discomfort. You are probably the best judge of when you
Will finally
need total knee replacement surgery. When the pain becomes so chronic
That even
medication does not seem to help, you are probably ready to consider surgery.
GEETING INTO SHAPE MENTALLY AND
PHYSICALLY
Take the
four essential steps that will help you get into shape before knee replacement
surgery.
1. Commit to the success of your surgery. Working as a team, you, your physician and
Your family must adopt a positive attitude toward the success of your
surgery.
Together, you will gain a clear understanding of the commons goals and
expectations
of the procedure.
2. Loss excess weight. Because excess weight causes strain to be placed on already –
Damaged joints, losing weight is
one of the best ways to improve the condition
Of your knee and optimize surgical results. Remember to seek your
doctor’s
advice
before beginning your weight loss program.
3. Start a physician approved, low-impact exercise plan. After a comprehensive
assessment of your condition, your
physician or physical therapist may recommend
a low-impact exercise plan that will
strengthen your knee without creating further
damage. Do not attempt an exercise
program without consulting your physician!
4. Stop smoking. If you have not already
done so, it is suggested that you stop smoking
This will be good for you during and after your
surgery.
ALL ABOUT TOTAL KNEE REPLACEMENT
SURGERY
Surgeons and
manufacturers have made remarkable advances in joint replacement technology
Over the
last few years. The materials are long lasting and durable. The surgical
methods have
Been fine
tuned and standardized. As a result, the chances for a successful outcome are
Excellent.
THE COMPONENTS OF YOUR NEW JOINT.
In total
knee replacement (also known as total knee arthroplasty, or TKA), the joint’s
bone-
End surfaces
are resurfaced with man-made materials. In total knee arthroplasty, the implant
(prosthesis)
design may vary according to your needs, but the most common implant consists
Of three
component parts. The patella, or knee cap, is made of high- density
polyethylene and
May be
supported by a metal tray.
BENEFITS OF KNEE JOINT REPLACEMENT.
Once your
new joint has completely healed, you will reap the benefits of the surgery.
These
include:
· Reduced joint pain (maybe no pain!)
· Increased movement and mobility
· Correction of deformity
· Increased led strength (if you
exercise)
· Improved quality of life ability to
return to normal activities and pastimes
Most likely,
running, jumping, or other high – impact activities will be discouraged.
RISKS OF KNEE JOINT REPLACEMENT
SURGERY.
As with any
major surgery, there are potential risks involved. It is important that you are
Informed of
these risks before the surgery takes place.
Infection.
Because a bacterial infection from your mouth could infect your new
joint, you
Will be
asked to complete all dental work before surgery. Consult your physician before
Scheduling
any post – Operative dental work.
Blood clots. You could develop blood clots. Many
TKA surgeons prescribe anticoagulation
Medications
after surgery. You may also need to wear elastic stockings for several weeks
To minimize
the risk of blood clots forming and to prevent emboli.
Pneumonia. Pneumonia can sometimes develop in
patients who are lying in bed right after
Surgery.
Getting out of bed soon after surgery is encouraged.
MAKING PREPARATIONS FOR SURGERY
MEDICAL EVALUATIONS
Before
surgery, your doctors needs to understand your overall health status. You will
be
Evaluated in
several ways.
Complete medical evaluation Your doctor will take your health history, an
inventory of
Medications
you now take, and will adminster a total
physical. X-ray images will be taken of
Your knee
that help the surgeon plan your surgery. Some patients will also need chest
X-rays,
ECGs and
other tests to ensure they are strong enough for surgery and recovery.
Preliminary lab work. As part of your pre admission
process, you will need to undergo routine
Lab work.
Your physician’s nurse can explain what each test is and why you need it.
Donate your own blood. You may be asked to donate some blood
to have on hand in case
You need it
during surgery. Some patients cannot donate their own blood. In these cases,
Using
pre-screened blood bank blood is recommended.
GETTING YOUR HOME READY.
To make your
life easier post-operatively, it pays to think ahead about how to adapt your
home
environment for safety and greater efficiency. Here are some tips that can
help:
Arrange for help now. You won’t be able to drive
immediately after surgery. This means
You will
need the assistance of someone who can drive you to your follow up doctor’s
Appointments,
as well as help you with shopping and errands. Try to line up this person’s
Assistance
now.
Reorganize your home.
Bending,
kneeling and squatting will be impossible immediately following your surgery.
Also remember,
you will be on crutches or a walker for a while. Place everyday essentials
In top
drawers or easy-access places. Remove electrical cords and clutter that pose a
hazard.
