Understanding Knee Pain
The knee is a complex, hinged joint. With support from cartilage, ligaments, and muscles, the two bones at the joint move over each other so you can straighten and bend your leg. A knee that becomes stiff and painful may be replaced with a knee prosthesis, which will allow you to walk without pain.
In a healthy knee , the surfaces of the thigh and shin bones are smooth so they can glide easily over each other. Cartilage covers the bones evenly, allowing smooth movement. Protected by the kneecap and held in place by muscles and ligaments, the joint bends freely.
In a problem knee, the surfaces of the bones may become rough, causing pain when they rub together. The cartilage may wear away, becoming rough and no longer allowing easy movement of the joint bones. Because of arthritis, the joint may be swollen and inflamed, resulting in stiffness and pain.
Your damaged knee joint can be replaced with new, smoothly surfaced components. The lower knee component will replace the rough surface of the shin bone, while the upper knee component will replace the surface of the thigh bone. The kneecap component will cover the underside of your kneecap.
Knee arthritis symptoms progessivly worsen over time. A painful knee can keep you from doing the things you enjoy in your life. The most common symptoms of knee arthritis are:
- Stiffness of the knee
- Swelling of the joint
- Pain in the knee
- Limited range of motion
- Tenderness along the joint
One solution is a decision to replace your knee and is your first step toward regaining control of your life. Technical advances have given us new materials to replace your problem knee. Therefore, when lesser methods are no longer able to control the pain and disability to your satisfaction, knee replacement becomes a reasonable option.
- Pain is severe enough to restrict work, recreation, and the ordinary daily activities.
- Pain is not relieved by anti-inflammatory medicine, the use of a cane, and other restricting devices.
- There is a significant stiffness of the knee.
- X-rays show advanced arthritis or other knee problems.
Knee replacement is an elective operation and there are always nonoperative alternatives. The decision to have the operation is not made by your doctor, but by yourself. The doctor may recommend the operation; however, your decision must be based upon weighing the benefits of the operation against the risks. You may wish to discuss the surgery with your own doctor or even get another opinion so all your questions are answered before you decide to have the operation.
Why the BioPro Knee Implant?
The BioPro® TKO (Total Knee Origin) implant is one of the more conservative knee implants available today. The TKO not only conserves bone by being one of the thinnest implants, but is one of the only implants that conserves all of the normal structures that Mother Nature put in place for very good reasons. The TKO retains all ligaments, including the ACL and PCL, restoring your post-operative knee to a more natural acting and responsive state.
The Surgical Procedure
Knee replacement is one of the most common forms of total joint replacements. To begin the surgical procedure, the patient will be given an anesthetic (usually a spinal unless contraindicated). The surgeon will then make an incision and prepare the knee for implantation of the prostheses by reshaping and resurfacing the bones of the arthritic knee joint. The surgeon will then place and secure the implants in the appropriate areas to replace the joints. Ultimately, the damaged and rough surfaces of the knee joint will be replaced with new, smooth-surfaced components. The lower knee component will replace the roughened surface of the shin bone. The upper knee component replaces the roughened surface of the thigh bone. The kneecap component covers the underside of your kneecap. When the surgery is finished, the incision will be closed and a small tube (called a hemovac) will be placed in the incision to help drain fluid from the operative area for the first day or so.
Complications of Knee Replacement Surgery
Most complications that occur after knee replacement are successfully treatable. Possible complications after knee replacement include:
Infections: Any infection in your body can spread to your joint replacement. Infections may occur while you are in the hospital of after you go home. Minor infections can be treated with antibiotics, while major infections may require surgery and removal of the prosthesis.
Blood Clots: If there is a severe pain and / or swelling that develops in your calf or thigh, you may have developed a blood clot. Blood clots result from several factors, including decreased mobility that causes a slow movement of the blood through your leg’s veins. Your doctor may take preventative action to reduce the possibility of blood clots, such as blood thinning medications, elastic stockings, exercises that increase the blood flow in the leg muscles, or plastic boots that inflate with air to compress the muscles in your legs.
Loosening: Loosening of the prosthesis within the bone may occur after knee replacement. If the loosening is significant and there is a large amount of pain, a revision surgery to correct the loosening may be necessary.
Wear: Wear can be found in several joint replacements. Excessive wear can lead to loosening and pain and may require revision surgery.
Prosthetic Breakage: Breakage of a knee replacement is extremely rare, but it can occur. If this case does occur, a revision surgery will be needed.
Nerve Injury: Nerves in the vicinity of the total joint replacement can be damaged during the total replacement surgery. This type of injury is not common and may often improve and/or completely recover after some time.
Stiffness: In some cases, the ability to bend the knee does not return to normal after an artificial knee replacement. Increased scarring after surgery can lead to an increasingly stiff knee. If this occurs, your surgeon may manipulate the knee to regain motion without injuring the joint.
It is also important to notify your surgeon or nurse if you experience any of the following symptoms:
1) Pain, soreness, swelling, or redness in the calf muscles of either leg.
2) Unexplained, increased pain in the operative area.
3) Redness, swelling, or puslike drainage from the area around the incision
4) Cough, high fever, or chills.
5) Chest pain, shortness of breath, or difficulty breathing.
What to Expect After Knee Replacement Surgery
After surgery, you will be taken to the Recovery Room for a period of close observation. Your blood pressure, pulse, and temperature will be monitored and close attention will be paid to the circulation and sensation in your legs and feet. Post operatively, you may have temporary nausea and vomiting due to anesthesia or medications. (Anti-nausea medication may be given to you when you are in your room to minimize nausea and vomiting.) It is also important to tell your nurse if you experience any numbness, tingling, or extreme pain in your legs or feet. When your condition is stabilized, you will be transferred to your hospital room.
When you wake up from surgery, you will rest in bed with your bandaged leg slightly raised by a pillow. A tube (called a hemovac) that may have been placed in you during surgery will drain excess fluid to keep swelling down, while an intravenous (IV) line may be used to provide fluids for nourishment, medication to prevent blood clots, and antibiotics to prevent possible infection. You may also have a catheter placed to aid in urination. To relieve pain, you can be attached to a special device that will allow you to get pain medication when you feel it is necessary.
At first, you will be restricted to ice chips and clear liquids, but your diet will be allowed to progress as your condition permits. Meanwhile, the surgeon and physical therapist will work together to set movement guidelines for you. The physical therapist may also recommend some gentle exercises that will help strengthen your new knee.
After total knee replacement surgery, it takes only a few months to regain strength and confidence in your new knee. With the help of your orthopedist and physical therapist, activities that you were not able to do before surgery can be enjoyable again.