Who Is Offered Knee Replacement Surgery
A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, have not reduced pain or improved mobility.
You may be offered knee replacement surgery if:
- you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced
- your knee pain is so severe that it interferes with your quality of life and sleep
- everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
- you’re feeling depressed because of the pain and lack of mobility
- you cannot work or have a social life
You’ll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.
Ial Knee Replacement Overview
A is also known as unicompartmental knee arthroplasty or unicondylar knee arthroplasty. In this surgery, damaged cartilage and bone are removed and replaced only in one diseased compartment of the knee. This differs from a total knee replacement, in which bone and cartilage from the entire joint are replaced.
Partial knee replacement is suitable for people who experience arthritis only in one compartment of the knee joint, rather than throughout the joint. It can also provide relief from pain and stiffness in some people who have medical conditions that make them poor candidates for total knee replacement surgery.
Mayo Clinic Q And A: Pain After Knee Replacement Surgery
DEAR MAYO CLINIC: It has been months since I had knee replacement surgery, but my knee is still hurting. Can anything be done at this point, or does the surgery just not eliminate pain in some patients?
ANSWER: Although its uncommon, a small percentage of patients continue to have chronic knee pain after knee replacement surgery. But when that happens, you dont have to just put up with the pain. Have your situation evaluated. Several additional treatment options may ease chronic knee pain after knee replacement.
Knee replacement surgery, also known as knee arthroplasty, is one of the most common orthopedic surgeries performed today. It is most often used to repair joint damage caused by osteoarthritis or rheumatoid arthritis that causes severe knee pain and makes it hard to perform daily activities.
During knee replacement, a surgeoncuts away the damaged bone and cartilage from your thighbone, shinbone andkneecap, and replaces it with an artificial joint. For most people, kneereplacement significantly improves mobility and relieves knee pain. But in somepatients, the pain persists after surgery.
Your first step in dealing withongoing knee pain in this situation is to make an appointment to see thesurgeon who performed your knee replacement. He or she can evaluate your kneeand check for possible complications from the surgery, such as an infection ora problem with the artificial joint.
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Knee Replacement Surgery Shouldnt Be Your First Line Of Treatment
Even if your knee pain is significant, most doctors will recommend non-operative treatment options before recommending knee replacement surgery. This might include weight loss, an exercise regimen, medications, cortisone or other injection therapies, a minimally invasive surgical procedure, such as a meniscectomy, or bracing.
How Long Will The New Knee Joint Last
For 8090% of people who have total knee replacement, the new joint should last about 20 years, and it may well last longer.
If you’ve had a partial knee replacement, you’re more likely to need a repeat operation about 1 person in 10 needs further surgery after 10 years.
The chances of needing another operation is greater if you’re overweight and/or involved in heavy manual work.
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Which Type Should I Have
Your surgeon will discuss this with you. It will depend on how much of your knee is affected by arthritis – it may not be possible to know this until your surgeon has started your operation.
If you have a partial knee replacement it is more likely that you will need to have it done again, than if you have a total knee replacement . Sometimes the reason for choosing to have a partial knee replacement is that it leaves the option to have a TKR at a later date. However it’s also more likely that you will need to have your total knee replacement re-done, if you had a partial knee replacement done before having your total knee replacement.
There are over 150 different designs of knee replacement and some of the differences between all the different types and makes of knee replacement parts aren’t known, particularly how they perform in the long term. In many countries, registries have been set up so that anyone who has had a knee replacement is entered into the register. The information collected is used to monitor how their replacement is performing. In the UK, patients also enter information about their health and quality of life before and after their operation.
A study of over 500 patients with osteoarthritis of the inner part of their knee has compared the effectiveness of total and partial knee replacement. The two groups were followed up five years after surgery, and asked to complete questionnaires about pain, activity and day-to-day living.
Looking After Your Knee Replacement
Your new knee will continue to improve for as much as two years after your operation as the scar tissue heals and you exercise your muscles. You’ll need to look after yourself and pay attention to any of the following problems:
Stiffness Sometimes the knee can become very stiff in the weeks after the operation for no obvious reason. Try placing your foot on the first or second step of the stairs, hold on to the banister and lean into your knee. This should help to improve movement and flexibility in your knee. Its very important to continue with the exercises you were working on in the hospital.If the stiffness doesnt improve after about six weeks your surgeon may need to move or manipulate your knee. This will be done under anaesthetic.
Pain Pain caused by bruising from the operation is normal in the first two months, and you’ll probably still need to take painkillers at six weeks to help you sleep through the night. You may still have some pain for as long as six months. If you still have pain after this, speak to your physiotherapist or GP.