Don’t wax
floors.
Obtain assistance items . It makes sense to have certain assistance
items ready when you
Return home.
Some suggested items might be a cordless phone,large apron with pockets,
Reaching
aids and bathing aids. Check with your surgeon and hospital to identify which
items
Will be
provided to you at discharge.
PACKING FOR THE HOSPITAL
When packing
your hospital bag, bring your list of medications and the telephone numbers
Of your
relatives or designated “help” person. Bring walking shoes, loose, comfortable
clothes,
Underwear,
books, personal care items and cash for sundries. Please don’t bring jewelry,
large
Amounts of
cash, credit cards or other valuable items to the hospital with you.
A NOTE ABOUT MEDICATIONS.
It is very
important to tell your doctor about every single medication you are taking,
even
Aspirin or
ibuprofen. Some medications are not compatible with anesthetic, and others
Could
increase bleeding or cause other problems. Your physician will determine which
Medications
you can continue up until your surgery, and which ones you must discontinue.
WHAT TO EXPECT THE DAY OF SURGERY
When you are
admitted to the hospital you will change into a hospital gown. Your vital
Signs are
taken by a nurse. An intravenous line containing medications and fluids will be
inserted
comfortably into a vein on your arm or neck. At this point, your
will arrive to begin administration of your
anesthetic for surgery. Once you are transferred to t
the operating table where the surgery will take
place. This is often the last thing you remember
before waking up in the recovery room. You may have
general anesthesia or spinal anesthesia
With
sedation.
WHAT TO EXPECT RIGHT AFTER SURGERY
In the
recovery room, you will recover from surgery until you are awake and alert. You
could
Experience
chills or nausea-these are normal side effects of anesthesia. You may notice:
Driange tubes and catheters.
Catheter may
be in place.
Pain Medications. To manage the pain you may feel right
after surgery, you will be given
Medication.
Elastic stockings.
You may be
fitted with elastic surgical stockings that help prevent blood clots and
improve
Circulation.
You may wear there stockings every day for six to eight weeks following
surgery.
CPM Machine. Your operated leg may be connected
to a CPM (continous passive motion)
Machine,
which slowly bends it up and down to improve range of motion.
You are
returned to your regular hospital room once you are completely awake. Your
family
Members may
then visit you in you room.
TWO DAYS AFTER SURGERY.
IV tubes and
lines are usually removed within the first few days following surgery. If a
Drain was
placed in your knee, then it will probably be removed a day or two after
surgery.
The start of physical therapy.
Physical
therapy usually begins for most patients within the first few days following
surgery.
The
therapist focuses on helping to increase the knee’s range of motion with
bending
Exercises.
You will also be building strength in the knee and muscles of the leg. Often
The CPM
machine is continued at a higher degree of bend.
Walking.
It is imperative
that you get up and begin moving as soon as possible. This ambulatory
Activity
helps prevent clots and speed your recovery. With the help of the therapist and
Nurses, you
should be able to get from the bed to a chair(transfer) at least once or twice
a
Day. You
will eventually be able to transfer with
your crutches or walker.
THREE TO FOUR DAYS AFTER SURGERY
Your
physical therapy will continue, except you will practice becoming more
independent
In your
exercises, transfers from bed to chair, stair climbing and other activities
your
Therapist
has designed for you. Your dressings will be changed, as well as your blood
Tested for
coagulation.
Before you
are discharged from the hospital, your physician and physical therapist will
Review
instructions for your continuing care and exercises at home. You will be given
Prescriptions
for medication you need.
LONG – TERM CARE OF YOUR KNEE.
Your knee
replacement should give you years of service. You can protect it by taking
A few simple
steps:
Watch for and prevent infection.
Because your
new knee is sensitive to infections, you must be diligent about preventing
Them. You
may need to take antibiotics before seeing the dentist. If you suspect a
bacterial
Infection of
any kind, notify your physician right away.
Follow-up care. When you leave the hospital,you will
be given a schedule of follow-up visits.
These visits
will ensure the long-term success of your operation. Your physician may want to
Check you
several times during the first year and annually thereafter. Often,follow-up
X-rays will
confirm proper placement and alignment of the implant.
Weight control. Keeping your weight under control will reduce the amount of
pressure
And stress
on your new knee. Avoid high-impact sports and
participate regularly in low
-impact
activities such as walking, swimming, golfing, or cycling. These are excellent
Ways to
strengthen your new knee and get the exercise you need to stay fit.
I hope the information was useful and pass it on to your friends and people who need it
Warm Regards
Chockalingam
