Knee replacement is also known as knee arthroplasty. Knee replacement surgery is a procedure done to extend over a knee that has previously been damaged by arthritis. To form the knee joint plus the knee cap, surgeons use plastic as well as metal parts to cap the end of each bone.
Knee arthroplasty surgery can only be performed in case you had severe knee injury from an accident or in cases of severe arthritis. This surgery is mainly aimed at reliving the patient from knee pain which can’t be stopped or even controlled by any other type of treatment. Before we get in to details, let us have a look at the different types of arthritis.
Type of Arthritis
- Osteoarthritis
This type of arthritis mainly affects older adults (seniors) and middle age adults. Osteoarthritis makes the adjacent bone plus the joint cartilage of the knee to breakdown.
- Rheumatoid arthritis
Here the patient goes through severe pain and stiffness due to inflammation in the synovial membrane. In the end it causes significant synovial fluid.
- Traumatic arthritist
- Traumatic arthritis is caused due to injury.
Knee Anatomy
A knee consists of two long bones which are joined together by tendons, muscles and ligaments. Each end of the two bones is protected by a layer of cartilage. The layer usually protects the knee and absorbs shock. A knee has a total of two groups of muscles which include the following.
- The quadriceps muscles are located at the front of the thighs. These muscles are responsible for straightening the legs.
- The hamstring muscles are located at the back of the thighs. These are responsible for bending the leg at the knee.
The knee has the following features:
- The femur which is the upper leg bone.
- Cartilage is the tissue layer which shields the surface of the joint bone. This layer prevents friction within the joint during movement.
- Tibia is the large bone in the lower leg.
- Synovial membrane is the tissue which is responsible for lining and sealing the joint into a joint capsule. Synovial membrane lubricates the joint with the synovial fluid. Synovial fluid normally appears to be clear and sticky.
- Patella is the kneecap.
- Meniscus is the curved part found in the knee cartilage as well as other joints. It is responsible for absorbing shock, deepening and also increasing contact area in the joint of the knee.
- Ligament is another part making up the knee. It gives support to the joint and it limits movement of the joint.
- The tendon is a connective tissue joining the muscles to the bones. The tendon is responsible for controlling movements of the joint.
When to Have a Knee Replacement Surgery
Now that you know what knee replacement surgery is, you also need to know when or why you should have the surgery. Of course, if you have any disability or severe pain in the knee, then you will need this surgery. However, the most common condition leading to a knee replacement surgery is when you have osteoarthritis.
Like we explained before, this type of arthritis causes the breakdown of the joint cartilage. It tends to limit movements and you will get severe pain. In case you have osteoarthritis then chances are you will find difficulty doing daily activities which requiring you to bend the knee. These activities may include climbing your stairs or anything of the sort and even walking.
Doing any of these activities when you suffer from this degenerative joint disease can cause you severe pain. Your knee will also swell simply because you have an unstable joint. In other cases of traumatic and rheumatoid arthritis, the patient will also suffer from a degenerating knee joint. Furthermore, if you have a torn cartilage or ligament and a fracture, you will end up having damage to the knee joint that only needing a surgery to heal.
In addition, knee arthroplasty may be needed in case you are on medical treatment that is not controlling the pain. Some of the medical treatments usually prescribed for degenerative joint disease include the following:
- Pain medication
- Walking devices to help the patient walk with minimal pain
- Anti-inflammatory medications
- Physical therapy
- Exercises to lose weight
- Injections adding lubrication to the joint in order to reduce the pain felt during any movements
- Reducing on daily activities
- Glucosamine sulfate
- Chondroitin sulfate
- Cortisone injections
You may also need a knee replacement depending on your doctor’s recommendations.
What Will Happen Before You Have A Knee Replacement Surgery?
Just like any surgery, you will need to complete some simple steps before the main procedure. These steps are very important and you will have to follow them so that you don’t face any additional problems during the procedure. Here is what will happen before the knee replacement procedure.
- The patient has to present a full medical history. On top of that, your doctor will have to perform a full physical examination just to check if everything is ok. The examination may include diagnostic and blood tests.
