Total knee replacement

Total knee replacement

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FAQs

Arthritis is an umbrella term for a number of disease entities in which the joints become inflamed and the cartilage that lines the bones deteriorates. Eventually, bone on bone wear occurs. As the disease progresses, patients often experience pain, stiffness, and disability. The vast majority of people diagnosed have osteoarthritis and in most cases the cause of their condition cannot be identified. One or more joints may be affected. Rheumatoid Arthritis (and other forms of inflammatory arthritis) is a disease that affects the entire system and multiple joints. This type of arthritis is an autoimmune disorder in which the body perceives the cartilage to be a foreign substance and attacks it.

If you have been diagnosed with osteoarthritis, having an affected knee does not mean that you will develop arthritis in the opposite knee. About 40 percent of patients who have osteoarthritis in one knee will have the same condition in the other knee. In contrast, patients with rheumatoid arthritis often develop problems in both knees.

The increasing deformity of becoming more bowlegged or knock-kneed represents the greater wearing out of cartilage and bone from one side of the knee as compared to the other.

The cracking sound represents the rough surfaces rubbing against one another. Instead of smooth cartilage sliding against cartilage, arthritic bone is rough and irregular, and will not glide well.

Modifying your activities to avoid those that bring on the pain may make your knee condition more bearable. In addition, losing weight will greatly decrease the forces across the knee joint, also reducing pain.

Physical therapy often does help in early stages of arthritis of the knee. Our orthopedic surgeon can teach you some of these exercises that focus upon strengthening the quadriceps muscle. In addition, we may prescribe physical therapy for your knee to give you a structured program to follow.

The decision to have a knee replacement is a personal one, and must take into account the risks and benefits of the procedure. Most patients will elect to have a total knee replacement when they can no longer bear the pain associated with their arthritis. Others will decide to have the surgery when they feel that their knee arthritis is preventing them from participating in activities that they enjoy.

We have performed knee surgery in persons upto the age of 95 years, as long as they have undergone a complete and detailed examination, full set of investigations, and have been given clearance for surgery by appropriate physicians.

We have operated on patients who are overweight (even as much as 145 kg!), diabetic, and have heart problems provided they have undergone a complete and detailed examination, full set of investigations, and have been given clearance for surgery by appropriate physicians. Diabetes and high blood pressure need to be controlled before surgery. Usually after bypass surgery or if stents have been inserted for ischemic heart disease, the general recommendation is to wait for 6 months before going for knee surgery.

Yes, healthy patients younger than 75 years old, with no cardiopulmonary disease may be candidates for such surgery. We can tell you more about what is involved.

The operation generally takes between 1 hour.

Most total knee replacements at KNEECARES are performed under regional anesthesia. It is called an epidural block, which is the same kind of anesthesia given to women in labor. The epidural anesthesia provides numbness from the waist down, so there will be no pain during surgery. In addition, patients are given a light sedative to make them as sleepy or awake as they want to be.

No. There are 6 simple exercises which will be shown to you while in hospital and which, like most of our patients, you will be able to do yourself even after going home. Rarely, if your muscles are very weak, you will be advised to work together with a physiotherapist to strengthen them.

Like most of our patients, you will be shown how to correctly climb up and down a few steps soon after your surgery. However, we will advise you to avoid climbing several floors for 1 month, after which you will be able to do so comfortably. Initially you may be more comfortable going up or down one foot at a time putting both feet on the next step. Over the next few months you will start going up and down in normal fashion once your muscle strength, balance and confidence return.

 You should avoid climbing several flights of stairs as a form of exercise and sitting cross-legged on the floor. This is to be avoided, especially if you are overweight, to prevent excess load on your new knee and to ensure that it lasts for many years.

You can drive a car 1 month after surgery once you can sit comfortably and have good control on your leg movements; you should be able to suddenly apply the brake when needed in an emergency. You should discuss this during your check-up 1 month after surgery.Return to work depends on the level of activity involved and mode of transport: those who are sedentary and do light work usually can resume in 4-6 weeks; those who do more strenuous work may need 6-8 weeks.

Current studies indicated that about 85 percent of prostheses will function well for 25 years. If your prosthesis wears out you may be a candidate for a second knee replacement.

The implant for a total knee replacement is made of a combination of metal and plastic. The metal parts are generally composed of cobalt chrome, and the plastic is made of ultra-high molecular weight polyethylene.

While in hospital you will be shown how to sit and get up from a bed, chair and commode, walk with a stick, climb up and down a few stairs. If you have an elevator in your residence, you can start going out of the house after suture removal at 2 weeks. After a month you will be able to ascend and descend several flights of stairs, drive a car, swim, go for walks, and use public transport.

While knee implants generally do not set off metal detectors, more sensitive machines may register the presence of the implant. Some physicians give their patients cards to show at the airport that explain that the bearer has received a knee prosthesis containing metal.

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