Who Needs Knee Replacement Surgery? Indications and Criteria for Joint Replacement

02/26/2024

Knee replacement surgery replaces damaged or worn-out knee joints. Surgery can help relieve discomfort and improve knee function. During surgery, broken bone and cartilage are replaced with metal and plastic components. A surgeon evaluates your knee's range of motion, stability, and strength to determine whether a knee replacement is suitable for you. X-rays help to determine the amount of damage. Your age, weight, activity level, knee size and form, and overall health determine the appropriate prosthetic joints and surgical treatments.

Why Is It Done?

The most common reason for knee replacement surgery is to relieve discomfort caused by arthritis. People who need knee replacement surgery typically have difficulty walking, climbing stairs, and getting out of chairs.If only one portion of the knee is damaged, surgeons may usually replace that part. If the entire joint needs to be restored, the ends of the thigh and shinbone are reshaped, and the joint is completely resurfaced. These bones are rigid tubes with a soft core. The prosthetic components' ends are put into the softer center of the bones.Ligaments are fibrous bands of tissue that help to connect joints. If the knee ligaments aren't strong enough to hold the joint together on their own, the surgeon may choose implants that can be connected so they don't break apart.

Is Total Knee Replacement for You?

The decision to have total knee replacement surgery should be made jointly by you, your family, your primary care doctor, and your orthopedic surgeon. Your doctor may refer you to an orthopedic surgeon for a full evaluation to see if you would be helped from this procedure.

When Is Surgery Recommended?

There are several reasons why your doctor might suggest knee replacement surgery. People who benefit from total knee replacement typically have:

• Severe knee pain or stiffness prevents normal tasks such as walking, climbing stairs, and getting in and out of chairs.  Walking more than a few blocks may be difficult without substantial pain, and you may need to use a cane or walker.
• Moderate to severe knee discomfort while resting, day or night.
• Chronic knee inflammation and edema that doesn't go away with rest or drugs
• Knee deformities — Bowing in or out of the knee.Patients with bent knee deformity may benefit from total knee replacement.
• Failure to improve significantly with other therapies such as anti-inflammatory medicines, cortisone injections, lubricating injections, physical therapy, or additional operations.

Candidates For Surgery

There are no age or weight restrictions for complete knee replacement surgery.
Surgery recommendations are based on a patient's discomfort and impairment rather than their age. The majority of patients who get total knee replacement are between the ages of 50 and 80, however orthopedic surgeons examine individuals on an individual basis. Total knee replacements have been performed successfully in patients of all ages, from young teenagers to the elderly for respective orthopedic conditions .

The Orthopaedic Evaluation

An assessment with an orthopedic surgeon includes various components:

• Medical history: Your orthopedic physician will ask you about your overall health, the severity of your knee discomfort, and your capacity to function.
• Physical Exam: This will evaluate knee motion, stability, strength, and total leg alignment.
• X-rays: These images might help you identify the amount of your knee's damage and deformity.
• Other tests: Blood tests or advanced imaging, such as an MRI scan, may be required to establish the status of your knee's bone and soft tissues.

Your orthopedic surgeon will go over the results of your evaluation with you and determine whether total knee replacement is the best way to treat your pain and improve your function. Other treatment options, such as drugs, injections, physical therapy, and surgical procedures, will be evaluated and discussed.Additionally, your orthopedic doctor will explain the potential risks and consequences of total knee replacement surgery, including those related to the procedure itself as well as those that could occur over time.

Risks

Knee replacement surgery, like all surgeries, has hazards. They include:
Blood clots. To mitigate this risk, surgeons often offer blood thinners. Blood clots are most commonly found in the legs. However, they can spread to the lungs and be fatal.

Nerve injury. Nerves in the area where the implant is put may be damaged. Nerve injury can result in numbness, weakness, and discomfort.

Infection. Infection might develop at the incision site or in deeper tissue. Surgery is occasionally required to treat infections.
The implants used for knee replacements are strong, but they may loosen or wear with time. If this occurs, more surgery may be required to replace any loose or damaged pieces.

How You Prepare

1. Food and medications: Your doctor may advise you to cease using certain drugs and nutritional supplements before surgery. You'll probably be told not to eat anything after midnight the day of your procedure.
2. Prepare for your recovery: You may require crutches or a walker for several weeks following the procedure, so plan ahead of time. Make sure you get a transport home from the hospital and assist with daily duties like cooking, bathing, and laundry.
3. To make your home safer and simpler to navigate during recuperation, consider the following:

• Because ascending stairs can be difficult, make your living space one storey.
• Install safety bars or a solid handrail in your shower or bathtub.
• Handrails on stairs should be secure.
• Get a solid chair with a firm seat cushion and backrest, as well as a footstool to elevate your leg.
• If you have a low toilet, consider getting a toilet seat riser with arms.
• Purchase a sturdy bench or chair for your shower.
• Remove any stray carpets or cords.

What you Can Expect

When you check in for your surgery, you will be asked to change into a hospital gown. You will be given either a spinal block, which numbs the bottom half of your body, or a general anesthetic, which induces sleep.To help reduce pain following surgery, your surgeon may inject numbing medication around nerves or in and around the joint.

During the Procedure

Knee replacement surgery typically takes one to two hours. To carry out the surgery, the surgeon:

• Make an incision over the kneecap.
• Removes diseased and damaged bone and cartilage while leaving healthy bone intact.
• Implants the replacement components into the thigh bone, shinbone, and kneecap.

After the Procedure

Following surgery, you will spend some time in a recovery area. The length of your hospital stay following surgery is determined by your particular needs. Many people can return home the same day.
The risk of blood clots rises following knee replacement surgery. To avoid this difficulty, you may have to:
Make your move early:You will be urged to sit up and walk with crutches or a walker shortly after surgery.
Apply pressure: During and after surgery, you may wear elastic compression stockings or inflatable air sleeves on your lower legs. The air sleeves will pinch and release your legs. This helps keep blood from accumulating in the leg veins, lowering the risk of clot formation.
Take a blood thinner: Following surgery, your surgeon may prescribe a blood thinner, either injectable or oral. Depending on how quickly you walk, how active you are, and your general risk of blood clots, you may require blood thinners for several weeks following surgery.
You will most likely be asked to perform frequent breathing exercises and gradually raise your level of activity. A physical therapist can demonstrate how to exercise your new knee. After you leave the hospital, you will most likely continue physical therapy at home or in a facility.

Conclusion

Knee replacement provides most individuals with pain relief, increased mobility, and a higher quality of life. Most knee replacements are predicted to last at least 15 to 20 years. Following rehabilitation, you can participate in a variety of low-impact activities such as walking, swimming, golfing, and biking. However, you should avoid high-impact activities such as jogging and sports that require contact or jumping. Consult your healthcare provider about methods to stay active after knee replacement.