People with knee joint pain, birth knee deformities, arthritis and osteoarthritis resume their daily activity again. About 1-1.5 million people are undergoing knee replacement surgery every year in the US and more than 15 million in the world. According to the reports, about 65% of knee replacement procedures are done in females and just 30-35% requirement comes in males. An important advantage for knee arthroplasty or knee replacement most of the time comes with a guarantee of 15-20 years this is why it is becoming the choice.
What Is Knee Replacement?
Knee replacement or knee arthroplasty involves replacing a damaged joint, cartilage or bone and implants a new artificial material it could be metal or plastic. Knee replacement surgeries can be performed in three ways :
- Partial Knee replacement – In partial surgery, treatment happens in only one particular area of a knee and mostly prosthesis is involved. If a person has arthritis in one area then he/she can go with this procedure.
- Total Knee replacement – It is done by replacing femur bone with metal shell and plastic. This is done in the patient who has pain in the entire knee so might take more time in the hospital because it involves many small and big procedures. The addition of polyethene post is very essential during total knee replacement.
- Bilateral Knee Replacement – In this procedure, surgeries of both legs considering all the parts of knees is performed.
The entire set of used materials in the knee replacement procedure, named as prosthesis.
Who Is A Good Candidate For Knee Replacement?
- People unable to do normal activities such as walking, standing for a longer time, climbing stairs, banding down due to stiffness and pain.
- When medicines, ayurveda, exercises, injections, other therapies and small surgeries don’t work one should immediately go with the knee replacement.
- Stubborn swelling that doesn’t reduce even after taking ample rest and pain killers.
- Continuously using walkers for long distances.
- Rheumatoid arthritis
- Those who have birth knee deformity and other knee problems
Apart from all these, follow-ups with the doctor and after examining everything the doctor will tell you whether you are a good candidate or not.
Which Tests Are Performed Before The Knee Replacement Surgery?
- X – RAYS – It detects and gives visible information on defects and areas which are uneven.
- Blood flow – Doctors check the blood flow, if the blood flow is not good or some significant uncorrectable deformity is there then the doctor might tell the patient to wait.
- Overall health observation – As soon as you enter the clinic or hospital doctor first go with a health check up.
- MRI scan – Accurate monitoring of cartilage, bone and soft tissue is possible with MRI scan.
What Are The Risk Factors While Going For A Knee Surgery?
- Infection – Infection of knee arthroplasty is seen in 1-2%people only but it is very dangerous as some wounds in the prosthesis area, if the wound is small and easily curable then some medicines, injections and doctor’s prescribed lotions can heal it efficiently. But for intense wounds, surgeons might schedule another surgery or use skin grafts. Also, infection happens in a specific duration mostly in 2-3 months after
- Osteolysis – In some skin becomes sensitive towards the plastic materials which are placed in the knee during surgery and allergy occurs but this is very rare.
- Pain – After surgery one feels the pain in one or other, it is natural. But if pain is uncontrollable then its a signal that you might have major complications, seek help from a doctor quickly.
- Neurovascular injury – This is more likely to happen in patients about 10-15% carry this after knee replacement. Numbness, tingling or burning sensation and tiredness, arises.
- Implant loosens – While bending the knee risk of implant’s unstability stays. But this happens mostly after 5-6 years of the surgery and only in 5-10% people but it loosens even more after 10-12 years.
- Blood clots – When blood clots in the leg veins, the open vein can reach to the lungs and starts the process of blood clotting. Their deep veins also form clot in thighs and calf.
- Anaesthesia – Sometimes too much anaesthesia can lead to the side effects such as vomiting, dizziness, nerve injury, pains, etc.
How To Fight Against The Risk Factors ?
- Use prescribed medicines such as heparin, aspirin, fondaparinux and enoxaparin this helps in maintaining consistency of blood.
- Do exercises such slow leg raising, calf raising, etc.
- If your doctors don’t know about your any chronic disease such as BP, diabetes, cholesterol, etc then inform them.
