Knee replacement is one of the most common orthopedic operations. The essence of the procedure is to replace the damaged sections of the knee with artificial parts (prostheses). In a joint release of three divisions (compartment) lateral (outer) and medial (inner), which adjoin the joint surfaces of the femur and bolshebertsovoy bones and patellofemoral – the space between the patella and the femur.
Damage to the cartilage covering the joint surfaces, can be caused by a variety of factors, including osteoarthritis and inflammatory arthritis (such as rheumatoid and psoriatic). Total Knee Replacement (Total Knee Replacement) means the replacement of all three parts of the knee joint.
Indications for knee replacement
Knee replacement surgery is planned. Usually it resort when other surgical methods of treatment (e.g. weight loss drugs and intraarticular injection) failed to relieve the pain caused by arthritic knee. In addition candidates for joint replacement should have radiographic evidence of significant lesions. Contraindications to surgery can be, for example, active infection of the knee, or a systemic infection, peripheral circulatory disorders, or a neurological disease affecting the lower limbs.
The main objectives of arthroplasty are pain relief, improved quality of life and preservation of function of the knee. The operation can be performed at any age, with the exception of children who are still growing.
The procedure for replacing the knee joint
Knee replacement is performed in the operating room under general, spinal or epidural anesthesia. With general anesthesia, the patient receives drugs intravenously and by inhalation of the gas mixture to induce sleep. The patient can not move and does not feel anything during the operation and did not remember anything about the procedure after its completion.
Spinal and epidural anesthesia is regional anesthesia techniques in which the injection of anesthetic into the area of the lower part of the back leads to the blockade of the sensitivity of the lower body. With spinal anesthesia, performed the introduction of anesthetic into the cerebrospinal fluid surrounding the spinal cord; with epidural administration of anesthetic medication is carried into the epidural space below the end of the spinal cord (caudal portion). Type of anesthesia is determined by an expert based on the individual characteristics of the patient.
The patient receives antibiotics to reduce the risk of infection. Incision is made to gain access to the internal surfaces of the joint. Then portions removed cartilage and bone with the lower surface of the upper femur and the tibia. This is followed by the implantation of an artificial joint, usually made of metal and plastic. Type of implant, the method of operation and location of the cut depends on the individual preferences of the patient and the surgeon performing the operation. All knee prosthesis consists of a femoral component, tibial and patellar components. There are many variations of the prosthesis from different manufacturers. Most of them are used at least 10 years. Artificial joint lasts longer in older, less physically active patients, and in patients with rheumatoid arthritis (compared to patients with osteoarthritis).
Total Knee Replacement is a common surgical procedure that can help in cases where the non-operational treatment (knee pads, or use orthopedic insoles and medication) are not helping. The operation involves the replacement of all three divisions of the knee joint of the prosthesis in order to reduce pain and improve joint functioning. Most candidates for surgery suffer from joint pain due to arthritis. In preparation for the knee replacement patient should be examined, including the survey, physical examination, x-rays, laboratory tests, and discuss with your doctor all the benefits and possible complications of the operation and to obtain information about alternative therapies. The operation is performed under anesthesia to temporarily immobilize and relieve pain. The surgeon makes the incision for accessing the knee joint cavity and then removing the part of the cartilage and bone from the lower surface of the femur and the upper surface of the tibia. Next is the implantation of an artificial joint made of metal and plastic. After the operation the patient receives medication to prevent infection and pain management. Also, measures are taken to prevent thrombus formation – blood thinning drugs and compressing device for feet or stockings. Some patients will be offered the use of devices for continuous passive motion – a mechanism that lifts and moves slowly operated leg. After surgery, you need to work closely with a physiotherapist to strengthen the muscle strength and resume normal range of motion in the knee joint. The patient can return to normal activities within three – six weeks after the operation, after the completion of the rehabilitation program, may engage in sports with a small load on the knee joint (walking, swimming, cycling). Postoperative complications are rare and can generally be avoided by careful post-operative care.
If you have any doubts about knee replacement surgery don’t forget to ask. Our Ortho Specialist Dr. Biren Nadkarni who have 15 years of vast experience in Joint replacement surgeries. Contact us or visit our website for more information’s