Bright Jordan

Total Knee Replacement

Classification: orthopedic; prosthetic therapeutic operation

Anesthesia type: General, spinal and epidural

Duration: 1 – 2 hours with additional 2 hours in the recovery room and 4 nights at the hospital

The knee is the largest joint in the body and having healthy knees is required to perform most everyday activities

Cause:

The most common cause of chronic knee pain and disability is arthritis. Although there are many types of arthritis, most knee pain is caused by just three types:

  1. Osteoarthritis
  2. Rheumatoid arthritis
  3. Post-traumatic arthritis.

Candidates for Surgery:

There are no absolute age or weight restrictions for total knee replacement surgery.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total knee replacement are age 50 to 80, but orthopedic surgeons evaluate patients individually. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

Orthopedic Evaluation

An evaluation with an orthopedic surgeon consists of several components:

  1. A medical history.
  2. A physical examination (this will assess knee motion, stability and strength).
  3. X-ray images (help to determine the extent of damage and deformity in your knee).

Other tests. Occasionally blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your knee.

Dental Evaluation Although the incidence of infection after knee replacement is very low, an infection can occur if bacteria enter your bloodstream. To reduce the risk of infection, major dental procedures (such as tooth extractions and periodontal work) should be completed before your total knee replacement surgery.

Urinary Evaluations People with a history of recent or frequent urinary infections should have a urological evaluation before surgery. Older men with prostate disease should consider completing required treatment before undertaking knee replacement surgery.

Realistic Expectations:

An important factor in deciding whether to have total knee replacement surgery is to understand what the procedure can and cannot do. More than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living, but total knee replacement will not allow you to do more than you could before you developed arthritis. With appropriate activity modification, knee replacements can last for many years.

The complication rate following total knee replacement is low. Serious complications, such as a knee joint infection, occur in fewer than 2% of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit full recovery.

Blood clots in the leg veins are one of the most common complications of knee replacement surgery. These clots can be life threatening if they break free and travel to your lungs. Your orthopedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings, and medication to thin your blood and it is available now in oral forms.

Physical Therapy:

Most patients begin exercising their knee the day after surgery. In some cases, patients begin moving their knee on the actual day of surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement to allow walking and other normal daily activities soon after your surgery.

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