Total Knee Replacement

Knee replacement is one of the most successful orthopedic surgeries performed today. Most patients experience reduced or eliminated knee pain, increased ability to move and an overall improvement in quality of life.

Knee replacement is where portions of the bones that form the knee joint are removed and replaced with artificial implants. It is performed primarily to relieve knee pain and stiffness caused by osteoarthritis.

Most people who get this surgery have advanced knee arthritis, in which the knee cartilage is worn away and the surface of the knee becomes pitted, eroded, and uneven. This causes pain, stiffness, instability and a change in body alignment. Knee replacement surgery can also help some people who have a weakened knee joint caused by an injury or other condition.

WHAT ARE THE DİFFERENT TYPES OF KNEE REPLACEMENT SURGERY?

There are two main types. Total knee replacement, where the entire joint is replaced with artificial surfaces, partial knee replacement, where only one damaged compartment of the knee is replaced total knee replacement is the more common of these two procedures.

WHAT ARE KNEE REPLACEMENT İMPLANTS MADE OF?

The selection of knee replacement prosthesis design and materials depends on each individual patient. The main implant components are made of metal – usually titanium or chrome-cobalt alloys. The implants are fixated in place either with a cement bonding agent or by osseointegration, in which a porous metal stem extends into the tibia and the patient's natural bone grows into it. A plastic platform or spacer will be inserted between the tibial and femoral implant surfaces. The spacer is made of polyethylene.

Most femoral components are made of metal alloys (cobalt chromium) or metal-ceramic alloys (oxidized zirconium). The patellar component is plastic (polyethylene). The tibial insert component is also plastic (polyethylene). The tibial tray component can be made of the following materials: Cobalt chromium (metal alloy), titanium (metal alloy), polyethylene (plastic).

CAN I AVOİD OR POSTPONE A KNEE REPLACEMENT?

The choice on whether to have surgery to address arthritis of the knee joint depends on multiple factors, including: The condition of the knee joint, the patient’s age and activity level In cases where the damage from arthritis is minimal, and/or if the patient does not have a very active lifestyle, nonsurgical treatments by be tried, including: Physical therapy, NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, weight loss to reduce pressure on the knee.

HOW DO I KNOW İF I NEED KNEE REPLACEMENT SURGERY?

You may need surgery if:

• Your knees are stiff and swollen.
• There is pain throughout the day, even at rest.
• Walking, getting up or climbing stairs is difficult and painful.
• Medication and therapy do not offer enough relief.
• Knee cartilage is so damaged and worn away that you are walking "bone on bone," in which the bones of the joint are scraping together.

Total knee replacement surgery generally takes about 60 to 90 minutes, but you should expect to be in the operating room for over two hours. Rehabilitation (physical therapy) will begin within 24 hours of surgery.

After your surgery, the nursing staff will position you in bed and help you turn until you are able to move on your own. You may have a pillow between your legs if ordered by your surgeon.

Very soon after surgery, a physical therapist will come to your room to teach you appropriate exercises and review your progress. Gentle exercises to improve your range of motion can help prevent circulation problems as well as strengthen your muscles.

Your rehabilitation program will begin as soon as you are medically stable and there are orders from your doctor to begin postoperative mobility. All patients begin rehabilitation within 24 hours of their surgery. Your motivation and participation in your physical therapy program is key to the success of your surgery and recovery. The physical therapist will assist you in the following activities: Sitting at bedside with your feet on the floor, transferring in and out of bed safely, walking with the aid of a device (walker, cane, or crutches), climbing stairs with aid of a device

Most patients progress to a straight cane, walker or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.

Patients are usually able to drive a car within three to six weeks after surgery and resume all other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take up to four months. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement.