Knee & Hip Replacement

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.

If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

Knee replacement surgery was first performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. Total knee replacements are one of the most successful procedures in all of medicine. According to the Agency for Healthcare Research and Quality, more than 600,000 knee replacements are performed each year.

Whether you have just begun exploring treatment options or have already decided to have total knee replacement surgery, this article will help you understand more about this valuable procedure.

SPECIFICATION

The most common cause of chronic knee pain and disability is arthritis. Although there are many types of arthritis, most knee pain is caused by just three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

Osteoarthritis. This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness. Rheumatoid arthritis. This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.” Post-traumatic arthritis. This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

Why it’s done

The most common reason for knee replacement surgery is to relieve severe pain caused by osteoarthritis. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have knee pain at rest.

Risks

Knee replacement surgery, like any surgery, carries risks. They include:

Infection
Blood clots in the leg
vein or lungs
Heart attack
Stroke Nerve damage

Signs of infection

Notify your doctor immediately if you notice:

Fever greater than 100 F (37.8 C)
Shaking chills
Drainage from the surgical site
Increasing redness, tenderness, swelling and pain in the knee

An infected knee replacement usually requires surgery to remove the artificial parts and antibiotics to kill the bacteria. After the infection is cleared, another surgery is performed to install a new knee.

Prepare for your recovery

For several weeks after the procedure, you might need to use crutches or a walker, so arrange for them before your surgery. Make sure you have a ride home from the hospital and help with everyday tasks, such as cooking, bathing and doing laundry. If you live alone, your surgeon’s staff or hospital discharge planner can suggest a temporary caretaker.

To make your home safer and easier to navigate during recovery, consider doing the following:

Create a living space on one floor since climbing stairs can be difficult.
Install safety bars or a secure handrail in your shower or bath.
Secure stairway handrails.
Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
Arrange for a toilet-seat riser with arms if you have a low toilet.
Get a stable bench or chair for your shower.
Remove loose rugs and cords.

Results

For most people, knee replacement provides pain relief, improved mobility and a better quality of life. And most knee replacements can be expected to last more than 15 years.

Three to six weeks after surgery, you generally can resume most daily activities, such as shopping and light housekeeping. Driving is also possible at around three weeks if you can bend your knee far enough to sit in a car, if you have enough muscle control to operate the brakes and accelerator, and if you’re not still taking narcotic pain medications.

After recovery, you can engage in various low-impact activities, such as walking, swimming, golfing or biking. But you should avoid higher impact activities such as jogging, skiing, tennis and sports that involve contact or jumping. Talk to your doctor about your limitations. A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a “cup-shaped” component of the pelvis called the acetabulum. The ball is the head of the thighbone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal (or ceramic) ball and stem inserted into the femur bone and an artificial plastic (or ceramic) cup socket. The metallic artificial ball and stem are referred to as the “femoral prosthesis” and the plastic cup socket is the “acetabular prosthesis.” Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement called methylmethacrylate. Alternatively, a “cementless” prosthesis is used that has microscopic pores which allow bony ingrowth from the normal femur into the prosthesis stem. This “cementless” hip is felt to have a longer duration and is considered especially for younger patients. Total hip replacement is also referred to as total hip arthroplasty.

SPECIFICATION

The preoperative evaluation generally includes a review of all medications being taken by the patient. Anti-inflammatory medications, including aspirin, are often discontinued one week prior to surgery because of the effect of these medications on platelet function and blood clotting. Other preoperative evaluations include complete blood counts, electrolytes (potassium, sodium, chloride), blood tests for kidney and liver functions, urinalysis, chest X-ray, EKG, and a physical examination. Your physician will determine which of these tests are required, based on your age and medical conditions. Any indications of infection, severe heart or lung disease, or active metabolic disturbances such as uncontrolled diabetes may postpone or defer total hip joint surgery.

If the condition of the hip allows it, some doctors will recommend a preoperative exercise program to build muscle and increase flexibility. This can help with recovery.

Total hip joint replacement can involve blood loss. Patients planning to undergo total hip replacement often will donate their own (autologous) blood to be stored for transfusion during the surgery. Should blood transfusion be required, the patient will have the advantage of having his or her own blood available, thus minimizing the risks related to blood transfusions.

What will recovery be like for the patient after surgery?

A total hip joint replacement takes approximately two to four hours of surgical time. The preparation prior to surgery may take up additional time. After surgery, the patient is taken to a recovery room for immediate observation that generally lasts between one to four hours. The lower extremities will be closely observed for both adequate sensation and circulation. If unusual symptoms of numbness or tingling are noted by the patient, recovery room nurses are available and should be notified by the patient. Upon stabilization, the patient is transferred to a hospital room.

During the immediate recovery period, patients are given intravenous fluids. Intravenous fluids are important to maintain a patient’s electrolytes and replace any fluids lost during surgery. Using the same IV, antibiotics might be administered as well as pain medication. Patients also will notice tubes draining fluid from the surgical wound site. The amount and character of the drainage is important to the doctor and can be monitored closely by the nurse in attendance. A dressing is applied in the operating room and will remain in place for two to four days to be later changed by the attending surgeon and staff.

Pain-control medications are commonly given through a patient-controlled-analgesia (PCA) pump whereby patients can actually administer their own dose of medications on demand. Pain medications occasionally can cause nausea and vomiting. Antinausea medications may then be given.

Measures are taken to prevent blood clots in the lower extremities. Patients are placed in elastic hose (TEDs) after surgery. Compression stockings are often added, which help by forcing blood circulation in the legs. Patients are encouraged to actively exercise the lower extremities in order to mobilize venous blood in the lower extremities to prevent blood clots. Medications are often given to thin the blood in order to further prevent blood clots.

Patients may also experience difficulty with urination. This difficulty can be a side effect of medications given for pain. As a result, catheters are often placed into the bladder to allow normal passage of urine.

Immediately after surgery, patients are encouraged to frequently perform deep breathing and coughing in order to avoid lung congestion and the collapse of tiny airways in the lungs. Patients are also given a “blow bottle,” whereby active blowing against resistance maintains the opening of the breathing passages.

What are total hip replacement complications?

The risks of total hip replacement include blood clots in the lower extremities that can travel to the lungs (pulmonary embolism). Severe cases of pulmonary embolism are rare but can cause respiratory failure and death. Other problems include difficulty with urination, local skin or joint infection, fracture of the bone during and after surgery, scarring, limitation of motion of the hip, dislocation of the hip replacement, and loosening of the prosthesis that eventually leads to prosthesis failure. Because total hip joint replacement requires anesthesia, the usual risks of anesthesia apply and include heart arrhythmias, stroke, liver toxicity, and pneumonia.

Knee & Hip Replacement

SPECIFICATION

SPECIFICATION

Schedule a Counselling

+91-9337431976 , 0674 3567913

Top Bone and Joint Clinic, Bhubaneswar, Odisha

Clinic Timing

Location