ALL ABOUT KNEE REPLACEMENT SURGERY

Knee replacement surgery (also called knee arthroplasty) relieves pain caused by osteoarthritis.

When having this disease, you may have difficulty sleeping at night because of severe knee pain. Also, you could have trouble doing small tasks, such as walking, kneeling, or going up and down the stairs. In these cases, knee arthroplasty can help restore lost mobility, correct knee distortion, and improve your quality of life. 

 And even though knee replacement surgery is considered a major procedure, its  success rate is very high. Usually, most patients do not need help to walk after the rehabilitation period.

WHAT IS KNEE REPLACEMENT SURGERY?

Knee replacement surgery involves replacing a normal knee joint with an artificial joint.

The knee joint can be replaced entirely or partially according to your particular case, each with its benefits and disadvantages.

IS KNEE REPLACEMENT SURGERY RIGHT FOR YOU?

Knee arthroplasty is usually performed on adults over 60 years old, affected by degenerative diseases. Osteoarthritis and rheumatoid arthritis are the leading causes of knee replacement surgery.

Indeed, this surgery is rare in young patients, and if done, it is usually due to car accidents or severe knee injury. Natural knee repair is often impossible in these cases, so a knee implant is the only option.

Knee replacement surgery is considered major surgery. So firstly, you must have tried non-invasive treatments to alleviate pain. If they turn out unsuccessful and preserving your natural knee is not an option, you can consider surgery.

The problem with non-invasive treatments and medication is that by the time they are no longer working, the knee deformity is advanced, and the patient cannot lead a normal life without pain. At this point, knee replacement surgery is the best and only option.

Our team of orthopedic specialists will tell you if you need knee arthroplasty surgery. We will also provide you with the cost of surgery.

HOW IS KNEE REPLACEMENT SURGERY PERFORMED?

The total knee replacement artificially replaces all the components of knee anatomy (femoral, tibial, and patellar components). To sum up, damaged cartilage and bone are removed from the knee joint. Then, artificial pieces are placed instead.

First, your surgeon will make an incision down the very front of your knee to expose the underlying kneecap. Then, this is moved to the side to get access to the knee joint.

The damaged ends of your shin bone and thigh bone are measured, cut, cleaned, and shaped to fit the final prosthesis.

A curved metal piece will replace the end of your thigh bone, and the shin bone will now have a metal plate at its top. These pieces are fixed in place using a special bone’ cement’, and in some cases, your bone will fuse with the replacement parts.

Also, you will have a plastic spacer between the pieces of metal to replace the cartilage, which usually reduces friction as your joint moves.

Finally, the incision is closed using stitches or clips, and a dressing is carefully applied to cover the wound. In rare cases, the doctor may put you in a splint to keep your leg immobile. However, you’re usually encouraged to start moving your knee as soon as possible.

PARTIAL KNEE REPLACEMENT OR TOTAL KNEE REPLACEMENT?

As its name implies, a partial knee replacement only replaces a part of the knee joint. Indeed, if only a portion of the joint is damaged by arthritis, a partial knee replacement can be a good option.

This kind of joint replacement can result in a more natural movement in the knee with the possibility of being more active compared to a total knee replacement.

In some cases, a partial knee implant is used when the patient is elderly, slender, and with little physical activity. It can also be an effective implant if the joint deformity is slight or if the patient does not have severe arthritis.

A partial replacement has many advantages, including a shorter hospital stay and a faster recovery. Blood transfusions are also unlikely.

Partial knee implants have been in use for several years, and the results are promising. Despite this, total knee surgery is the “go-to” option in most cases.

Indeed, most patients with degenerative arthritic knee diseases undergo total knee replacement surgery. But do not worry because our orthopedic specialists will advise you on the type of knee implant that best suits your case.

WHAT MATERIALS ARE USED IN TOTAL KNEE REPLACEMENT SURGERY?

The material used depends on many factors, including the patient’s characteristics and age.

Most artificial knees include metal and/or plastic parts. Some orthopaedic surgeons have various options, including ceramic on ceramic, metal on metal, or ceramic on plastic.

The most used materials are metal, stainless steel, cobalt, chrome, titanium alloys, polyethylene, and ceramic. These materials allow similar mobility to that of the damaged joint.

WHAT ARE THE RISKS OF KNEE REPLACEMENT SURGERY?

As in all surgical procedures, knee replacement surgery presents some risks. However, many of them can be minimized by following the orthopaedic surgeon’s recommendations.

