Knee Replacement

Knee Replacement

Knee Replacement
Painful knees are a common problem - often the result of wear-and-tear from sports injuries or obesity, which leads to a degenerative form of arthritis called osteoarthritis. Pain relievers and other treatments can help. When knee damage is severe, a total knee replacement can relieve the pain and allow you to be more active again. Learn more about knee replacement surgery from out experts.

Recently Answered

  • 1 Answer
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    A Orthopedic Surgery, answered on behalf of
    A partial knee replacement, rather than a total knee replacement, is better for you if you are a candidate for it. With the partial or unicompartmental  knee replacement, doctors don't violate any of the ligaments, so it feels much more natural, much more stable.

    Obviously, not everybody is a candidate for a partial knee replacement. If you have arthritis on the outside or under your kneecap, then you wouldn't be a good candidate for a partial knee replacement. Doctors wouldn't just do a partial job; they'd want to get all your pain relieved. A total knee replacement is a great thing for an arthritic knee. The pain's gone, you can walk a lot better and generally function a lot better; but it feels just a little bit mechanical because it is a little bit mechanical. But if you're a candidate for a partial knee replacement, this is a very good way to go.


     
  • 1 Answer
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    A Orthopedic Surgery, answered on behalf of
    You will need to be sedated during knee replacement surgery. Doctors usually use a spinal anesthesia with a little long-acting morphine. They also will infiltrate local anesthesia about your knee to improve the pain relief. You will also have some supplemental sedation. 
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    A Orthopedic Surgery, answered on behalf of
    Recovery from muscle-sparing knee replacement takes about six weeks. That's when most people are feeling really good. Hospital stay is about one or two days, and most people get off their walker by about 10 days.
     
  • 1 Answer
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    A Orthopedic Surgery, answered on behalf of
    The following people are not candidates for muscle-sparing knee replacement surgery:
    • Somebody who has has already had one done and has to have a revision.
    • A person who has a severe deformity and the surgeon needs to do some fancy techniques to correct the deformity.
    • A person who is very overweight.

     
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    A Orthopedic Surgery, answered on behalf of
    There are benefits and risks to having both knee replacements done at the same time. If you do them both at the same time, obviously the benefit is that you don't have to come back, but surgeons can't do the less invasive procedure. If the surgeon is doing robotic surgery on your left knee, he or she needs to stand on your right side and gain access to the joint there. When surgeons do them both at the same time, there are two complete teams so that you're not on anesthesia twice as long. As a result, the surgeons would be running into each other. You would need to have the traditional technique if you do both knees at the same time. You also have to be in the hospital for longer -- about four days. You also have to go to a rehab hospital for a few weeks and stay there because you don't have a leg to stand on, so it's much harder to get over.

    If you do them one at a time, the obvious benefit is you get the less invasive technique. As a result, you get to go straight home after a couple of days and it's easier to get over, but the downside is you have to come back. One option is not better than the other, you just have to weigh the risks and benefits.
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    A Orthopedic Surgery, answered on behalf of
    What Is the Recovery Time After a Total Knee Replacement?
    The recovery time after a total knee replacement varies from patient to patient, says Steven Warren, MD, specializing in orthopedic surgery at Palms of Pasadena Hospital in St. Petersburg, Florida. Learn more in this video.
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    A Orthopedic Surgery, answered on behalf of
    Many elderly people have other complicating medical conditions that must be understood and, if possible, improved prior to joint replacement surgery and then managed postoperatively. This often requires the person's doctor or a specialist working as part of the team.

    A great hospital with a proven track record, which provides designated teams specializing in the care of people with hip and knee replacement, also is a must. Because elderly people often have other serious conditions and/or significant past medical histories, caring for them in a hospital with full medical services, including intensive care units (ICUs) and 24-hour-a-day, in-house intensivist care, is extremely important.

    DISCLAIMER: Trinity Health recognizes that people seek medical information on a variety of topics for a variety of reasons. Trinity Health does not condone or support all practices covered in this site. As a Catholic health care organization, Trinity Health acts in accordance with the Catholic tradition.