- Also to inform you about your allergies before the operation is very important some people have allergies like metal or any other alloy. So early informing gives them time to find another alternative to add as a shell while knee replacement or knee arthroplasty.
What Happens During The Knee Replacement Procedure?
To decrease the pain of patients, doctor’s provide certain anaesthesias on the basis of your medical records and sedatives so that the area becomes numb temporarily ( during the ongoing surgery) mostly using general anesthesia, epidural or spinal anesthesia. Observation of the heart and lungs is also a part of the surgery.
The procedure includes the separation of femur i.e.thigh bone, shin bone, bones and cartilages which are present between these two. Then comes metal shells made up of nickel, cobalt, chromium or titanium, are carefully placed. Use of plastic material is done to support the kneecap or to use it instead of the backside. This gives durability and flexibility to the knee to do movements.
What To Do After The Knee Arthroplasty Or Knee Replacements?
Pain stays for some weeks or some months depending on your surgery type bilateral surgery might take 2 months or so. Some doctors recommend opioids but in my personal opinion, it is not advisable as it has numerous side effects such as breathing problems, pain while passing out the urine, drowsiness, vomiting,etc.
Hire a good physiotherapist as your doctor is going to give the list of few exercises such as occupational therapy, weight-bearing, leg-stretching in bed, sidekicks, quadriceps sets, etc. Also buy crutches or front-wheel walker if you don’t have one, for more support while walking.
How Long Does Knee Replacement Surgery Take To Recover?
Your recovery time varies with the type of surgery, age and gender but in general it takes 3- 4 weeks for partial knee replacement, 4-6 weeks for total knee replacement and 3-4 months for bilateral knee replacement. You may help decrease knee replacement recovery time by using multimodal analgesia ( combination of medicines) after the advice of the doctor.
IDEAL HOSPITAL STAY :
Generally, if surgery is successful then doctor’s will keep you 3-4 days under observation in the hospital but if major complications are there then might take a week or so.
What Will Happen In First Few Days After The Knee Replacement Surgery?
In some reputed and well-organised hospitals, doctors give facility of physiotherapist in the hospital. In initial days physiotherapists will give support in standing and waking up from bed.
For Rehab :
As a doctor’s assisted nurse, physiotherapists and occupational therapists have more information about your surgery and follow doctor’s instruction. They will help you to get faster relief so to join rehab is always advisable.
- They help you in dressing, giving medicines on time.
- Gives different and super easy examples on getting up from the bed.
- Observation of your movements happen through CPM and other related devices.
- Gradually on 2nd and 3rd day physicians might ask you to climb a couple of stairs.
- Slowly and steadily by 4th and 5th you will be able to dress by yourself, bathing and washroom without support will be not difficult for you at this time.
- In 4-5 weeks you will not need crutches or front wheel walkers anymore and at this time you can start some exercises such as brisk walking, lawn mowing, cooking for loved ones, etc.
So, rehab is a best choice for the healing process and super fast recovery. You can take help from the doctor’s assisted physicians as per your preference but I suggest you take for at least 5-7 days.
What Is The Cost Of Knee Replacement?
It basically depends on the hospital, doctor, your stay, rehab therapy after the surgery, regular check up appointments, ambulance cost, on your medical insurance, etc.
On an average, $15,000 – 50,000 for total knee replacement
$ 10,000 – $ 30,000 – partial knee replacement
$ 20,000 – $ 60,000 – bilateral knee replacement
What To Do At Home After Knee Replacement?
- EXERCISE – Yoga, cycling for 10-15 mins, water exercises, etc. can be done.
- DIET – As 40-50% of the knee replacement patients are overweight it is very essential to keep an eye on the diet, eat 2000-2500 calories a day not more than that and add iron rich food in your diet such as broccoli, spinach,etc. Also eat enough micronutrients and macronutrients. Add some herbs and protein supplements which are made with natural ingredients.
- While going in slippery areas use handrails such as in a bathroom, laundry area, etc.
- Invest on a chair or bench in the bathing section.
- Use flat footwear or flip-flops while going outside instead of heels.