Total Knee Replacement surgery is considered when all other conservative measures have failed to provide successful intervention, and may be performed for the following reasons:
1. To relieve pain
2. To improve alignment and correct the bony deformity
3. To improve joint stability
4. To maximize quality of life
5. To optimize activities of daily living
Total Knee Replacement surgery is a common procedure performed on more than 6,00,000 people worldwide each year. With recent advances in surgical technique and implant design, patients are experiencing dramatic improvement in knee pain, function and quality of life along with improved life of implants.
How will Knee Replacement help you?
A) Improvement in quality of life: After Knee replacement you will have less pain and greater mobility to perform day to day activities more easily knee replacement will help you to lead a more comfortable and independent life
B) Pain relief: with the new knee joint, you will feel considerable reduction or even disappearance of pain in Knee joint.
C) Improvement in Joint Range of Motion: The replaced knee can largely restore your previous range of motion
Getting Ready For Knee Replacement
A) Medical Evaluation: You will be asked to have a complete physical examination before knee replacement surgery to assess your health. These tests will also help to identify any condition that could interfere with your knee surgery
B) Tests: You may need to get several laboratory tests done like Blood analysis, Urine analysis and cardiac work-up. This will help your doctors to plan your surgery.
C) Preparing your Knee: You should not have any external or internal infection; especially your knee and leg should be devoid of any skin infection or irritation.
D) Blood Donation: A transfusion may be necessary after surgery; therefore you may wish to donate blood prior to surgery.
E) Other important points to remember:
You have to be physically healthy, which means you should not have any fever or any other active infection, etc.
Tell your doctor about any treatment/medication you may be taking. Your doctor may ask you to stop taking medications which may interfere with your surgery
Tell your doctor about any treatment of significance, such as dental extractions or peri-odontal work, that you may be scheduled for, during the peri-operative period.
F) Preparation for the Hospital:
G) Evening before Surgery:
DO not eat or drink after midnight ( as per Doctor`s advice)
Shower (with 5 min scrub to surgical area with special liquid/soap provided)
KNEE REPLACEMENT SURGERY
Total Knee Replacement is a surgical procedure by which a arthritic knee joint is replaced with an artificial knee. During a total knee replacement surgery:
The lower end of the femur ( Thigh bone) is removed and replaced with a metal shell/covering
The upper end of the Tibia (lower leg bone) is also removed and replaced with a metal/plastic stem
In between these two components, a polyethylene spacer is inserted that provides the bearing surface.
If your knee cap is also affected then a plastic button may also be added under the knee cap surface
RECOVERY IN THE HOSPITAL
After Knee replacement surgery, you will have to stay in the hospital for few days. You may experience some pain during the recovery period which will be managed by some analgesic medication
Movement of the joint is important for its speedy recovery. Light exercises should begin immediately after surgery. Walking will help you to recover faster.
Before you are discharged from the hospital, you will be helped to achieve:
Getting in and out of the bed by yourself
Bending your knee approximately 90 degrees or more
Straightening your knee, completely
Walking with crutches or a walker on a level surface and climbing up and down 2 to 3 stairs
RECOVERY AT HOME
You should continue to stay active when you are at home for full recovery. You will observe a gradual improvement and increased endurance, over the next 3 to 6 months.
A) Planning your work: You will be able to walk on crutches or a walker soon after surgery. But you will need help for many weeks with tasks like cooking, shopping, bathing, etc.
B) Home Planning:
Fix safety bars in your shower or bathroom
Secure your staircase with supports for safety
A stable chair with good cushion
If commode height is low, then seat extension may be required
Remove all loosed carpets and cords to avoid falls
Do`s during recovery period
Keep the wound area clean and dry
If your wound appears red or begins to drain, inform the doctor
For leg swelling, keep the legs elevated
Inform your doctor immediately if you have calf pain, chest pain, or shortness of breath
Regular physiotherapy to strengthen thigh and calf muscles
Practice regular walking with a walker/crutches
Don’ts during recovery period
Do not play high impact sports
Avoid gaining weight
Do not take bath or shower until the sutures are removed. This may take 10 to 14 days after surgery
In a small percentage of patients, as with all major surgical procedures, complications can occur which may be:
1) DVT/Pulmonary Embolism: When the blood clots in large veins of leg (DVT) and in some instances, may get dislodged from there and travel to lung capillaries and cause Pulmonary embolism. Steps to minimize this complication are
a) Foot and ankle excercises to increase blood flow and enhance venous return in the lower leg
b) Blood thinning agents
c) Elastic stockings
d) Early Mobilisation
If you develop swelling, redness, pain and tenderness in the calf muscle, report to the doctor at the earliest
2) Infection: Although great precaution is taken before, during and after operation, infections do occur in a small percentage of patients following knee replacement surgery. Steps you can take to minimize this risk:
a) Immediately report any redness, swelling, tenderness, increased drainage, persistent fever above 100 deg
b) Take your medications as directed
c) Strictly follow incision care guidelines
3) Knee Stiffness: In some cases, mobility of the knee may be significantly restricted and you may develop contracture in the joint which leads to stiffness in the joint To maximize knee range of motion: