Total Knee Replacement

Dr. Rahul Damle - Total Knee Replacement Surgeon in Pune

 

Introduction

 

This provides information for you and your family regarding total knee replacement surgery. The goals are to restore your knee to a painless, functional status, and to make your hospital stay as beneficial, informative and comfortable as possible. Meet the Best Orthopedic Doctor in Pune Dr. Rahul Damle has vast experience in Total Knee Replacement surgery

Normal Knee

 

The main reason for replacing any arthritic joint with an artificial joint is to stop the bones from rubbing against each other. This rubbing causes pain. Replacing the painful and arthritic joint with an artificial joint gives the joint a new surface, which moves smoothly and without causing pain.

 

Total knee replacement is a surgical procedure in which injured or damaged parts of the knee joint are replaced with artificial parts. The ends of the thigh bone (femur) and the shin bone (tibia) are removed and sometimes, the underside of the kneecap (patella) is removed. The artificial parts are cemented into place. Your new knee will consist of a metal shell on the end of the femur, metal and plastic trough on the tibia, and if needed, a plastic button in the kneecap.

Total Knee Replacement

 

The knee joint is formed where the thighbone (femur) meets the shinbone (tibia). A smooth cushion of articular cartilage covers the end surfaces of both of these bones so that they slide against one another smoothly. The articular cartilage is kept slippery by joint fluid made by the joint lining (synovial membrane). The fluid is contained in a soft tissue enclosure around the knee joint called the joint capsule.

 

The patella, or kneecap, is the moveable bone on the front of the knee. It is wrapped inside a tendon that connects the large muscles on the front of the thigh, the quadriceps muscles, to the lower leg bone. The surface on the back of the patella is covered with articular cartilage. It glides within a groove on the front of the femur. For better treatment meet Dr. Rahul Damle who is the best Total Knee Replacement Surgeon in Pune

Who is a candidate for a total replacement?

 

Total knee replacements are usually performed on people suffering from severe arthritic conditions. Most patients who have artificial knees are over age 55, but the procedure is performed in younger people as well.

The circumstances vary somewhat, but generally, you would be considered for a total knee replacement if you have any of the below :

  • You have almost daily pain.
  • Your pain is severe enough to restrict not only work and recreation but also the ordinary activities of daily living.
  • You have the stiffness of your knee.
  •  instability (constant giving way) of your knee.
  • You have deformity (lock-knees or bowlegs).

This is elective surgery, it is not a matter of life or death. The decision to proceed with total knee replacement surgery is ultimately yours, it is you who must accept the risks and potential complications. Dr. Ruhul Damle is the Best knee Replacement Surgeon in Pune who is expert to treat all type of orthopedic disorders. If you suffering any orthopedic problem visit Rahul Damle’s Clinic.

What can I expect from an Artificial Knee?

 

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and can’t do. An artificial knee is not a normal knee, nor is it as good as a normal knee.
If replacement provides you with pain relief and if you do not have other health problems, you should be able to carry out many normal activities of daily living. About 90 percent of patients with stiff knees before surgery will have better motion after a total knee replacement. More than 90 percent of individuals who undergo total knee replacement 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 won’t make you a super-athlete or allow you to do more than you could before you developed arthritis.
Activities that overload the artificial knee must be avoided. Some types of activities must be avoided for the rest of your life, including jogging and high impact sports. Dr. Rahul Damle is the best orthopedic doctor in Pune.

PATIENT EXPECTATIONS SURGEON EXPECTATIONS
100% pain relief 90-100% pain relief
100% normal walking pattern Trace of limp to 100% normal walking pattern
Able to run and jump Should avoid running or jumping
Able to bend knee fully Can bend to 110-120°
The knee will "last forever" The knee will last for about 15 years
The knee will never get infected Occasional knees will get infected !

How successful is total knee replacement surgery?

Results are generally very good, most people are relieved of nearly all of their knee pain.
Approximately 90% of total joints will last 15 yrs – depending on patient use and activity levels. This may vary from person to person.

The goals of total knee replacement are, in order of priority:

1. pain relief
2. standing and walking that is not limited by the knee
3. improved knee motion
4. improved knee strength

How long do artificial knees last?

