Total Knee and hip Replacement
Knee replacement, also called arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury.
Various types of arthritis may affect the knee joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, may cause damage to the cartilage of the knee.
The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments.
The most common condition that results in the need for knee replacement surgery is osteoarthritis. This is a degenerative, joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees. Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury can also lead to degeneration of the knee joint. In addition, fractures, torn cartilage or torn ligaments also can lead to irreversible damage to the knee joint over the years.
Knee and hip joints replacement, it is necessary for people with the following symptoms.
- Limits movement and may cause pain. People with severe degenerative joint disease may be unable to do normal activities that involve bending at the knee, such as walking or climbing stairs, because they are painful.
- The knee may swell or “give-way” because the joint is not stable.
- Realignment of Bowleg and Knock Knee Deformities
- Medical treatments are not satisfactory; knee replacement surgery may be an effective treatment. Some medical treatments for degenerative joint disease may include, but are not limited to, the following: Anti-inflammatory medications
- Glucosamine and chondroitin sulfate
- Pain medications
- Limiting painful activities
- Assistive devices for walking (such as a cane)
- Physical therapy
- Cortisone injections into the knee joint
- Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
- Weight loss (for obese persons)
The most common age for knee replacement is between 60 and 80 years old. There may be other reasons for your doctor to recommend a knee replacement surgery.
During the procedure
Knee replacement requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices. Knee replacement surgery is most often performed while you are asleep under general anesthesia. Your anesthesiologist will discuss this with you in advance.
After the procedure
In the hospital
After the surgery you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room. Knee replacement surgery usually requires an in-hospital stay of several days.
It is important to begin moving the new joint after surgery. A physical therapist will meet with you soon after your surgery and plan an exercise program for you. Your pain will be controlled with medication so that you can participate in the exercise. You will be given an exercise plan to follow both in the hospital and after discharge.
You will be discharged home or to a rehabilitation center. In either case, your doctor will arrange for continuation of physical therapy until you regain muscle strength and good range of motion.
At home
Once you are home, it is important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit. To help reduce swelling, you may be asked to elevate your leg or apply ice to the knee. Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
Notify your doctor to report any of the following:
- Fever
- Redness, swelling, bleeding, or other drainage from the incision site
- Increased pain around the incision site
You may resume your normal diet unless your doctor advises you differently.
You should not drive until your doctor tells you to. Other activity restrictions may apply. Full recovery from the surgery may take several months.
It is important that you avoid falls after your knee replacement surgery, because a fall can result in damage to the new joint. Your therapist may recommend an assistive device (cane or walker) to help you walk until your strength and balance improve.
Making certain modifications to your home may help you during your recovery. These modifications include, but are not limited to, the following:
- Proper handrails along all stairs
- Safety handrails in the shower or bath
- Shower bench or chair
- Raised toilet seat
- Long-handled sponge and shower hose
- Dressing stick
- Sock aid
- Long-handled shoe horn
- Reaching stick to grab objects
- Removing loose carpets and electrical cords that may cause you to trip
- Avoiding stair-climbing until recommended by your doctor
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
More Information
Department of Surgery
Tel. +66(0)53-582-888 Hours: Monday-Sunday Cell Phone: +66(0)93-765-7354