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All about knee joint replacement

Knee joint replacement is a procedure to interchange the worn-out knee joint with an artificial, human-made knee replacement known as a prosthesis. In this surgery, the damaged knee cartilage and bone are taken out, and new synthetic pieces are placed inside the knee. The human-made prosthesis is mostly made up of metal alloys, polymers, and plastics and emulates the functions of a knee. As per the American Academy of Orthopaedic Surgeons (AAOS), the newly replaced knees can fit according to one’s needs and specifications. The knee replacement surgery typically takes about two hours, but the post-procedure recovery and rehabilitation could last a few months. The knee replacement procedure is also termed as knee arthroplasty. Knee joint replacement is quite a common surgery these days, and over 600,000 knee replacements are done every year in the United States.

What is the purpose of a knee joint replacement?

The most common reason for knee replacement surgery is the damage caused due to arthritis – it could be osteoarthritis or rheumatoid arthritis. Knee joint replacement is only recommended once other treatments and less invasive healing methods have not succeeded. Some common first-line treatment alternatives include weight loss, painkillers or other medications, physical therapy, and assistive devices like using a cane or a knee brace. The significant factors in deciding if you should go for knee joint replacement are:

● How severe is your knee pain and can you manage daily activities like walking or climbing stairs?

● Are your knees deformed like bows, or “blow out” frequently?

● What is your age?

● How is your overall health?

Knee replacement surgery is for people who are over the age of 55. If one gets their knees replaced at a younger age, then they might outlive their replaced knees and may need a revision.

How do you prepare for knee joint replacement?

As a first step, your doctor evaluates your general health and capability to handle the anaesthesia risks. They assess:

  • Complete medical history
  • Your physical examination
  • Blood tests
  • X-rays
  • Any other imaging tests

Your doctor would also find out if there were any prior surgeries or any ongoing health conditions that you might have. He would also ask about any medication and supplements you’re taking and might request you to stop taking some or all of those medicines before the knee replacement surgery.

He could also enquire if you are allergic to any specific medicine or anaesthesia. The doctor would decide on general anaesthesia or local anaesthesia in your spine, depending on your overall condition.

After the procedure, you can most likely walk with the help of a walker initially and then with crutches for some weeks. However, before the knee joint replacement surgery, you should prepare your home to make your recovery time easy for yourself:

  • Install rails or handles in showers and also around the toilet.
  • Keep a chair and footrest to elevate your leg.
  • Keep your living space on the ground floor to avoid stairs.

Your surgeon and the physical therapist would give you proper instructions on how you can prepare for the surgery. It is essential to follow those instructions as much as possible.

What happens after knee joint replacement?

To get into the surgery, you would have to change into a hospital gown, and an IV would be given to you to provide you with the required fluids and nutrients. Then anaesthesia is administered just before beginning the procedure. During the knee joint replacement surgery, which lasts for around one to two hours, the surgeon would make a surgical cut just above your knee. Then they remove the damaged cartilage and bone and put in the artificial knee joint to the femur, or your thighbone, and tibia, the main bone present in the lower leg. Surgeons use specialised pins screws, and cement to affix the new joint. In the end, they sew the incision wound by stitching it and then apply a bandage. The patient recovers from the procedure in a particular recovery room where some doctors monitor vital signs.

What are the complications associated with knee joint replacement?

Every surgery or procedure entails the risk of excessive bleeding and other complications like the formation of blood clots or infection. Your surgeon would explain in case there are any risks and what could be done to minimise them. As per statistics, less than 2 per cent of the patients undergoing total knee replacement have serious complications.

Some complications related to knee joint replacement surgery are:

  • Excess bleeding
  • Blood clots formed in the leg or lungs
  • Breathing problems due to anaesthesia
  • Sudden heart attack
  • Knee stiffness
  • Any nerve damage in the knees
  • Stroke
  • Artificial knee wear and tear over time

You must get in touch with your doctor immediately in case you experience any of these symptoms:

  • Drainage from the surgical scar
  • Chills
  • Fever going over 100°F (37.8°C)<
  • Severe pain, swelling, redness, and soreness in the knee

Infection is also a considerable concern for patients who get surgeries for artificial joints. There is a fear of bacteria and some other contaminants infecting your new artificial knee. In case you get an infection in the knee, and it gets serious, then your surgeon might have to take out the whole or some part of the artificial knee to treat the infection. After they are confident that it’s treated, then they implant once again.

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