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360 DEGREES OF

KNEE REPLACEMENT

SURGERY

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360 dEGREES Of KNEE REPLACEMENT SURGERY

Table of ContentsIntroduction ...........................................................................3

When You Should Consider Knee Replacement Surgery .........4

Total vs. Partial Knee Replacement Surgery ............................6

How to find the Best Knee Replacement Surgeon for You ......8

What to Expect during the Operation ..................................12

Recovering from Knee Replacement Surgery ........................14

Conclusion ............................................................................15

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If you or a loved one has knee problems, you know how severely that can limit your activity level. Knee problems can make it difficult or impossible to participate in activities such as walking, jogging, dancing, playing golf, or nearly any outdoor pursuit. Sometimes, the pain can be so debilitating that it forces patients into an unsatisfying, sedentary lifestyle which can lead to a range of other health problems.

Before considering a surgical treatment for your knee problems, it is wise to exhaust all other options. No surgery is without risk, but when noninvasive treatments are ineffective, surgery may be the only option left. The first step should always be to consult with an orthopaedic surgeon or sports medicine specialist. Depending on the exact nature of your knee problem, the physician may recommend one or more noninvasive treatments.

The usual first treatment is the use of anti-inflammatory medications to reduce the pain and swelling. These medications may be oral or topical. In more severe cases, steroid or viscosupplement injections directly into the knee joint may provide effective relief. Using a knee brace can keep your knee in the proper alignment and reduce your risk of further injury or joint damage. The doctor may direct you to wear a brace while doing certain activities such as jogging or playing sports.

There are also special exercises you can do to strengthen the muscles around the knee to better support the knee joint. Your doctor may give you a program of exercises or suggest physical therapy.

A knee replacement surgery may be your best choice when none of these treatments are effective, if you have a severe injury, or if you have joint deterioration brought on by disease.

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WHEN YOU SHOULd CONSIdER KNEE REPLACEMENT SURGERYKnee problems are common and may affect people of any age. Whether they are brought on by injury, overuse, or disease, even minor knee problems can severely limit your activities. Keeping your knees healthy and functioning correctly will go a long way toward maintaining a healthy lifestyle, especially as you age. In this section, we will discuss what causes knee problems.

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• Injury – Knee injuries are often unavoidable. Of course, if you are playing sports, you should always wear the appropriate clothing and protective gear. But sometimes, no matter what you do, you will be involved in an accident that causes a knee injury. If you think you have suffered a knee injury, you should consult a physician as soon as possible.

• Overuse – Knee problems caused by overuse are most common among athletes and people with jobs involving manual labor. The best way to avoid these types of knee problems is by always employing proper techniques when lifting or pushing heavy objects. Also, you should maintain appropriate posture at all times, particularly when you are bending or squatting.

• Disease – There are many diseases that can lead to knee problems, and one of the most common is osteoarthritis. Osteoarthritis often develops naturally when the cartilage designed to cushion and protect your joints wears away as you age. There is no real cure for osteoarthritis, but there are things you can do to manage the symptoms and slow the progression of this disease.

There are three typical causes of knee problems:

If you have knee problems that are causing either severe pain or pain that persists despite conservative treatment, you may be a candidate for knee replacement surgery.

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TOTAL KNEE REPLACEMENT SURGERY VS. PARTIAL KNEE REPLACEMENT SURGERYThere are more than 700,000 total knee replacements performed in the United States every year. A total knee replacement is the most common option, but for some patients, a partial knee replacement may be a possibility. Before you attempt to evaluate your knee problems and treatment options, it is helpful to understand how the knee is put together. The human knee consists of three primary sections called compartments. The inner part of your knee is known as the medial compartment. The outer compartment of the knee is called the lateral compartment. The upper part of your knee, located between the kneecap and the thighbone, is called the patellofemoral joint. The tendons, cartilage, and ligaments in these three compartments work closely together to generate the proper functioning of your knee, but it is possible to replace one compartment without disturbing the others.

