What do you need to know about Knee Replacement Surgery?

 

Image Source: Total Orthocare

The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee. Our knee is very much capable of absorbing the shocks and jerks that are felt while doing ordinary tasks like walking, running and jumping to some extraordinary tasks such as parkour. Even after all this our knees are still one of the most vulnerable joints in our body. Constant friction between the bones can cause knee pain and even degrade the bones beyond repair. When it happens, knee replacement surgery comes into picture. So let’s now take a look at what is knee replacement surgery?

Various conditions revolve around that decide knee pain. Many of them can be subdued or totally eliminated using non invasive procedures, however, some require a surgery. Your doctor will decide whether a knee replacement surgery is needed based upon the severity of the damage caused to your knee. These conditions more or less include Chondromalacia patella, knee osteoarthritis, knee effusion, meniscus tear, ACL or anterior cruciate ligament strain or tear, PCL or posterior cruciate ligament strain or tear, MCL or medial collateral ligament strain or tear, Patellar subluxation, Patellar tendonitis, Knee bursitis, Rheumatoid arthritis, Gout, Pseudogout, and Septic arthritis.

While knee replacement surgery is the last resort there are plenty of diagnoses performed to rule out the possibility of a non surgical approach. These tests include:

> Physical examination: By examining the location of knee pain and looking for swelling or abnormal movement, a doctor gathers information about potential causes of damage or stress on the knee.

> Drawer test: With the knee bent, a doctor can pull (anterior drawer test) and push (posterior drawer test) the lower leg while holding the foot stable to check the stability of the ACL and PCL knee ligaments.

> Valgus stress test: Pushing the calf outward while holding the thigh stable, a doctor can check for injury to the medial collateral ligament (MCL). Pushing the calf inward (varus stress test), a doctor can look for injury to the lateral collateral ligament (LCL).

> Knee X-ray: A plain X-ray film of the knee is typically the best initial imaging test for most knee conditions.

> Magnetic resonance imaging (MRI scan): Using high-energy magnetic waves, an MRI scanner creates highly detailed images of the knee and leg. An MRI scan is the most-often used method of detecting ligament and meniscal injuries.

> Arthrocentesis of the knee (joint aspiration): A needle is inserted into the joint space inside the knee, and fluid is drawn out. Various forms of arthritis may be diagnosed through knee arthrocentesis.

> Arthroscopy: A surgical procedure that allows examination of the knee with an endoscope.

Knee replacement surgery, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. Knee replacement surgery is not usually the first option for treating knee pain. Various alternative treatments may help bring relief. If you’re experiencing knee pain, ask your doctor about less invasive ways to address it. Knee replacement surgery is most commonly performed in people with advanced osteoarthritis and is considered when conservative treatments have failed to show the desired results. Total knee replacement is also an option to correct significant knee joint or bone trauma in young patients.

The treatment for knee pain includes multiple other ways which are both invasive as well as non invasive. These include:

> RICE therapy: Rest (or reducing daily activities), Ice, Compression (as with bandage support) and Elevation. RICE is good initial therapy for many knee conditions.

> Pain medicines: Over-the-counter or prescription pain relievers such as acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) can treat most knee pain.

> Physical therapy: An exercise program can strengthen the muscles surrounding the knee, increasing the knee’s stability.

> Cortisone injection: Injecting steroids into the knee can help reduce pain and swelling.

> Hyaluronan injection: Injection of this “goo” material into the knee may reduce pain from arthritis and delay the need for knee surgery in some people.

> Knee surgery: Surgery may be done to correct a variety of knee conditions. Surgery can replace or repair a torn ligament, remove an injured meniscus, or entirely replace a severely damaged knee. Surgery may be done with a large incision (open) or smaller incisions (arthroscopic).

> Arthroscopic surgery: An endoscope (flexible tube with surgical tools on its end) is inserted into the knee joint. Arthroscopic surgery has a shorter recovery and rehabilitation period than open surgery.

> ACL repair: A surgeon uses a graft (cut from your own body or a donor’s body) to replace the torn ACL.

To increase the likelihood of a good outcome after surgery, multiple weeks of physical therapy is necessary. In these weeks, the therapist will help the patient return to normal activities, as well as prevent blood clots, improve circulation, increase range of motion, and eventually strengthen the surrounding muscles through specific exercises.