Listed below is the step by step procedure of total knee replacement surgery:
Total knee replacement is a complex surgical procedure wherein knee joint is replaced with prosthetic implant made up of artificial material or metals. Orthopedic surgeon takes precise measurements of the knee joint in order to determine the size of knee implant. Each component of knee is then replaced with metallic component and held in place with bone cement. The surgery takes around 2-3 hours to complete. Total knee replacement surgery is also called as total knee arthroplasty.
Total knee replacement surgery becomes necessary if:
In pre-operative preparation phase, doctor will first review all your current medications that you are consuming. Anti-inflammatory and blood-thinning medications may be discontinued or adjusted before the surgery.
Secondly, doctor will evaluate hip and ankle joint carefully to ensure optimal outcome and quick recovery. Since, these joints lie near to knee joint, they have to be in good health. If these joints also pain severely, then knee replacement surgery will not yield significant improvement.
Thirdly, doctor will tell you to undergo routine blood test to assess symptoms of anemia and infection. You will also have to undergo liver function test and kidney function test to check possibility of abnormal metabolic rate. ECG and chest X-ray are also conducted prior to the surgery to exclude any risks to heart and lungs.
Lastly, if you weigh above 200 pounds, the surgery will not yield permanent or good result as excess weight will exert undue strain on your knees.
On the day of surgery, again your vitals (blood pressure, body temperature, pulse rate etc.) will be checked. The area of knee will be cleaned with an antiseptic lotion to get rid of all the bacteria. Hair from that area will also be removed. Patient has to wear surgical gown which is already sterilized to reduce chances of infection.
To perform total knee arthroplasty, anesthesiologist will first administer general anesthesia. The procedure of total knee implant is explained in following steps:
Patients who have undergone total knee replacement surgery need to practice certain precautions in order to ensure quick recovery. Here are some of the tips that can help you to recover soon:
Knee joints are designed in such a way that they are able to bear whole body weight. But, soon after total knee replacement surgery, new knee joint is unable to do so. Hence, doctors advise patients to make use of cane or crutches to support their weight. With time, the knee joint will strengthen and will be able to bear your whole body weight effortlessly.
Avoid sitting or standing for long period of time. Try to keep the operated knee straight as long as possible. Avoid squatting, kneeling and bending of the knee joint. Do not sleep on the side where the knee joint has been operated. Climb one stair at a time. Avoid any activity which puts undue stress on your new knee joint.
Your physiotherapist will chalk out an exercise regime that will help in strengthening muscles around the knee joint. Physical therapy is indispensable to enhance overall knee replacement surgery's outcome. Studies have revealed that patients who get physiotherapy classes, recover more quickly than those who do not.
Follow-up procedures should strictly be implemented on time to assess outcome of total knee arhtroplasty. It is in these follow-up procedures that any faults which might have occurred during the surgery come to light. Also, you need to get in touch with your doctor if you notice any abnormality like redness or inflammation etc.
Complications generally arise within 6 weeks post total knee replacement surgery. Hence, one needs to not ignore or underestimate importance of follow-up procedure. The schedule of follow-up procedure will be decided by the doctor.
Another important aspect of quick recovery is your diet. Diet plays an indispensable role when it comes to healing and strengthening your muscles. Since, total knee replacement surgery is an intensive one, one needs to intake sufficient amount of nutrition to give energy to surrounding knee joint muscles.
Proteins, nicknamed as building blocks of body, are important constituents of muscles. Hence, patient needs to consume good amount of protein to gain muscle and increase its endurance. Animal protein (poultry, eggs, fish, meat etc.) provides complete set of essential amino acids. Plant sources also provide all essential amino acids proteins if eaten in right combination. When legumes or dals are combined with rice, vegans are able to fix their protein requirement.
Calcium and phosphorus are another minerals which make your bones strong. Good food sources of these minerals are milk and diary products, green leafy vegetables, cruciferous vegetables like cauliflower and broccoli, orange etc. Other basics of keeping your health in good condition like eating balanced diet and keeping your body hydrated will help in improving overall health.
Knee arhtroplasty has now become mainstream surgery since many people are opting for it. It has become much safe than earlier; thanks to innovations and advancements done in medical science. However, though it has become relatively safer surgery than earlier, risks and complications associated with it cannot be ignored. Here are some common complications associated with total knee replacement surgery:
It's normal for a patient to feel uncomfortable for a day after the surgery. It takes time for the effects of anesthesia to fade away. Modern anesthesia is safe, but it can invoke negative reaction. General anesthesia may cause irregular heart beat in some of the patients. Common side effects of anesthesia are dizziness, vomiting, sore throat, drowsiness, shivering, pain in the site of injection, discomfort etc.
Generally, surgery or injury both increase the chances of blood clots. When blood clot occurs in the legs, it is termed as deep vein thrombosis (DVT). DVT possesses minor risk. However, it could become a cause of major concern if it travels up to lungs or heart through bloodstream. To avoid the problems of blood clot, doctor will prescribe you blood thinning medicines like warfarin, aspirin etc. Lower leg exercises and elevating your leg at frequent intervals will increase blood circulation and also help in preventing clots from forming.
Since knee joint is exposed during surgery, chances of infection are likely. To reduce chances of infection, operation theaters have air filters that restrict particles in the air. Also, surgeons and their assistants follow strict hygiene rules and dress up in protective wear. Doctors also prescribe antibiotics prior and after the surgery, to reduce chances of infection.
Some patients may show negative reaction to metallic components used in total knee replacement surgery. Most of the metal implants are composed of titanium or chromium-cobalt based alloy. Hence, its important that you check if you suffer from these metal allergies to avoid complications.
Scar tissue or other complications can sometimes lead to loss of motion in the knees. Special exercise and physical therapy could be a possible solution to this kind of problem. Severe stiffness in the knee is called arthrofibrosis which can be cured by follow up procedure in which either the prosthetic knee implant is adjusted or scar tissue is broken up.
Improper placement, malfunctioning of knee joint etc. can cause failure of prosthetic implant. Some parts of prosthetic implant or mechanical components (that includes polyethylene component as well) can wear off as well causing implant failure. Another cause of implant failure could be prosthesis loosening up after a long period of time.
Simple and easiest way to detect if your implant is working optimally or not is by carrying out knee bend test. If your knee bends well, your implant is working properly. But, if you are not able to bend your knee, chances of implant failure cannot be ignored. Revision surgery or follow up surgery is the solution for implant failure.
During total knee replacement surgery, neurovascular damage is inevitable. But, sometimes, it may happen that the nerve which leads to foot might feel numb. After few months, as nerves and tissues heal, the problem disappears.
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