Full knee replacement is one of the most popular surgeries for orthopedic surgeons, especially in sports medicine and dealing with older patients. This surgery is performed to help a person return to a better quality of life. It is performed on patients that are afflicted with constant knee pain due to trauma, injury or arthritis generally. It is considered one of the most successful surgeries in all of medicine with over 600,000 performed annually, which equals 2 per month for every active orthopedic surgeon in the United States.
Why knee replacement surgery?
Knee replacement surgery, or knee arthroplasty, is usually the last remaining option in a host of treatments to combat injury, trauma or arthritis of the knee. However, if a patient suffers from destructive knee degeneration that has limited their mobility and causes constant pain and irritation that prohibits an active lifestyle, it may be time to have a full knee replacement. The most common reason for knee replacement surgery is due to osteoarthritis. The increasing pain and decreasing motor function necessitates replacement to ensure a healthy and prolonged life. Most patients of knee replacement are over the age of 65 and the implants can last between 15-20 years depending on their use. Those in ill-health that would be a risk for any type of surgery would generally not undergo this surgery.
How is it done?
There are four major steps to replacement. Generally the bones are resurfaced with implants and not totally replaced. The first step is considered preparing the bone surfaces to accept the surgical implants. The cartilage is removed from the tibia and femur as well as a small amount of the underlying bone as well. Step two involved inserting the metal surgical implants into the bones, either through cementing them in place or press-fitting them into the bones. The third step is the resurfacing of the underside of the patella to match the new implants, although some orthopedic surgeons opt not to do this part of the procedure. Lastly, a plastic spacer is inserted between the two metal implants to provide a smooth gliding surface, much like what cartilage provides in a natural knee-joint.
Complications and Risks
There are several real risks and complications in knee arthroplasty that a patient will need to consider. Each and every risk is possible and depends on the surgeon, hospital, environment, equipment and patient. There are a number of factors involved.
The risks include:
The risks include:
- Deep Vein Thrombosis is the most common, which is a clot in the deep veins of the leg, which can cause pulmonary embolism, where the clot travels to the lungs causing possible fatal complications.
- Infections of the area around the wound from surgery or deep in the bone or tissue surrounding the implants can occur at any time during surgery or afterwards, even years later. It is usually treatable with antibiotics, but can require further surgery in severe cases.
- Stiffness of the knee with a limited range of motion can occur, even with major advancements in implant technology especially with patients already suffering range of motion restrictions.
- Bleeding into the knee-joint or further damage to ligaments, muscles or tendons in the area around the surgery.
Ensure the surgery is necessary with your orthopedic surgeon before contemplating it. As a major surgery the risks, although small can be life altering. Generally the surgery is a success and most patients enjoy renewed vigor and activities with increased range of motion.
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