Total Knee Replacement Surgery

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What is a total knee replacement?

Total knee replacement is the surgical procedure where the diseased knee joint is replaced with an artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thighbone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. End of the lower leg bone (tibia) is removed and then it is replaced with a channeled plastic piece of metal stem. Depending on the condition ofthe kneecap portion of the knee joint, a plastic “button” may also be added under the kneecap surface. The artificial components of total knee replacement are as the prosthesis.

What patients should consider a total knee replacement?

Total knee replacement surgery is considered for patients whose knee joints have been damaged by either progressive arthritis, trauma, or other rare destructive diseases of the joint. Common reason for the knee replacement is severe osteoarthritis of the knees.

Regardless of the cause of the damage to the joint, the resulting progressively increasing pain and stiffness and decreasing daily function lead the patient to consider total knee replacement. Decisions are regarding when to undergo knee replacement surgery are not easy. Patients should understand the risks as well as the benefits before making these decisions.

What are the risks for undergoing a total knee replacement?

Risks of total knee replacement include blood clots in the legs that can travel to the lungs (pulmonary embolism). Pulmonary embolism may cause the shortness of breath, chest pain, and even shock. Other risks include urinary tract infection, nausea and vomiting (usually related to pain medication), chronic knee pain and stiffness, bleeding into the knee joint, nerve damage,blood vessel injury, and infection of the knee which can require reoperation. Further, the risks of the anesthesia  may include potential heart, lung, kidney, and liver damage.

What is involved with the preoperative evaluation for total knee replacement?

Before the surgery, the joint adjacent of the diseased knee to be  carefully evaluated. This is important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield significant improvement in function as the nearby joint may become more painful if it is abnormal. Furthermore, all medications that the patient is taking are reviewed. Blood-thinning medications such as warfarin (Coumadin) and anti-inflammatory medications such as aspirin may have to be adjusted or discontinued prior to surgery.

Routine blood tests of liver and kidney function and urine tests are been evaluated for the signs of anemia, infection, or abnormal metabolism.

Total Knee Replacement Surgery Recovery:-

Within 24 hours after surgery, a patient is encouraged to walk with the aid of a walker or other orthopedic device. A patient may stay in the hospital for 3 to 7 days. Patients who require extra attention or do not have home support may be transferred from the hospital to a rehabilitation center.

Physical Therapy After Knee Replacement Surgery:-

After discharge, outpatient physical therapy will be prescribed. A physical therapist will teach the patient:

  • Knee strengthening exercises
  • Knee stretches will inhibit with the development of scar tissue, that can be reduce the range of motion

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