    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.
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    A Orthopedic Surgery, answered on behalf of
    If a total knee replacement (TKR) has failed, a review of the surgeon’s operative report is important. This report could give clues regarding specific difficulties or peculiarities that were encountered during the operation.

    The surgeon also needs to review the “implant record.” Like the operative report, the implant record is also a permanent part of the medical record and contains labels provided by the manufacturer naming the company that manufactured the implant, the implant brand name, size, U.S. Food and Drug Administration (FDA) number and expiration date.

    This information becomes critical if more surgery is being considered, and also might give a clue as to why the knee is not performing satisfactorily. Particular brands or types of implants may have known problems and a poorer track record than others.

    DISCLAIMER: Trinity Health recognizes that people seek medical information on a variety of topics for a variety of reasons. Trinity Health does not condone or support all practices covered in this site. As a Catholic health care organization, Trinity Health acts in accordance with the Catholic tradition.

    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.
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    A Orthopedic Surgery, answered on behalf of
    For a failed total knee replacement (TKR), the surgeon might suggest aspirating the knee to look for evidence of infection. Joint infection is often a difficult diagnosis to make.

    A test has become available called the Synovasur test. Synovial fluid is aspirated and sent to a special laboratory where specific tests are performed. These include measuring a biomarker called alpha defensins. Biomarkers are proteins that act as the body’s natural antibiotics and are present when the body is fighting infection but not present in other conditions that can mimic infection.

    The Synovasure test has greatly improved doctors' ability to diagnose infection, as it helps differentiate inflammation and other causes of knee pain from infection.

    DISCLAIMER: Trinity Health recognizes that people seek medical information on a variety of topics for a variety of reasons. Trinity Health does not condone or support all practices covered in this site. As a Catholic health care organization, Trinity Health acts in accordance with the Catholic tradition.

    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.
  • 1 Answer
    A
    A Orthopedic Surgery, answered on behalf of
    If a total knee replacement (TKR) has failed, good quality x-rays are important. These include an x-ray taken with you standing (which physiologically loads to the joint) and occasionally also a full-length x-ray that includes the hip and ankle.

    These x-ray images give important information regarding component alignment, sizing and if the joint appears stable or loose. X-rays also reveal what type of method was used to fix the components to the bone. The types of information revealed by x-ray images include the following:
    • Were the components cemented or press-fit with the hope that stability would be achieved with bone ingrowth?
    • Do the interfaces where the bone contacts either the cement or prosthesis appear acceptable or is there a suggestion of loosening or osteolysis (bone destruction)? Accessing the equality of the inside and outside prosthetic joint space might give clues regarding soft tissue balance.
    • Does the patella appear to be tracking centrally or is it pulled to one side?
    • Are there residual bone spurs, which could be causing irritation or inhibit motion?
    A review of the x-rays that were taken prior to TKR also gives clues regarding the knee’s preoperative deformity, appearance and underlying anatomy.

    At this point, many times the surgeon will have a pretty good idea of what is causing the problem. Further x-rays might be necessary as well as other studies such as blood work, including an erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).

    Occasionally, the surgeon will request a bone scan, radioactive white blood cells (WBC) labeled scan, or metal artifact reduction sequences (MARS) magnetic resonance imaging (MRI). In special circumstances computed tomography (CT) is ordered to help better understand component positioning.

    DISCLAIMER: Trinity Health recognizes that people seek medical information on a variety of topics for a variety of reasons. Trinity Health does not condone or support all practices covered in this site. As a Catholic health care organization, Trinity Health acts in accordance with the Catholic tradition.

    Please note, the information contained on this website is provided to supplement the care provided by your physician. It is not intended to be a substitute for professional medical advice. Always seek the advice of a qualified health care provider if you have questions regarding your medical condition or before starting any new treatment. In the event of a medical emergency always call 911 or proceed to your nearest emergency care facility.