- It is important to have a session with your doctor about the procedure. Here they will explain to you everything about the surgery and what you can expect.
- Get a form of consnt from your doctor. Read through it and sign before the procedure.
- Provide information on any over the counter medications you were taking. Also, you have to inform the doctor if you are allergic to any sort of medications.
- In case you are pregnant or you think you are, the doctor must know about it.
- Look for a physical therapist to help you with the recovery process. Also, you will need to get an orthopedic expert witness just in case the surgery isn’t performed well.
- Lastly, stay without food for at least 8 hours before the surgery.
The procedure
The procedure will be done in the following steps:
- Once you are at the hospital, a gown will be provided for to wear before the operation.
- Next,sit on the operating table and wait to be positioned accordingly.
- After, an IV line will be attached to your hand
- You may also get attached to a urinary catheter
- Any excessive hair on the area that the surgery will be performed on will be trimmed
- An anesthesiologist will make sure that your vitals are good by checking the monitor every step. He/she will also have to put you to sleep with general anesthesia
- The area will be cleansed and then the surgeon will make an incision
- Then the damaged surface of the knee joint will be removed. The knee prosthesis will be used to resurface your knee joint.
- After, the incision made will be closed with surgical Staples and a drain placed over it to drain any fluids.
- A bandage will be applied to keep the area from infections.
Healing Process
After the surgery, you get to be transferred from the operating room to a hospital room to begin recovering. You will have to stay at the hospital for days depending on your recovering progress. After everything is checked and you’re in a good condition, a physical therapist will meet up with you and give you an exercise program.
You will start with a CPM machine. This machine will not require you to move at all as all the exercise will be done while you are in bed. It will move your new knee joint in different motions while the pain will be limited by medications to allow you to be more active in the exercise. After sometime in the hospital, you will be discharged and be given continuous physical therapy from home or from a rehabilitation center.
When you go home, make sure you always keep the knee area clean to avoid infections. Endeavour to follow the specific bathing instructions as given by your doctor. Also, try to keep the leg elevated to avoid swelling. Pain medication taken as per your doctor’s instructions will help to relieve you of any pain.
What to Expect After the Procedure
Here we are not going to talk about the positive outcome of the procedure but rather the negatives of the procedure. Of course just like any procedure/ surgery, you can expect some complications to occur. Some of the most common complications are not limited to the following:
- Fracture
- The prosthesis wearing out or in some cases loosening
- Getting infection due to improper care
- Continued bleeding
- Clots of blood in your lungs and even the legs
- More pain and stiffness
You may also face dislodging on the knee joint which has been replaced. You may end up finding yourself replacing the knee joint once again in future. The procedure can also cause the blood vessels or even the nerves in the knee joint replaced to get damaged. It can result to knee joint becoming numb or just weak.
Some other risks can come about due to your medical history or condition. However, in some cases, you will find that the procedure doesn’t go well due to the mistakes done by the surgeon. If this happens you will need an orthopedic expert witness who has experience as well as knowledge on your problem to help testify to your case.
Orthopedic Surgeon Expert Witness and Why You May Need One
Orthopedic expert witnesses are medical experts that have got extensive experience in a medical field. Their experience is usually got from working in a healthcare institute for decades. They are relevant in case where there are any injuries involving bones on any part of the body.
An orthopedic surgeon expert witness usually has the qualities to convince and perform in a court room. The best has the ability to captivate, be listened to and taken serious while explaining the case. They are also good at physical therapy, pain management and therapy. These experts will also inform you about the actual costs that come with a knee replacement procedure, the Dos and the Don’ts.
What you can do to speed up the recovery
This can be achieved by making some small modifications to keep you in good health. The following can be done to help when you are home:
- Install safety handrails along your stairs and in your bathroom
- Get a dressing stick
- Have a sock aid
- Increase on the shower hose
- Remove anything that can make you trip and fall in the house
- Raise your toilet seat
- Follow your doctor’s instructions after the surgery