Infection You should speak to your GP or hospital if you notice any signs of infection, for example:
- breakdown of the wound with oozing/pus or sores
- increased pain
- redness and the affected area feeling warmer than usual or smelling unpleasant.
You should also look after your feet see a doctor or podiatrist if you notice any problems such as ingrown toenails that could become infected.
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Is It Time For A Total Knee Replacement
Climbing stairs has become an ordeal. Taking the dog for a long walk is out of the question. Squatting to pick up a grandchild just doesn’t happen anymore. When you’re not able to do the things you want and love to do, your body may be telling you it’s time for a total knee replacement.
A total knee replacement is a major surgery that requires a big commitment on your end to recover from it. For the first three months after surgery, you’ll be healing and doing exercises to build strength and improve your range of motion. Full recovery from a total knee replacement takes a up to a year.
Before you and your orthopedic specialist decide it’s time, you’ll want to give noninvasive therapies a chance, including:
- Modifying your activities.
- Using a cane or walker.
- Working with a physical therapist.
There’s no age range for having a total knee replacement. It’s a matter of decreasing function and increasing pain that matches up with what X-rays of your knee are showing. For instance, if you’re 50, have bad arthritis and are unhappy with your quality of life, then it’s reasonable to undergo a total knee replacement to regain function and mobility at a younger age.
You’ll also consult with an orthopedic surgeon and begin preparing for surgery by:
Depending on a number of factors, you may be a good candidate for same-day surgery. Be sure to discuss this option with your surgeon. Otherwise, expect to spend one or more nights in the hospital.
Topics in this Post
Minimally Invasive Partial And Total Knee Replacement
Minimally invasive is a term used for any type of surgery that is less invasive than traditional or open surgery. Minimally invasive partial or total knee replacement surgeries are innovative procedures that can be as effective as traditional surgery.
Minimally invasive knee replacements use smaller and fewer incisions around the knee, and have been proven to reduce postoperative pain, minimize trauma to tissue, and quicken recovery time.
The most appropriate candidates for minimally invasive knee replacements have minimal or moderate deformity, maintain a healthy weight, have few pre-existing health conditions and are motivated to participate in the rehabilitation process.
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What Are The Risks Of Having Knee Replacement Surgery Too Soon
The average age of someone who gets a knee replacement is about 70 years old. However, some people decide to get knee replacement surgery as young as 50.
There are several reasons younger people may opt for a knee replacement, particularly those who are extremely active or athletes. If youre young and considering a knee replacement, here are a couple things to know:
- Your implant can wear out prematurely. If youre in your 40s or 50s, youre likely living a more active life than someone in their 60s or 70s. More activity, means more wear and tear on the joint implant, which can cause it to wear out more quickly than expected. And that means pain, stiffness and mobility issues can return.
- Knee replacements dont last forever and you may need another surgery. Many patients have knee replacements that last for 20 years or more. But the longer and harder you use your replacement joint, the more likely it becomes that youll need a second knee replacement surgery to replace a worn out implant. And of course, knee replacement surgery carries some risks, especially as you age.
What Are The Advantages Of Partial Knee Replacement Over Total Knee Replacement
Compared to total knee replacement, partial knee replacement better preserves range of motion and knee function because it preserves healthy tissue and bone in the knee. For these reasons, patients tend to be more satisfied with partial knee replacement compared with total knee replacement. They are still candidates for total knee replacement should they ever need it in the future.
There is also less blood loss during surgery, and knee motion recovers faster with partial knee replacement.
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This Common Procedure Can Help Reduce Pain And Restore Your Ability To Move Better But How Do You Know When Its Time For Surgery
Knee replacement surgery is one of the most successful procedures in all of medicine, according to the American Academy of Orthopaedic Surgery . Its also very common: Over 790,000 knee replacements are performed each year in the United States. A complete knee replacement more correctly, a resurfacing places metal pieces to recreate the surface of the joint, with a plastic separator in between and possibly a plastic resurfacing of the inside of the kneecap .
Although youll need a little help afterward, you should be able to begin walking again either the same day or the day after surgery. And the procedure is overwhelmingly successful: The AAOS estimates that 90% of modern total knee replacements are still working more than 15 years after surgery.
How do you know if you need a knee replacement in the first place? Deciding when its time is a personal decision between you and your doctor, but there are some factors that make you a more likely candidate for surgery.
What Happens After Knee Arthroplasty
After surgery, you will get moved to a recovery room. The healthcare team will watch you for a short time to make sure you wake up from the anesthesia without complications. Theyll also monitor your vital signs and pain level.
