Knee Joint Replacement

The most common reason for people to require a knee joint replacement is chronic arthritis pain, often caused by osteoarthritis and rheumatoid arthritis. 



Most knee joint replacement surgery patients are over the age of 55, but if necessary surgery can be done at any age. The goal of knee joint replacement is to reduce joint pain, allowing increased mobility of the knee joint. The new ‘kneejoint replacement’ procedure is considered a great improvement compared to the less often used total knee replacement. There are several reasons for this. The newer knee joint replacement surgery is performed through an incision as small as 3 to 6 inches where as the total knee joint replacement requires a large incision (8 to 12 inches). The smaller incision often means less blood loss, less tissue damage, a shorter hospital stay (about 5 days), faster recovery, and much less scarring.

The Surgery

Surgeons make an incision over the front of the patella (knee cap), then the patella is drawn back out of the way in order to see the knee joint. The damaged surface of the end of the femur (thigh bone) and the top of the tibia (shin bone) are removed. The prosthesis is then placed and, using bone cement, is cemented to the ends of the bones. The surgery is often completed under general anaesthesia, but may also be completed with a spinal or epidural aesthetic and can take from one to three hours. The combined method is often used in order to give better pain relief.



Both knees (bilateral) can be replaced at the same time if required, as long as the patient has no other major health problems such as heart disease, severe asthma, etc. When bilateral knee surgery is completed, usually a longer stay in hospital is required. Out-patient physiotherapy is a vital part of the joint replacement program. You will need the  medical equipment to accommodate sitting, such as an elevated chair and commode, after the surgery. Some patients may need in-home care if they do not have someone available to assist them in their daily activities, or take them to doctor or physiotherapy appointments etc.

Complications

1. Post-surgical loosening of the implants
2. Infection ina joint that has been replaced
3. Blood clots in the legs (deep vein thrombosis) – this risk increases with the condition of your veins pre-op and the time staying in bed post-op.

If you have any pre or post operative concerns please contact your surgeon or general practitioner. In over 90% of cases, knee joint replacement is complication-free and gives considerable pain relief with improved mobility.

Joint Replacement

Do you have chronic joint pain? Do your joints click, click, click every time you move? If you answered ‘Yes’ to these questions it is possible you may need a joint replacement.

Joint replacement is one of the most impressive achievements in the history of orthopedic surgery.

Presently more than 750,000 hip and knee surgeries are performed every year. Joint replacement is an elective surgery and commonly used for hips and knees. Over the last 50 years, many great improvements have been made in the design, manufacturing, and implantation of man-made hip joints, giving an increased percentage of successful long-term outcomes. With all the improvements made to joint replacement implants most are estimated to last a approximately 15 years.

Options before Surgery

Your doctor will try a variety of medications most often including anti-inflammatory medications (aspirin or ibuprofen), gold shots, Methotrexate, Imuran and natural substances like glucosamine & chondroitin to ease pain and reduce swelling around the joints prior to surgery being considered. it is often recommended that patients use a cane/walker while walking, decrease physical activity, lose weight if necessary, join a water exercise program and do range of motion exercises. If the pain and swelling does not significantly decrease joint replacement may be the only option.

During & After Surgery

Orthopedic surgeons can replace a painful, dysfunctional joint with metal alloys, high-grade plastics, and polymeric materials making a very functional, long-lasting prosthesis. During the surgery the patient will be under general, epidural or spinal anesthesia. After surgery patients stay in the hospital for three to seven days resting and working with a physical therapist and an occupational therapist to regain their strength and mobility and to learn how to protect their new joints from unnecessary wear and tear.

Risks

With every surgery there are risks and possible complications. If you have a disease that interferes with blood clotting or if you have any lung, heart or kidney problems you may be at risk undergoing general anesthesia. Other things to think about are your physical condition before surgery, how bad your arthritis is, and what joint replacement surgery you'll be having.  Nerves in the area of the total joint replacement could possibly be damaged during the surgery. But this is rare and the nerves often improve over time and may completely recover. If you have concerns do not hesitate to talk to your surgeon or your anesthesiologist.

Joint replacement surgery is on the increase and can be attributed to baby boomers who would like to keep an active lifestyle. Also young athletic patients who repetitively injure their joints are experiencing an earlier onset of osteoarthritis that impacts their daily lives which in return will result in more joint replacement surgeries.