Knee replacement is a relatively mature procedure that addresses joint deformity and pain and restores normal walking, but post-operative running and jumping can be limited, as well as reduced joint flexion. In short, this procedure is a boon for patients who cannot walk normally and have joint pain. Let’s look at some of the aspects of this surgery that can affect the outcome.
There are four major elements that contribute to the success of knee arthroplasty.
What type of patient chooses joint replacement surgery?
Total knee arthroplasty is a larger joint reconstruction surgery, mainly used in cases of severe joint pain, instability, deformity, and severe impairment in activities of daily living, which have been ineffective or ineffective with conservative treatment.
1. Age.
The majority of cases requiring total knee arthroplasty for knee lesions are in the 60-70 year old group, and most are in stage III-IV osteoarthritis with severe joint pain, deformity, and joint dysfunctional activities, and have undergone repeated and repeated conservative treatments that are ineffective or poor. In other cases, the age restriction is relatively relaxed, such as cases of rheumatoid arthritis, tuberculous arthritis, and ankylosing spondylitis.
2. Diagnosis.
Rheumatoid arthritis, osteoarthritis, traumatic arthritis, tuberculous arthritis
(the condition is in a resting state), hemophilic arthritis, primary or secondary osteochondral necrotizing disease, ankylosing spondylitis knee arthritis, etc.
3.Signs and symptoms.
a, pain: VAS pain assessment, walking pain, night pain, need to take painkillers.
b. Deformity: inversion and valgus deformity, flexion contracture deformity.
c. Dysfunction: ROM changes, walking distance is significantly shortened.
d.Conservative treatment is ineffective or the effect is not significant.
e. X-ray: standing orthopantomograph (full-length X-ray of the lower extremity is best if available): joint space narrowing or disappearance, subchondral bone sclerosis, cystic change, bone redundancy, patellofemoral space narrowing or disappearance, patellar tilt and displacement.
One principle is that we treat the patient, not the x-ray. Even if the x-ray changes are obvious, and the patient’s symptoms, signs and functional performance are mild, do not easily perform total knee arthroplasty for the patient.
4. Patient general condition.
The majority of total knee arthroplasty cases are elderly patients, and each patient is unique in that there are varying degrees of heart, brain, lung, kidney, hematologic, diabetic, or tumor disease. Understanding and evaluating the patient’s systemic condition and strictly grasping the indications and contraindications for surgery are critical to determining whether the patient is eligible for surgery and whether the patient can safely survive the perioperative period.
5.Local condition.
To understand the skin blood flow, skin sensation, previous surgical scars, limb swelling, varicose veins and functional activities of foot and ankle joints, in order to determine the corresponding surgical plan. Initial understanding of osteoporosis by X-ray.