Although uncommon with knee replacement surgery, it’s important to know that with any surgical procedure, if unexpected bleeding occurs a blood transfusion may be required. Thankfully, the option for less invasive surgery nearly always results in decreased blood loss, less pain, and quicker recovery. A partial knee replacement is no different, and typically results in a better, faster recovery for patients. Unfortunately, partial knee replacements are only recommended in limited cases. When there is a possibility that a patient’s knee problems will get worse over time, which is usually the case, a partial knee replacement patient may eventually need a total knee replacement. When this is the case, it is much better to perform just one surgery than to perform multiple surgeries.

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Total knee replacements are not without issues of their own. Total knee replacement patients will almost certainly gain significantly more flexibility than they had before surgery, and their knee pain will be dramatically reduced or even eliminated. Unfortunately, an artificial knee simply cannot match the performance of a healthy human knee.

Only your doctor can determine the viability of partial knee replacement or total knee replacement in your case.

Partial Knee Replacement Total Knee Replacement

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HOW TO fINd THE BEST KNEE REPLACEMENT SURGEON fOR YOUThough it may be common, knee replacement surgery is still a serious medical procedure. Knee replacement is also expensive when the costs of the procedure, hospital stay, and rehabilitative care are all added up. Most people have health insurance that will pay at least some of the bill, but as the patient, you still have the responsibility to seek out the best medical care.

Finding the best surgeon for your knee surgery is not actually that much different from choosing any other type of professional service provider. You must determine the most important characteristics, and find a provider that most closely meets those criteria. Here are a few characteristics to consider when choosing a surgeon:

• Expertise – For most people, this is the most important attribute, and it probably should be. Be sure to ask your surgeon how many knee replacements he or she has performed in the last 12 to 24 months. What was the typical outcome?

• Personality – Doctors are individuals with different personalities and styles of providing care. Whenever possible, choose a physician with whom you can get along.

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• Staff – Very few doctors work completely independently. They depend on staff to schedule appointments, bill insurance, and take care of other administrative tasks. Most of the time, the doctor’s staff is who you will be speaking and dealing with. Choose a physician with a competent office staff who makes you feel comfortable.

• Board Certification – The American Board of Medical Specialties certifies physicians in a wide variety of specialties, including orthopaedic surgery. All board certified physicians meet stringent requirements of quality patient care and continued training. Board certification is not a guarantee that a physician will be right for you, but it is a good place to start.

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Choosing the best surgeon will make a big difference in your recovery. Once you have found a few choices with whom you would be comfortable, you should have a conversation with each prospective surgeon before making your final decision. You can get the conversation started with this list of five essential questions to ask your knee replacement surgeon:

1. How many knee replacements have you performed in the last 24 months? What was the typical outcome? All medical cases are unique, and your recovery will depend on a large number of factors. Even so, if the surgeon will not clearly answer this question, it is a warning sign.

2. What potential complications should I be aware of? No matter how routine a surgical procedure is, complications are always a possibility. Any surgeon who tells you otherwise is not being truthful. Be sure that you understand and are willing to accept the risks before proceeding.

3. Will I need to stay in the hospital? If so, for how long? In some cases, a knee replacement procedure may be performed on an outpatient basis. However, the typical hospital stay is two or three days for a single knee and five to seven days if both knees are replaced. Some patients may require additional days in a rehabilitation facility.

4. How long will I be out of work? And when can I drive? Time out of work depends on the type of work that you do, the type of knee replacement (partial or total), and whether one or both knees were replaced. Returning to driving a car depends on which knee was replaced, and may take a few weeks. These questions are best discussed with your surgeon.

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5. What therapies will I need after surgery? Rehabilitation begins almost immediately after you wake up from surgery. Within the first 24 hours, you will begin standing and walking using an assistive device with the help of a physical therapist. It is crucial you get up and use your artificial knee as soon as possible. A 4-6 week regimen of physical therapy is typical after a knee replacement. Your therapist will provide exercises that will help strengthen your muscles; he or she will also monitor your exercises and perhaps modify them as your knee improves.

