THE KNEE JOINT
Joints are the areas where bones meet, and movement
occurs. The knee joint is made up of the femur above and the tibia
below. The two bones are separated by cartilage that acts as a cushion and
allows movement.
REASONS FOR SURGERY
The reasons for total
knee replacement surgery in Delhi are: severe pain, loss of mobility,
or deformity of the knee. Symptoms may be due to osteoarthritis,
rheumatoid arthritis, or trauma among others.
Osteoarthritis, commonly called "wear and tear,"
is the most common cause for a total knee replacement.
ABOUT KNEE
REPLACEMENT
The knee joint is made up of the ends of the thigh bone
(femur) and the shin bone (tibia). These bones normally slide over each
other with ease because they are covered by soft cartilage. If an injury
damages the cartilage or is worn away by arthritis, for
example, it can make the joint ache or stiff.
Generally, a new knee joint improves mobility and decreases
pain, although your new knee will not be able to bend as much as a normal knee
joint.
Depending on the condition of your knee joint, they will
replace part or all of your knee joint. A total knee replacement is more
common.
Artificial knee pieces can be made of metal and / or
plastic, and a knee replacement can last up to 20 years.
WHAT ARE THE
ALTERNATIVES?
Knee
replacement surgery in Delhi is generally recommended only if nonsurgical
treatments, such as physical therapy and exercise, taking medication, or using
physical support devices such as a cane, no longer help decrease pain or
improve mobility.
Alternative surgical procedures include arthroscopy
in Delhi (if the arthritis is not very severe) or osteotomy (in which
the leg bones are cut and put back). You may have already had these
procedures before your knee replacement.
The surgeon will explain your options.
PREPARING
FOR A KNEE REPLACEMENT
The orthopaedic
surgeon in Delhi will explain how to prepare for the
operation. For example, if you smoke, they will ask you to stop smoking,
as this increases your risk of chest and wound infection, which can delay your
recovery.
Typically, you must stay in the hospital for about five
days, and the surgery is performed under general anesthesia. This means
that you will be asleep during the operation. Otherwise, if you prefer,
the surgery can be performed under epidural or spinal anesthesia. This
type of anesthesia completely numbs from the waist down, and you will remain
awake during the operation.
If you are going to have general anesthesia, you will be
asked to fast. This means that you should not eat or drink, normally, for
about six hours before general anesthesia. However, it is important to
follow the instructions of your anesthetist.
In the hospital, the nurse can check your heart rate and
blood pressure and do a urine test.
Your surgeon will explain to you what will happen before, during, and after the
procedure, and any pain you may have. This is your opportunity to
understand what will happen, and it may be helpful to prepare questions about
the risks, benefits, and other alternatives to the procedure. This will
help you stay informed so that you can give your consent if you are asked to
sign a consent form to carry out the procedure.
You may be asked to wear compression stockings on your
unaffected leg to prevent blood clots from forming in your veins (deep vein
thrombosis, DVT). You may need an injection of a blood-thinning medicine
called heparin in addition to, or instead of wearing, compression stockings.
WHAT
HAPPENS DURING A KNEE REPLACEMENT?
Generally, a knee
replacement in Delhi takes about two hours.
The orthopaedic
in Delhi will make a single cut (10 to 30 cm long) in the front of your
knee. You will push the kneecap to the side to reach the knee
joint. The surgeon will remove the worn or damaged surfaces from the end
of the femur and the top of the tibia. Typically, he will remove the
anterior cruciate ligament and may remove the posterior cruciate ligament. For
support, the best
orthopaedic in Dwarka will not remove the collateral ligaments. It
will shape the surfaces of the femur and tibia to fit the artificial knee joint
and then fit the new joint over both bones.
Sometimes the back of the kneecap is replaced with a piece
of plastic. This is known as patella lining.
After placing the new joint, the surgeon will close the wound with stitches or
clips and cover it with a bandage. The surgeon will place a tight bandage
on your knee to help minimize swelling.
WHAT SHOULD I EXPECT
AFTER
You will need to rest until the anesthesia wears
off. After epidural anesthesia, you may not be able to feel or move your
legs for several hours.
You may need pain relievers to ease any discomfort when the
anesthesia wears off.
You may have an intermittent compression pump attached to
special pads on your lower legs for the first day or so. By inflating the
cushions, the pump encourages healthy blood circulation and helps prevent a
DVT. You can also have a compression stocking on your unaffected leg. This
helps maintain circulation.
A physiotherapist
in Dwarka (a movement and mobility specialist) will visit you daily to
guide you through exercises that will help you recover.
You will stay in the hospital until you can walk safely with
the help of a cane or crutch. When you can go home, you will need to ask
someone to drive you.
Before you go home, the nurse will give you recommendations
for caring for your knee and a date for your follow-up appointment.
How long it takes for the sutures to disappear will depend
on the type used in the surgery. However, for this procedure they usually
go away in about six weeks. Nonabsorbable sutures and clips are removed
10-14 days after surgery.
RECOVERING
FROM KNEE REPLACEMENT SURGERY
If necessary, you can take an over-the-counter pain
reliever, for example acetaminophen or ibuprofen. Follow the instructions
in the patient information leaflet that comes with your medicine, and if you
have questions, ask your pharmacist.
Physical therapy exercises are an indispensable part of your
recovery, so it is essential that you continue to do them for at least two
months.
You will be able to move around your house and go up and
down stairs. For a few weeks, some everyday activities, such as shopping,
will be difficult for you to do. You may need to use a cane or crutches
for about six weeks.
You may be asked to wear compression stockings at home for
several weeks.
When resting, raise your leg and support your knee to help
prevent leg and ankle swelling.
Depending on the type of work you do, you may be able to go
back to work after six to 12 weeks.
Follow your surgeon's recommendations for driving. You
should not drive until you are sure that you can brake in an emergency without
discomfort.
WHAT ARE THE RISKS?
Knee
replacement surgery in West Delhi is a common and generally safe
procedure. However, in order to make an informed decision and consent, you
must be aware of the possible side effects and risk of complications associated
with this procedure.
Side effects
These are the unwanted, though mostly temporary, effects of
successful treatment; for example, feeling dizzy as a result of general
anesthesia.
Your knee will hurt and be swollen for up to six months.
You will have a scar on the front of your knee. You may
not have sensation in the skin around the scar. This may be permanent, but
it should get better in two years.
Complications
Complications are problems that occur during or after the
operation. Most of the people are not affected. Possible
complications from any operation include unexpected reactions to anesthesia,
excessive bleeding, or clot formation, usually in a vein in the leg (DVT).
Complications specific to knee replacement are rare, but
include:
- Wound
or joint infection Antibiotics are given during and after surgery to
prevent this complication.
- Unstable
joint. The knee joint may loosen and may require surgery to correct
it.
- Damage
to blood vessels or nerves. It is usually mild and temporary.
- Scar
tissue. Scar tissue formation can limit movement. You will
likely need another surgery to correct it.
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