Do you doubt that you can handle surgery?
You may have undergone many medications or other conservative treatments to reduce your joint pain, or you may have even undergone surgical treatment such as arthroscopic surgery. However, if these treatments do not completely resolve the problem, or if your condition worsens, total knee surface replacement is the only right option for you. To determine if you are a candidate for joint replacement surgery, your doctor will perform a thorough examination. When planning your treatment, your doctor will take into account your general condition to maximize your safety.
Your Disease History
Your surgeon will learn about your past medical conditions. In addition to asking about the location of your knee pain and how it worsens, you will be asked about other systemic conditions such as high blood pressure, coronary artery disease, diabetes, liver disease, kidney disease, etc. If you have, please tell your doctor. If you have had surgery before, be sure to tell your doctor as well, and if you have had any anesthesia or bleeding problems in the past.
Your physical examination
Your doctor will examine your knee fully, such as any swelling around the joint, any pressure in the nearby muscles and tendons, strength, stability, and mobility of the joint.
X-Ray
X-rays can show the image of your knee joints. An x-ray of both knees will be taken. It can show changes in the size and shape of the joints, as well as lesions such as bone spurs, cysts, or bone defects. X-rays can also help your doctor design joint replacement surgery. The surgeon will use the x-ray to determine exactly where to place the prosthesis.
Your treatment plan
Your doctor will use the results of your exam and tests 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 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.
Preparing for surgery
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, high blood pressure, 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.
Risks and complications
As with any surgical procedure, there are risks and complications associated with total knee arthroplasty, however, the chances of them occurring are very, very low. They include: unexpected reactions to anesthesia, blood clots, infection, damage to the knee bones and surrounding blood vessels and nerves, and dislocation of the knee.
Surgical procedure
Once the pre-operative preparation is complete, we will take you to the operating room. Once in the operating room, the anesthesiologist will administer anesthesia. 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.
Fitting the joint
The surfaces of all the bones in the 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 fitted in that order. These prostheses then form your new joint. A drainage tube will be placed in your knee joint.
After surgery
After surgery, you will be taken back to your room. You will be closely monitored and given pain medication through a tube that will be placed in your back. Your knee will be placed in 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, the rehabilitation staff will help you with exercises. You will learn many specific ways to exercise in order to get back to your normal life as soon as possible. You will learn how to increase muscle strength and improve lung capacity. We will give you temporary pain medication if necessary to facilitate movement. Exercise increases blood flow and reduces wound swelling. 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 will be able to 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 use it and teach you how to put weight on the joint. With exercise, you will soon be able to walk with a walker.
Spirometry
You will have to cough hard and breathe deeply often after surgery to improve your breathing depth. You will have to do this several times in an hour.
In your room
On the day of surgery, you will be closely observed and will be provided with all the equipment mentioned below.
1. Knee passive motion 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.
All in all knee replacement is a demanding surgery, but far less scary than you might think. Let us do what we can for your aching joints and give you back a pair of beautiful legs and a healthy gait.