6. Is surgery my only option? Perhaps you would prefer to avoid surgery. Depending on your specific situation, there may be nonsurgical alternatives available. A surgeon will likely recommend surgery, but should also be able to advise you of other options you may have.

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WHAT TO ExPECT dURING THE OPERATIONWhether you are having a total or partial knee replacement surgery, the steps involved in your surgical procedure will be virtually identical. Most likely, medical staff will direct you to arrive three to four hours before the scheduled surgery time. If you have other health issues or a severe injury, a pre-surgery overnight stay may be necessary. When you arrive at the hospital, your first step will be to provide information to your caregivers. You will be answering questions related to your other health issues, insurance, and religious preferences. The answers to these questions will help the hospital meet your needs during your stay. When you are finished checking in, you will receive an ID bracelet and be asked to change into hospital clothing. If you prefer, your spouse or other loved one is welcome to wait with you until it’s time for surgery.

From that time until your procedure begins, you will stay in the pre-surgery preparation area. A nurse or doctor will start an IV that will be used to administer the anesthesia and other necessary medications. The anesthesiologist or his or her assistant will likely meet with you and ask more questions to help determine the best type of anesthesia to use. If you have not done so yet, you will be asked to sign a surgical consent form.

Your safety is always a number one priority, and any mistakes that occur beyond this point have the potential to be serious. If you were to undergo the wrong procedure, it would be extremely detrimental for you and present an enormous liability to the hospital. To avoid this frightening possibility, the surgeon or other medical personnel will verify exactly what procedure you are having performed. The site of your surgery should be marked with a special pen. Then, you will be

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moved to the operating room. Again, your safety is the number one priority.A hospital operating room is a busy place filled with medical personnel and equipment. Even for minor surgery, you should not be surprised to see six or more people on your surgical team. Once you are prepped, the anesthesia will be administered. For a knee replacement, the choices include either spinal or general anesthesia. Your surgeon and anethesiologist will help you determine which option is best for you.

The surgery itself should take somewhere between one and three hours to complete. After surgery, you will be transported to the recovery room where your vitals will be monitored for another one to three hours. If you have family members present, the surgeon will update them on how your surgery went. Once you are finished in the recovery room, you will be taken to a hospital room.

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RECOVERING fROM KNEE REPLACEMENT SURGERYPain management has drastically improved over the years, providing patients with a speedy recovery and discharge to home. Advanced pain management also helps patients return to their daily activities much faster than before.

After your knee replacement procedure, a two or three day stay in the hospital is typical. The length of your stay is based on the exact procedure that was performed. If you had a partial knee replacement procedure, you should expect a shorter stay. During this time, your care will be focused on getting you ready to go home. After the initial recovery phase, the hospital staff will have you standing and walking. At first you will have assistance, then move to a walker, then a cane, and then finally walk unassisted. Your nurses and therapists will help you progress from basic exercises to more complex and challenging ones. These more advanced exercises will help your recovery process go more quickly and smoothly.

After the hospital stay, you will be released with instructions to continue physical therapy and/or home exercises. Four to six weeks of physical therapy is typically prescribed, though depending on your situation, you may need more or less. Your physical therapy will also be complemented by exercises that will be performed at home. Whether they are done at your physical therapy facility or at home, these exercises are designed to regain knee motion and to strengthen the muscles around your knee joint. The stronger muscles will better support your new joint and give you better mobility. Depending on your other health issues and how well your therapy and exercise go, you should expect a full recovery in three to six months.

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CONCLUSIONIf you have been suffering from knee problems for a significant length of time, the relief that is usually achieved by a partial or total knee replacement is well worth the time and expense of this surgical procedure. The first step toward your recovery and regaining your active lifestyle is to consult with a competent orthopaedic surgeon. Our doctors are among the best in the medical industry, and we specialize in using the most advanced treatment methods. If you would like to schedule a consultation with one of our doctors or have any questions, please visit our website, www.premierortho.com, to find a Premier Orthopaedic office in your neighborhood.