About 90 % of total knee replacements are successful for up to 15 years. The major long-term problem is loosening. This occurs because either the cement crumbles (as old mortar in a brick building) or the bone melts away (resorbs) from the cement.

Preparing for Surgery

Preparing for a total knee replacement begins a few weeks ahead of the actual surgery date. Maintaining good physical health before your operation is important. Activities that will increase upper body strength will improve your ability to use a walker or crutches after the operation.

Pre-op Medical Check-up :

During your pre-op visit, lab tests will be advised to ensure that you are in good general health. Chest x-rays and an ECG are obtained if you have not had one taken for six months or if otherwise indicated. If at any time you become ill, such as with a cold or flu, you need to call your doctor. Remember, we want you to be in your best possible health!

The doctor will also make sure that a urinary tract infection is not present. Urinary tract infections are common, especially in older women, and often go undetected. Teeth need to be in good condition. An infected tooth or gum may also be a possible source of infection for the new knee. The orthopedic surgeon may ask you to see a medical doctor.

You may be instructed to stop taking your anti-inflammatory medications (Ibuprofen, aspirin, etc ) one week before surgery. Bring a written list of past surgeries and of the medications and dosages that you normally take at home.

A physician will also review your medical history and the medications that you take. He will listen to your heart and lungs, and do a general physical exam. He will check for any type of infection. If the infection is found, surgery is generally delayed until the infection is cleared.

Will I need blood?

Most patients don’t require a blood transfusion after a single side total knee replacement.
If needed it, there is always blood available in the blood bank.

What are the risks of total knee replacement?

Total knee replacement is a major operation. The effect of most complications is that you must stay in the hospital longer.
The most common complications are not directly related to the knee and usually do not affect the result of the operations. These complications include urinary tract infection, blood clots in a leg, or blood clots in a lung.

1. Infection



Infection can occur following any type of surgery. To minimize the potential for infection to occur at the time of surgery, antibiotics are given before & after surgery. Infection following a total knee replacement is of special concern because of the prosthetic components. The prosthetic components have no blood supply and this makes them susceptible to infection. If the prosthetic components become infected, additional surgery is almost always required to treat the infection.

2. Persistent Pain

While more than 95% of patients have complete or nearly complete relief of pain following a total knee replacement, there are some patients with some persistent pain. In many cases, the pain resolves with time. In other cases, a specific cause for the pain can be identified and treated.

3. Blood Vessels and Nerves



There are several major blood vessels and nerves around the knee. Rarely, a major blood vessel or nerve is injured during total knee replacement surgery.

4. Blood Clots



Blood clots can form in the large veins of the legs and pelvis following major surgery, such as total knee replacement. It is possible for such a clot to break loose from the vein and travel to the heart. The clot can pass through the heart and into the lungs. This is called a pulmonary embolus. To prevent this from happening, blood thinners are prescribed post-operatively

5. Other Medical Complications



In a few patients, due to the advanced age & co-existing medical problems, there may be some medical complications like Hematemesis ( GI Bleed, etc), breathlessness, etc. This may necessitate a stay in the ICU for monitoring & so on.

Limitations of Total Knee Replacement Technology

 

In many ways, a total knee replacement is similar to a set of automobile tires. How long the knee replacement lasts is related to the type and amount of use, and not simply how long it has been implanted.

Although it is anticipated that a total knee replacement will last for many years, some fail sooner than expected. The main causes of failure are loosening, wear, osteolysis and component breakage. Fortunately, these occurrences are rare. Unfortunately, they can occur and generally necessitate additional surgery.

Fracture of the bone around a total knee replacement can also occur and surgery may be necessary to stabilize the fracture.

Loosening, wear, and osteolysis generally occurs slowly over time. The patient may not initially experience any pain or other symptom indicating a problem. For this reason, It is recommended generally that all total knee replacements be decided with every year x-rays. This way, problems can be detected and treated early and, therefore, more easily. Rahul Damle provides the best Knee Replacement surgery in Pune. He The  Best Orthopedic Doctor for Total Knee Replacement surgery in Pune.

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