We spent much of our lives in school and formal training to become the best possible physician. However, that does not imply that we operate on every patient in every situation. Consider this. We want your knee replacement to be incredibly successful to improve your life, reduce your pain, and improve your function.
This outcome gives us huge satisfaction and pride in our work. We want our patients to recover uneventfully and not spend long periods of time in the hospital with difficult complications. This is not to say that we do not manage complicated patient. When a patient presents with other medical problems or high-risk knee problems, we have be cautious and deliberate in our management when deciding on our plan of action.
We do understand that sometimes complications may be unavoidable and we need to manage them and take whatever time is necessary to rectify them. But, it's always better to avoid the complication in the first place. Here is why this key ingredient is so important. Many patients come to us who are not the ideal surgical candidate, but have fulfilled number one and number two in the algorithm.
Many patients have medical reasons that will increase their complication rates. Patients with diabetes and patients who smoke have increased risk of pneumonia and stroke. Morbidly obese patients have increased rates of infections and failure of the knee replacement components. Patients with chronic leg swelling, poor circulation or wounds that heal very slowly have increased rates of blood clots and wound complications.
As a surgeon, we have to decide, do we want to take that risk along with you. Are you as a patient willing to try to mitigate these risk factors? Even if you tried, could you be successful?
Other times the medical risks just can't be reversed even with the best intentions. Some patients' medical problems put them at incredibly high risk. What if the patient has significant history of stroke and heart attack? Let's assume that as a patient you are qualified in our two-step algorithm and you are healthy.
Well, shouldn't that immediately mean that you're ready to have the knee replacement and you're going to have an excellent outcome? Not always. They may expect either no pain or minor pain , or occasional aching, swelling or some minor stiffness. Some patients will actually feel like the replaced knee is their own, and others will notice some mechanical clicking or other unusual sensations such as numbness. Even if they experience these minor issues, they will still feel much better than they did before surgery.
When you look at the studies this number that I'm discussing is an over estimation. So why the difference? It comes down to patient selection. Next Steps. View full-size infographic. Arthritis is interfering with your life. Your knees are stiff and swollen. Your knee hurts when you rest. Your leg bows in our out. You want to stay physically active. You want long-lasting relief. How quickly you recover from surgery will depend on your: age, how strong your knee was before surgery, and whether you have other health problems like diabetes or rheumatoid arthritis.
These diseases weaken your immune system and can slow down healing. Next Steps If you have any of the symptoms above and think you may benefit from knee replacement surgery, make an appointment with one of our orthopedic doctors. It's confidential and you have a right under the Data Protection Act to see what details are kept about you.
Page last reviewed: 02 August Next review due: 02 August When a knee replacement is needed Knee replacement surgery is usually necessary when the knee joint is worn or damaged so that your mobility is reduced and you are in pain even while resting. Other health conditions that cause knee damage include: rheumatoid arthritis haemophilia gout disorders that cause unusual bone growth death of bone in the knee joint following blood supply problems knee injury knee deformity with pain and loss of cartilage Who is offered knee replacement surgery A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, have not reduced pain or improved mobility.
You may be offered knee replacement surgery if: you have severe pain, swelling and stiffness in your knee joint and your mobility is reduced your knee pain is so severe that it interferes with your quality of life and sleep everyday tasks, such as shopping or getting out of the bath, are difficult or impossible you're feeling depressed because of the pain and lack of mobility you cannot work or have a social life You'll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.
Types of knee replacement surgery There are 2 main types of surgery: total knee replacement — both sides of your knee joint are replaced partial half knee replacement — only 1 side of your joint is replaced in a smaller operation with a shorter hospital stay and recovery period Other surgery options There are other types of surgery which are an alternative to knee replacement, but results are often not as good in the long term.
Other types of surgery may include: arthroscopic washout and debridement — a tiny telescope arthroscope is inserted into the knee, which is then washed out with saline to clear any bits of bone or cartilage osteotomy — the surgeon cuts the shin bone and realigns it so that your weight is no longer carried by the damaged part of the knee mosaicplasty — a keyhole operation that involves transferring plugs of hard cartilage, together with some underlying bone from another part of your knee, to repair the damaged surface Preparing for knee replacement surgery Before you go into hospital, find out as much as you can about what's involved in your operation.
Recovering from knee replacement surgery You'll usually be in hospital for 3 to 5 days, but recovery times can vary. Risks of knee replacement surgery Knee replacement surgery is a common operation and most people do not have complications.
Complications are rare but can include: stiffness of the knee infection of the wound infection of the joint replacement, needing further surgery unexpected bleeding into the knee joint ligament, artery or nerve damage in the area around the knee joint deep vein thrombosis DVT persistent pain in the knee a break in the bone around the knee replacement during or after the operation In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.
Some people may not be able to have one at all, depending on their age, weight, medical conditions, and other factors. If you are unsure, consult with a surgeon and get a second opinion. Your future health and lifestyle may be riding on it.
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