Frequently Asked Questions On Total Knee Replacement
Total knee replacement, also known as total knee arthroplasty, is a surgical procedure performed to replace a damaged or severely arthritic knee joint with an artificial joint, called prosthesis. The procedure is typically recommended when conservative treatments, such as medication, physical therapy, and assistive devices, have failed to alleviate pain and improve knee function.
During a total knee replacement surgery, the orthopedic surgeon removes the damaged portions of the knee joint, including the ends of the thigh bone (femur) and shin bone (tibia), as well as the backside of the kneecap (patella). These bone surfaces are then resurfaced with metal implants, while a plastic spacer is inserted between the metal components to allow for smooth movement.
Robotic-assisted total knee replacement (TKR) is a relatively newer approach to performing the surgery, utilizing advanced technology to assist the surgeon during the procedure. While there are potential benefits associated with robotic TKR, it’s important to understand that both robotic and conventional TKR methods have been successful in improving patient outcomes and have similar clinical outcomes.
After surgery, patients typically undergo a period of rehabilitation, including physical therapy, to regain strength, flexibility, and mobility in the knee joint. With successful rehabilitation, many individuals experience significant pain relief and an improvement in their ability to perform daily activities. Patient is able to walk with support from day 1 post-op but for complete pain relief it may take up to 3 months post-surgery.
Initially, you may be advised to avoid activities that involve excessive bending or twisting of the knee joint. This includes activities like squatting, kneeling, crossing the legs, climbing stairs, etc. Over time, as your knee heals and gains flexibility, these activities may be gradually reintroduced under the guidance of your healthcare provider. Strenuous activities and high-impact exercises should be avoided, especially in the early stages of recovery. Activities like running, jumping, contact sports, and heavy lifting may stress the new knee joint. Low-impact exercises, such as walking, swimming, and cycling, are generally encouraged as they promote joint flexibility and strengthen the surrounding muscles.
Pain medications and blood thinners may be prescribed to manage pain and prevent blood clots. It’s important to follow your doctor’s instructions regarding medication dosage and timing.
The longevity of a total knee replacement (TKR) can vary depending on several factors, including the patient’s age, activity level, overall health, and the type of implant used. While TKR implants are designed to be long-lasting, they may wear down over time due to normal wear and tear, leading to the need for a revision surgery. The majority of TKR implants are expected to last for 15 to 20 years or even longer.
Frequently Asked Questions On Knee Arthroscopy
Knee arthroscopy is a minimally invasive surgical procedure that utilizes a small camera called an arthroscope to visualize and treat various knee conditions. The surgeon makes small incisions in the knee and inserts the arthroscope to view the joint and perform necessary repairs or treatments. Some of the common knee arthroscopy surgeries include:
ACL Reconstruction: This procedure involves the replacement of a torn anterior cruciate ligament (ACL) with a graft. The graft can be taken from your own tissue (autograft) or a donor tissue (allograft). The surgeon uses arthroscopic techniques to remove the damaged ACL and insert the graft to reconstruct the ligament.
Meniscus Repair or Meniscectomy: The meniscus is a C-shaped cartilage in the knee joint that acts as a shock absorber. Arthroscopy can be used to repair a torn meniscus by suturing the torn edges together or removing the damaged portion (meniscectomy) if it is irreparable.
Cartilage Repair: Arthroscopic techniques can be employed for the treatment of certain cartilage injuries in the knee. Procedures such as microfracture, osteochondral autograft transfer (OATs), or autologous chondrocyte implantation (ACI) may be performed to stimulate new cartilage growth or transplant healthy cartilage cells into the damaged area.
Synovectomy: In cases of chronic inflammation or conditions like rheumatoid arthritis, arthroscopy can be used to remove inflamed synovial tissue (synovectomy) from the knee joint.
Patellar Realignment: This surgery is performed to correct patellar (kneecap) instability or malalignment. It involves repositioning or realigning the patella to improve stability and reduce pain.
Loose Body Removal: Arthroscopy can be used to remove loose fragments of bone or cartilage within the knee joint that may cause pain, catching, or locking of the joint.
These are just a few examples of knee arthroscopy surgeries. The specific procedure performed will depend on the individual’s condition and the findings during the arthroscopic examination. The surgeon will determine the most appropriate surgical approach based on the patient’s symptoms, imaging results, and physical examination.
ACL stands for Anterior Cruciate Ligament. It is one of the four major ligaments in the knee joint that helps provide stability and support during movement. The ACL is located in the center of the knee and connects the femur (thigh bone) to the tibia (shin bone). Its primary function is to prevent excessive forward movement of the tibia in relation to the femur and control rotational movements of the knee.
Injuries to the ACL are relatively common, especially in sports that involve sudden stops, changes in direction, or jumping. ACL injuries often occur during activities that put stress on the knee, such as pivoting, landing awkwardly, or direct impact to the knee. These injuries can range from a partial tear to a complete rupture of the ligament.
Whether or not you need surgery for an ACL tear depends on several factors, including the severity of the injury, your activity level, and your overall goals and preferences
In general, complete tears of the ACL (where the ligament is completely torn) often require surgical intervention, especially for individuals who have an active lifestyle that involve pivoting, cutting, or jumping. ACL reconstruction surgery is commonly recommended in these cases to restore knee stability, reduce the risk of further damage to the knee joint, and enable a return to pre injury activities.
On the other hand, partial tears or cases where the ACL is not completely torn may be treated non-surgically, depending on the individual circumstances. Conservative management options for partial tears may include rest, physical therapy, strengthening exercises, and the use of knee braces. Non-surgical treatment may be considered for individuals with lower activity levels, older age, or those who do not participate in sports or activities that place significant stress on the knee.
