Friday, April 25, 2014

Knee Arthroplasty Overview

The knee, being the largest joint in the body, is required to function normally to perform everyday activities. An inflammation of the joint can cause the wearing out of its cartilage. Over time, this inflammation leads to loss of cartilage and the exposure of the bone over the surface of the skin. This damage can be treated with a surgery to replace the joint with an artificial one called the prosthesis.

Knee arthroplasty or better known as knee replacement is a surgery for those with severe knee damage. The process can relieve the pain and allows the person who undergoes such procedure to become more active after the replacement has been done.

A knee replacement can be performed when the knee joint has already reached a point wherein painful symptoms can no longer be controlled with non-surgical treatments. These non-surgical treatment alternatives include: loss in weight, modification in activities, anti-inflammatory medications, supplement intakes, and fluid shots.

Knee replacement surgery can either be performed partially or totally. In partial knee replacement, surgeon replaces only one part of the knee joint; whereas in total knee replacement, the surgeon would remove the damaged cartilage and bone from the knee joint. The surgery consists of a replacement in the diseased or damaged surfaces with metal or plastic components that would then be shaped accordingly, which would allow the continued motion of the knee.

More than 90% of people who underwent a total knee replacement have experience a dramatic reduction in knee pain and a significant improvement in the performance of everyday activities.

Knee replacement surgery has become common and 90% of patients who went through with the surgery have good results. However, there are still known risks that need to be considered before deciding to go through with the procedure.

These are the risks and complications involved in knee replacement surgery:

  • Artificial joint could be dislocated.
  • Infection
  • Loosening of the prosthetic implant over time
  • Pneumonia
  • Allergic reaction to the new implant (metal or plastic)
  • Nerve or blood vessels injury
  • Blood clots in the leg veins (deep vein thrombosis) or in the lungs (pulmonary embolism)
  • Loss of knee motion
  • Bleeding
  • Anesthetic complications
  • Numbness in the part of the wound
  • Knee bones fracture

Infection has been considered the most serious complication but has a rough rate of 1% only. Deep vein thrombosis, nerve injuries, persistent pain or stiffness, and prosthesis failure has occurred in patients with an approximate rate of 15%, 2%, 23%, and 2%, respectively.

It is noted, however, that only about one in 50 patients had significant problems that resulted in total knee replacement.

The success rate of knee replacement surgery is high. However, the success of the procedure is based partly on the rehabilitation after the surgery. Patients should participate actively in the rehabilitation to expect a good result. Rehabilitation must begin immediately after the knee replacement surgery. Patients work with a physical therapist which focuses on the maintenance of knee replacement motion and ensuring that the patient can safely walk is the emphasis during the early stage of the rehabilitation.

After the surgery, patients are vulnerable to falls. A fall during the first weeks after the surgery can damage the implanted knee and could result to a need in further surgery. It is therefore, advisable to use crutches or a walker until balance and strength are improved. The surgeon and/or the physical therapist will help the patient decide on what the required assistive safety aides to use following the surgery and when these aides’ usage can be discontinued.

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