A total knee replacement procedure, also known as knee arthroplasty, is performed to provide relief from pain usually caused due to osteoarthritis and restore function to severely diseased or affected knee joints. Studies conducted by the World Health Organization (WHO) have revealed that osteoarthritis is the second most prevalent rheumatologic disorder and the most common joint disorder with a prevalence rate of 22% to 39% in India.
As per Dr. Sinukumar Bhaskaran, Consultant- Orthopaedics & Joint Replacement Surgery, Manipal Hospitals, Kharadi, Pune, ‘total knee replacement procedures have become necessary for treating patients with various knee disorders’.
The procedure involves the removal of damaged cartilage and bone from the shinbone, kneecap and thighbone and replacing it with an artificial joint made of high-grade plastics, polymers and metal alloys.
A doctor or an anaesthesiologist may advise the patient to stop taking certain dietary supplements and medications, such as aspirin and non-steroidal anti-inflammatory drugs that make it harder for blood to clot, steroids and other medications that affect the functioning of the immune system and augment the risk of post-surgical infection, and opioid pain medications that reduce tolerance to various pain medications, before the procedure. Furthermore, patients should inform the doctor about any nutritional supplements and homeopathic medications that they take.
In addition, the patient should not consume anything after midnight on the day of the procedure. Besides, doctors also recommend the following measures before a total knee replacement procedure:
As nicotine augments the risk of deep vein thrombosis or post-surgical infection and impedes healing, doctors strongly suggest reducing the consumption of tobacco before knee arthroplasty.
As alcohol interferes with the effects of anaesthesia, alcohol consumption should be limited to a couple of drinks before the procedure.
Patients suffering from cold, flu, herpes breakout or any other diseases must inform their doctors about their condition before the procedure.
As a total knee replacement procedure is a major surgery, it requires several preparatory and diagnostic tests, including checking blood count and the blood clotting process, urine tests and electrocardiograms (ECGs). The procedure is generally performed under spinal, epidural or general anaesthetic. Knee replacement surgery in Bangalore is available at Manipal Hospitals, book an appointment today.
Following a total knee replacement procedure, pain medicines are generally given by the doctor to alleviate pain and discomfort. While non-opioid (non-narcotic) medicines are usually given for minimizing pain, in some cases, opioid (narcotic) medicines are prescribed before physical therapy and sleep for at least a few weeks.
A combination of pain-relief techniques that minimize side effects and complement each other is generally adopted for treating pain. This method is called multimodal analgesia. If the pain remains under control, the patient may be asked to walk a few steps with the help of a walker or a physical therapist as putting some weight on the new knees (with assistance) so soon after surgery usually accelerates the recovery process. Consult with our orthopaedics expert in Bangalore to know more about the treatment.
Moreover, the patient is asked to move around a bit as soon as possible, perform some exercises (under the supervision of a physical therapist), take anti-clotting medications and wear compression boots to mitigate the risk of blood clots in the legs (also called deep vein thromboses).
Doctors also prescribe antibiotics after total knee replacement procedures to minimize the risk of infections. Besides, patients are also advised to eat healthy foods, avoid smoking and control blood sugars (if diabetic) after these procedures to reduce the risk of infections.
Physical therapy is another important component of the recovery process. A personalized and effective recovery and rehabilitation plan is critical for the success of the knee replacement procedure as it can help the patient:
Get discharged from the hospital sooner
Regain range of motion and knee strength quickly
Resume physical activities
Besides, some doctors also prescribe recovery plans that involve the use of continuous passive motion (CPM) machines which help straighten and bend the affected leg by slowly moving it while the patient is lying on their back. This machine can be used by a patient for up to 8 hours a day. These machines are also recommended to patients for temporary use at home after discharge from the hospital.
Following a total knee replacement surgery, knee replacement patients are given certain weight-bearing guidelines to follow both in the hospital and at home. The pressure that the knee can support after the procedure usually depends on the following factors:
The type of surgery performed (one-sided knee replacement or a total knee replacement)
The condition of the bone
The type of prostheses and how it can be fixated to the natural bone
However, patients will be asked to put more weight on the knee gradually to enable quicker healing.
Here are a few things a patient can do to prepare themselves better for a TKR:
Reduce the consumption of alcohol, tobacco, certain medications and substances as per the doctor’s advice.
Get assistive equipment, such as sock aids, shoe horns, walking aids, walker, cane, that may be required after the procedure.
Exercise to strengthen and condition the bones and joints to enable faster recovery post procedure.
Patients may experience mild pain after the procedure. Some patients have reported a sharp rise in the intensity of pain after the initial healing phase of a few months.
Patients can accelerate their recovery process by:
Wearing knee braces
Undergoing physical therapy and rehabilitation
Patients should be able to bend/flex their knees to at least 90 degrees within 7 to 10 days after the procedure.
With proper care and physical therapy, patients can recover from a TKR in 2-3 months.
Patients should be informed about the slow pace of the recovery process after a knee replacement surgery. Although the pace of recovery differs for everyone and generally depends on the type of surgery that they have undergone, it is usually slow and it may take the patient a minimum of 2-3 months to fully recover from the procedure.
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