Occasionally, people who have knee replacement surgery go home the same day. If you need to stay in the hospital, it will likely be for one day. Additional time spent in the hospital is based on medical necessity.
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Ial Or Total Knee Replacement Surgery With Clearpoint Health Network
Patients from across Canada and all over the world choose Clearpoint Health Networks private surgery clinics for partial or total knee replacement surgery. Our orthopedic surgeons have years of experience and achieve excellent results for our patients. We are committed to helping you regain full motion in your knee so that you can go back to your daily activities and live pain free. We strive to provide exceptional pre- and post-operative care. We aim to provide all our patients with a compassionate, caring, and rewarding experience. Clearpoint Health Network is a network of accredited private healthcare clinics across Canada, with centres in Toronto, Vancouver, Winnipeg, and Calgary. Contact us to receive rapid access to the knee surgery you need, so you can go back to living a healthy and active life.
Your Pain Prevents You From Doing Normal Activities Or Caring For Yourself
If you cant get relief from other treatments, your knee pain may start interfering with your daily life.
In general, the timing of a total knee replacement is determined by the impact the knee is having on your quality of life, says Jay Lieberman, MD, chief of orthopaedic surgery at Keck Medicine and chair and professor of orthopaedic surgery at the Keck School. If conservative treatments are not working and you have significant pain while walking, you may be a good candidate for surgery.
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Technical Details Of Total Knee Replacement
Total knee replacement surgery begins by performing a sterile preparation of the skin over the knee to prevent infection. This is followed by inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incision–typically 6-7 in length though this varies with the patients size and the complexity of the knee problem–is made down the front of the knee and the knee joint is inspected.
Next, specialized alignment rods and cutting jigs are used to remove enough bone from the end of the femur , the top of the tibia , and the underside of the patella to allow placement of the joint replacement implants. Proper sizing and alignment of the implants, as well as balancing of the knee ligaments, all are critical for normal post-operative function and good pain relief. Again, these steps are complex and considerable experience in total knee replacement is required in order to make sure they are done reliably, case after case. Provisional implant components are placed without bone cement to make sure they fit well against the bones and are well aligned. At this time, good function–including full flexion , extension , and ligament balance–is verified.
Finally, the bone is cleaned using saline solution and the joint replacement components are cemented into place using polymethylmethacrylate bone cement. The surgical incision is closed using stitches and staples.
Anesthetic
Length of total knee replacement surgery
Pain and pain management
So Am I Too Young To Have A Knee Replacement
Given the information presented, it can be difficult to decide when to have your knee replacement, especially if you are younger than 70. There are a number of factors that go into this decision and it is important to consider that the younger you get your knee replaced, the more likely you are to need a revision, especially if you are a male. But that does not mean that you should wait forever! If you have significant pain and decrease in function as a result of severe knee osteoarthritis, you would benefit from a knee replacement, regardless of how young you are. In this case, if you wait too long, the knee replacement may not be as effective.
If your osteoarthritis is only mild and is not causing significant pain or dysfunction, and you are only in your 30s, 40s, 50s, or 60s, then it is probably best that you hold off on having your knee replaced. There are other ways to manage your osteoarthritis, such as exercise. Surgery should be reserved for people who have more severe osteoarthritis that is not effectively managed with other treatments, such as exercise and physical therapy.
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Nerve And Other Tissue Damage
There’s a small risk that the ligaments, arteries or nerves will be damaged during surgery.
- Fewer than 1 in 100 patients have nerve damage and this usually improves gradually in time.
- About 1 in 100 have some ligament damage this is either repaired during the operation or protected by a brace while it heals.
- About 1 in 1,000 suffer damage to arteries that usually needs further surgery to repair.
- In about 1 in 5,000 cases blood flow in the muscles around the new joint is reduced . This usually also needs surgery to correct the problem.
Lose Weight To Lessen Stress On Your Knees
Number one on Valaiks list of ways to reduce knee pain and delay knee replacement: reaching and maintaining a healthy weight.
Extra weight puts pressure on the knees and increases stress on the joint, increasing pain and making it hard to exercise, Valaik explains. Research compiled by the Johns Hopkins Arthritis Center confirms that carrying extra pounds raises your risk of developing knee arthritis and speeds up the destruction of cartilage that cushions the joint.
I know its not easy, he says, but losing weight really helps, whether youre dealing with arthritis in one or both knees. If you are overweight or obese, consulting with a nutritionist or a bariatric specialist may be the right place to start.
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