Thursday, 22 March 2012

Knee Replacement Surgeries

KNEE ARTHRITIS
Arthritis of the knee is a disease condition where in the normal smooth bearing surface of the knee-joint (articular cartilage) is damaged or lost, leading to pain, sometimes deformity that leads to loss of function and disability. The various causes that can lead to arthritis include age related wear & tear (osteo arthritis), wear & tear due to extra demand (e.g. obesity), injury to the knee, inflammation (rheumatoid arthritis) and other causes.
SYMPTOMS
Pain is the most important symptom. Pain is accompanied by loss of motion & restriction of activity leading to dependence on others and permanent disability. Deformity often accompanies arthritis due to bone damage leading to ‘bow knee’ or ‘knock knee’ deformity. Loss of balance, instability and loss of confidence are other outcomes of this disease process.
CONSERVATIVE TREATMENT
In earlier stages of arthritis, pain relieving medicines have a very important role. Physiotherapy and exercises help throughout the management of arthritis and also play a vital role after any surgery as well. It is in the best interest of the patient and the affected knee to have strong and active muscles around the knee which act as a motor to drive the machine i.e. the knee.
ExercisesWalkingSwimmingWeight Control
SURGICAL TREATMENT
Depending on the patient’s complaints, age, activity, bone quality and stage of arthritis various surgical options are:
Knee arthroscopy
(Key hole surgery)		Realignment procedure (Osteotomy)Partial knee
replacement		Total knee replacement (TKR)

JOINT REPLACEMENT WHEN?
  • Pain not controlled by medicines
  • Stiffness (loss of motion)
  • Instability
  • Disability
  • Restriction of day to day activities
TKR surgery is performed principally for pain relief. Although the range of motion of the knee may improve following surgery, this is not the primary aim of the surgery and extra motion should be regarded as a bonus
SURGICAL PROCEDURE
The damaged bearing surface of the knee joint (articular cartilage) is replaced by metallic prosthesis (made up of cobalt-chromium or titanium), which articulates with a polyethylene bearing. These prosthetic components are fixed to the bone using bone-cement or rarely using coated components onto which bone grows. The right decision about appropriate prosthesis for a particular patient is made.
RISKS
Total knee replacement is a major surgical procedure with very high success rates. However, like any other surgical procedure it is also associated
with some risks, which are uncommon, but must be kept in the mind. These risks include:
  • Wear & loosening
  • Venous blood clots
  • Infection
DESPITE ALL THESE POTENTIAL PROBLEMS, THE VAST MAJORITY OF PATIENTS ARE VERY HAPPY WITH THIS PROCEDURE...
RECOVERY
The patiens are admitted for less than one week after surgery. All patients usually walk on the next day of surgery. This is a major operation and may take 3 to 6 months for full recovery. Some patients continue to experience improvement in he performance of their new knee up to as long as 1-2 years. The recovery is much faster in thinner and hard working patients and those who are motivated to participate in active rehabilitation.
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