Replacing a Damaged Knee You use your knee every step of the way, so a sick knee can make your life very painful. You may even feel pain when you squat to tie your shoes. However, you don’t have to live like this. In many cases, an orthopedic specialist who specializes in joint disease can replace your damaged knee. This is a safe and effective procedure. For most patients, a total knee replacement means restoring pain-free knee motion. This booklet will help you understand what knee replacement means to you. It will also answer many of the questions you may have. No matter how old you are, a faulty knee can prevent you from participating in the activities you enjoy. The pain and stiffness can even limit your daily life. Knee problems get worse over time. The following can cause your knee pain.
Chronic diseases, age-related strains, and injuries that do not heal well The benefits of knee replacement You may not have to live with knee pain for the rest of your life. Total knee replacement surgery can almost always relieve your joint pain. Your damaged knee joint is replaced with an artificial joint (prosthesis). The surgery does not make you young again, but the vast majority of patients who have total knee replacement receive all of the following benefits.
Complete disappearance or significant reduction in joint pain.
Increased strength in the leg. As knee pain disappears, you are able to use your leg more, which strengthens your muscles.
Improved quality of life. You are able to perform daily activities with ease and participate in some sports.
Long-term pain-free activity. The majority of total knee replacements with imported prostheses last for many years.
Knee function A healthy knee joint is able to extend and flex freely. It absorbs pressure and glides smoothly; thus allowing you to walk, squat, and turn without any pain. However, when the knee joint breaks down, it can no longer cushion pressure. You will feel pain when you move. Sometimes the joint may become swollen or even uncomfortable at rest.
The knee joint is located where the thigh and calf bones meet. A healthy knee joint is able to move freely. This is because the joint is covered with a smooth layer of cartilage and surrounded by strong muscles.
Cartilage is a smooth layer of soft tissue. It covers the surface of the ends of the thigh and lower leg bones and the deeper surface of the knee. Healthy cartilage relieves pressure and allows the knee joint to glide freely.
The ligament is another type of soft tissue. It holds the bony ends of the joint together.
Muscles provide the power for the movement of the knee joint.
Tendons attach the muscles to the bones.
Knee joint disease When the knee joint is diseased, the cartilage gradually destroys or disappears over time. Because the cartilage does not repair itself, the damage gets worse and worse. At first, you may feel only a little stiffness in the joint. When the cartilage in the joint breaks down, the bone ends are exposed and rub against each other in direct contact, causing pain.
Osteoarthritis can cause the cartilage to break down or disappear after years of normal knee use. The exposed bone ends rub directly against each other and their surfaces become rough and damaged. The joint is constantly worn down. Excessive weight or a problem with the shape of the joint such as a rotundity or X-leg puts additional stress on the knee joint and can accelerate the destruction of the joint.
Inflammatory arthritis Chronic diseases such as rheumatoid arthritis or gout can cause swelling and heat in the joints. As the disease progresses, cartilage can disappear and joint stiffness can occur.
InjuryA fall or impact on the knee can damage the knee or cause a fracture. If this injury does not heal well, it can cause the cartilage to wear away.
If you are experiencing any of the above discomforts and would like to come to the hospital, you can call and schedule your appointment in advance to reduce your waiting time at the clinic. It is best if your husband, wife, parents, or children can accompany you to the appointment. Please bring your recent lab results and x-rays with you.
If you do not have an Echocardiogram, you will be taken to the Echocardiogram room for a knee X-ray. You and your companion will then be led into the consultation room for an examination by the doctor. Once the doctor confirms that your knee needs joint replacement surgery, you will be given a detailed explanation of the benefits and risks of this procedure. If you have any questions or requests, please do not hesitate to ask them and we will answer all of your questions and do our best to accommodate your requests. If you agree to undergo the procedure, we will schedule your inpatient surgery date and perform the necessary pre-surgical tests on an outpatient basis.
Are you a candidate for surgery?
You may have already received many medications or other conservative treatments to reduce your joint pain. You may even have undergone surgical treatment such as arthroscopy to resolve your joint problem. However, if these treatments do not completely resolve the problem, total knee surface replacement is the only right option for you. To determine if you are a good candidate for joint replacement surgery, your doctor will perform a thorough examination. X-rays of both of your knees will be taken. When planning your treatment, your surgeon will consider how a procedure can best improve your quality of life.
Your medical history Your doctor will learn about your past medical conditions. He or she will ask you about the area of your knee pain and how it worsens. If you have other joint conditions or have had a traumatic injury to the joint, tell your doctor. If your condition requires surgery, be sure to tell your doctor if you have had any past anesthesia or bleeding problems.
Your physician will examine your knee fully, such as swelling around the joint, pressure on nearby muscles and tendons, strength, stability and mobility of the joint.
X-rays will show a picture of your knee joint. It can show changes in the size and shape of the joint, as well as lesions such as bone spurs, cysts, or bone defects. X-rays can also help your doctor design joint replacement surgery. Your surgeon will use the x-rays to determine exactly where to place the prosthesis.