When there is suspicion for a multi-ligament knee injury, four main ligament areas of the knee must be assessed for possible injury. Within these areas, there can be several bundles or structures that need to be reconstructed.
The four main ligament areas of the knee that need assessment include: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), posterolateral knee and medial knee (MCL). Although most complex knee injuries are thought to occur due to a knee dislocation, in actuality, a complete knee dislocation is very rare. Thus, an evaluation of a knee injury that , which involves at least two ligaments being torn, is considered a complex knee injury. Almost all complex knee injuries involve either the anterior cruciate ligament (ACL) and/or posterior cruciate ligament (PCL). Combined with this may be a knee ligament injury involving the medial knee structures (commonly called the MCL). In addition, the posterolateral corner structures of the knee must be completely evaluated.
Here is a general timeline that may give you an idea of the different stages of recovery:
Initial Recovery (0-2 weeks): During the first couple of weeks, you will focus on managing pain and swelling, regaining range of motion in your knee, and beginning gentle exercises to strengthen the surrounding muscles. You will need crutches and knee braces initially to support and protect the surgical site.
Rehabilitation (2-6 weeks): Physical therapy becomes a crucial part of your recovery during this phase. You will continue to work on increasing range of motion, improving muscle strength and control, and gradually progressing to weight-bearing exercises. Your physical therapist will guide you through a customized rehabilitation program.
Functional Recovery (6-12 weeks): At this stage, you will start focusing on more complex exercises to restore balance, stability, and functional movements. Your physical therapist will help you reintegrate activities such as walking, jogging, and light impact exercises. You may also begin sports-specific training if you participate in high-demand activities.
Return to Sport (6-9+ months): The timing for returning to sports or high-impact activities varies depending on individual factors and the guidance of your healthcare team. Typically, it takes several months of progressive training and rehabilitation to regain the strength, stability, and confidence required for sports participation. Your surgeon or physical therapist will assess your readiness and guide you through a gradual return-to-sport program.
It’s important to note that each person’s recovery timeline can be different, and there may be individual variations based on factors such as healing rate, rehabilitation progress, and adherence to the rehabilitation program.
The longevity of a total knee replacement (TKR) can vary depending on several factors, including the patient’s age, activity level, overall health, and the type of implant used. While TKR implants are designed to be long-lasting, they may wear down over time due to normal wear and tear, leading to the need for a revision surgery. The majority of TKR implants are expected to last for 15 to 20 years or even longer.
Frequently Asked Questions On Total Hip Replacement
Total hip replacement (THR), also known as total hip arthroplasty, is a surgical procedure performed to replace a damaged or diseased hip joint with an artificial joint, called prosthesis. The hip joint is a ball-and-socket joint where the head of the femur (thigh bone) fits into the acetabulum (socket) of the pelvis.
Total hip replacement is usually recommended for individuals who have severe hip pain and limited mobility due to conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, hip fractures, or other hip joint disorders. The surgery aims to relieve pain, improve joint function, and enhance overall quality of life.
There are several types of implants used in total hip replacement (THR) such as Metal-on-Polyethylene, Ceramic-on-Polyethylene, Ceramic-on-Ceramic, etc. It’s important to note that the choice of implant is based on individual factors and is determined by the orthopedic surgeon during the preoperative evaluation and discussion with the patient. The surgeon will consider factors such as age, activity level, bone quality, and any specific medical considerations to select the most suitable implant for each patient.
Maintaining proper posture and body mechanics is important during the recovery phase. This includes avoiding crossing the legs, sitting on low chairs or stools, or bending at the hip beyond the recommended range of motion. These precautions help prevent dislocation and promote proper healing.
Frequently Asked Questions On Shoulder Arthroscopy
Shoulder arthroscopy is a minimally invasive surgical procedure that involves the use of a small camera called an arthroscope to visualize and treat various shoulder conditions. It is performed through small incisions in the shoulder, allowing the surgeon to access and address problems within the joint.
Some common shoulder arthroscopy surgeries include:
Rotator Cuff Repair: The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Arthroscopy can be used to repair a torn rotator cuff by reattaching the torn tendon to the bone using sutures or anchors.
Shoulder Impingement Surgery: Impingement occurs when the structures within the shoulder joint rub against each other, leading to pain and limited range of motion. Arthroscopy can be used to remove or reshape the structures causing impingement, such as the acromion or inflamed bursa.
Recurrent shoulder dislocation: This procedure is performed to treat shoulder instability, particularly in cases of recurrent shoulder dislocation. Arthroscopy is used to repair or tighten the torn or stretched ligaments and labrum in the shoulder joint.
SLAP Repair: SLAP stands for Superior Labrum Anterior to Posterior. This surgery is performed to treat a specific type of shoulder injury where the labrum (a ring of cartilage) is torn from the top to the back of the shoulder joint. Arthroscopy allows for the reattachment or repair of the torn labrum.
Removal of Loose Bodies or Bone Spurs: Arthroscopy can be used to remove loose fragments of bone or cartilage within the shoulder joint that may cause pain, catching, or limited mobility.
Shoulder Capsular Release: This procedure is performed to address shoulder stiffness and limited range of motion. Arthroscopy is used to release tight or thickened joint capsule tissues, allowing for improved mobility.
Shoulder arthroscopy offers several advantages over traditional open surgery, including smaller incisions, reduced pain, faster recovery, and fewer complications. The specific procedure performed will depend on the individual’s condition and the findings during the arthroscopic examination
Maintaining proper posture and body mechanics is important during the recovery phase. This includes avoiding crossing the legs, sitting on low chairs or stools, or bending at the hip beyond the recommended range of motion. These precautions help prevent dislocation and promote proper healing.