Your treatment plan The doctor will use your examination and lab results to develop the right treatment plan. Surgery may be the best way to treat your condition. Total knee replacements can last for many years. If the first replacement wears out, it can often be replaced again. However, if you are still very young, your doctor may recommend that you have surgery later. Medication or arthroscopy can reduce your symptoms until you are old enough for surgery. However, patients with rheumatoid arthritis may not be age-restricted.
If you have other medical conditions that may adversely affect your surgery, they should be effectively controlled or treated before surgery. In particular, heart disease, diabetes, hypertension, liver disease, kidney disease, or dental disease. This will promote healing after joint replacement and reduce the risk of surgery. If you smoke, it is best if you stop it.
You will have an electrocardiogram, blood and urine tests, liver and kidney function, blood clotting and other laboratory tests done as an outpatient. A chest X-ray may be needed. Please tell your doctor about any medications you are taking, such as hormones, anti-inflammatory drugs, pain relievers, etc. Blood transfusions are often required after surgery. To prevent blood transfusion reactions, you should use your own blood as much as possible. Usually blood is drawn from your body one week before the procedure and then returned to you after the procedure. If necessary, you can use someone else’s blood that has been tested and proven to be healthy.
Inpatient Surgery You are usually admitted to the hospital 3 days prior to your surgery. Please prepare loose fitting clothes and pants. A systematic physical examination will be performed. The anesthesiologist will visit you the day before your surgery. It is normal for you to feel a little nervous. But it is important to rest well. This is a common procedure in our hospital, and we usually have very good results. We will give you intravenous antimicrobials the night before the procedure. No food or drink is usually allowed from 8pm until the next day of surgery.
Risks and complications As with any surgical procedure, there are possible risks and complications associated with total knee arthroplasty. They include.
Unexpected reaction to anesthesia Blood clots Infection of the knee bone and peripheral vascular nerve damage Dislocation of the prosthesis Procedure When the pre-operative preparation is complete, we will take you to the operating room. Once in the operating room, an anesthesiologist will administer anesthesia to you. This will allow you to sleep or not feel anything below the waist during the procedure. A very thin catheter will be placed. We will then make an incision directly in front of your knee joint, cut through the joint surface, remove any diseased joint surfaces, and fit you with a new joint surface. Finally, the incision is closed with sutures. The length of the incision is approximately 15-20 cm and the incision is usually made directly in front of the knee joint.
The surfaces of all the bones in the mounting joint are cut to fit the prosthesis. After testing for a good fit, the thigh bone prosthesis, calf bone prosthesis and knee bone prosthesis are installed in that order. These prostheses then form your new joint. A drainage tube will be placed in your knee joint.
You will be sent back to your room after surgery. You will be closely monitored and your post-operative pain will be managed by placing an intravenous pain pump. Your knee will be placed on a passive knee mobilizer, the main purpose of which is to move the knee joint so that it can bend and straighten passively.
During your stay in the hospital, the rehabilitation staff will help you exercise. You will learn many skills to get back to your normal life as soon as possible. You will learn how to increase the strength of your muscles and improve your lung capacity. To make it easier to move around, we will give you pain medication before you exercise.
Exercise increases blood flow and reduces wound swelling. And the increased strength of the muscles in the front of the thigh makes the knee joint more stable. Exercise also allows you to bear weight without pain so that you can return to your normal work and life as soon as possible.
Walking again You can stand and walk the day after surgery. The IV tubing will be a little inconvenient for you to use the walker, but your rehab provider will teach you how to fix the problem and teach you how to use the joint for weight bearing. With exercise, you will soon be able to walk with the walker.
Spirometry involves coughing and deep breathing after surgery to improve your breathing depth. You will have to do this many times within an hour.
When you wake up after the surgery, we will take you back to your room. You will usually feel some pain. Please tell us honestly about the level of pain and we will give you the best pain relief treatment. Soon after surgery, you will receive the fastest and safest treatment possible. Each room is equipped with heating, cooling, air conditioning and a bathroom. If you have any questions or requests during your stay, please do not hesitate to ask and our medical staff will do everything possible to solve your problems and meet your requests. Your illness will be treated and recovered quickly and effectively in a comfortable, warm environment.
You will be closely monitored in your room on the day of surgery and will be provided with all the equipment mentioned below.
1.Passive knee machine, mainly used for passive flexion and extension of the joint.
2. Special socks to prevent the formation of blood clots. You will also be given medication to prevent the formation of blood clots.
Treatment of pain During the first few days after the surgery, we will help you to stop the pain by giving you pain medication intravenously or intramuscularly. It is normal if you still have mild pain after the medication is administered. However, please contact your nurse or doctor immediately if any of these conditions occur
The pain gradually gets worse.
Significant pain or swelling.
Redness, warmth and discharge from the incision.
Chest pain or difficulty breathing.
Fever over 39 degrees.
Be careful to avoid activities that do not sprain your knee, which is most likely to happen when you turn around without moving your foot.
Do not participate in strenuous sports such as long-distance running, high jumping, long jumping, walking or basketball.
Activities you should do to strengthen your muscles are to walk every day, longer each week than the previous week, and you will feel better each day.
Pre and post-surgery precautions Cure dental disease before surgery; prepare your own blood; stop taking aspirin or ibuprofen for a few days after surgery; keep the incision dry after surgery; notify your doctor immediately if there is any sign of infection; complete limb exercises.