The main risks are bleeding and infection.

Intravenous antibiotics are administered one hour before and 24 hours after surgery to minimize the risk of infection. Then, you will continue to take them orally.

There is also the risk of thrombosis within the venous system of your legs. Hence, you will receive blood thinners to prevent the formation of blood clots.

Also, prolonged immobility increases the risk of clots formation. So, the patient must be encouraged to move from the day after the surgery, following the specialists’ guidelines.

WHAT IS THE SUCCESS RATE OF KNEE REPLACEMENT SURGERY?

Knee replacement surgery is one of the most common surgical interventions performed today by orthopaedic surgeons.

The success rate is very high. Most patients do not need help for walking after full recovery.

THE STAGES OF KNEE REPLACEMENT SURGERY

Before the surgery

Once the surgery date has been set, the patient must go to the Diagonal clinic facilities to carry out a series of preoperative examinations. You will have blood tests, telemetry, and knee x-rays.

Is knee replacement surgery painful?

The patient will not experience any pain during the intervention. Total knee arthroplasty is performed under epidural (numbed from the waist down) or general anesthesia (completely asleep).

The total duration of knee replacement surgery is usually 2 hours.

How long does it take to recover from knee replacement surgery?

Knee replacement recovery depends on each patient, and physical therapy is key.

You are usually encouraged to start walking soon after the intervention to strengthen the knee muscles as quickly as possible.

Indeed, regular physical activity is crucial in recovery after surgery. The better and more exercises are performed, the shorter the recovery time becomes.

Your physical therapists will instruct you on the rehabilitation exercises and use of crutches. A couple of daily rehabilitation sessions are scheduled throughout the patient’s stay in the clinic (six days). When discharged, the patient usually leaves the clinic on his own foot, only with the help of crutches. Daily activities can be restarted 3 to 6 weeks after surgery.

LIVING WITH A KNEE IMPLANT

Total recovery after knee replacement surgery is between 6 and 7 months.

Orthopaedic surgeons advise following these guidelines to extend the life of your knee implants:

  • Quit smoking: Tobacco is even more harmful to patients with newly implanted knee prostheses. It increases the risk of the prosthesis becoming infected or loose.
  • Maintain an ideal weight: Being overweight shortens the life of the knee prosthesis. Its parts will wear out sooner.
  • Do moderate physical exercise: It is essential to maintain a certain level of physical activity since a toned musculature will make the knee prosthesis work better. However, high-impact sports can quickly deteriorate or displace your knee prosthesis.
  • Regular check-ups: regular consultations allow future complications to be detected on time.
  • Keep an eye for infections: A knee prosthesis has a high risk of infection by bacteria. To avoid this, it is necessary to heal your wounds properly, maintaining good body hygiene (especially teeth and hands hygiene.)
  • Avoid falls: A direct impact on the knee prosthesis can dislodge some of its parts. It can also break the bone in which it is implanted or break some of its components.

WILL I BE ABLE TO PLAY SPORTS AFTER KNEE REPLACEMENT SURGERY?

After the intervention, patients who want to play sports must consider that engaging sports can quickly deteriorate or displace the knee prosthesis. Non-recommended high-impact sports include jogging and soccer (although it could be adapted for veterans).

However, each patient is unique, and there are numerous documented cases of patients who were able to practice sports with caution between 6 and 9 months after the intervention.

Still, risks are present. The fact that a patient has previously practiced sport reduces the probability of injury.

There is a long list of knee prosthesis-friendly sports, such as walking, cycling, dancing, skiing, Pilates, among others. Finally, everything will depend on your age, physical state, and the type of implant used.

The Diagonal clinic has specialists in sports medicine. Many athletes attend our facilities for consultations or to undergo different surgeries.  If your passion is playing sports, you can be sure that our experts will know how to give you the necessary guidelines to continue practicing your sport with caution.

HOW MUCH DOES A KNEE REPLACEMENT SURGERY COST?

The cost of knee replacement surgery depends on many factors. We would be delighted to answer your query, so please, fill in the contact form.

If you have any medical reports or exam results from other centers, we would appreciate it if you could send these tests to us by email so we can offer you the solution that best suits your needs. You can be sure that this information will always be treated with maximum confidentiality.

Qualified personnel is placed at your disposal, and they will advise you in your language and accompany you during the hospital process. If the doctor does not speak your language, a personal interpreter can accompany you throughout all your visits.

FAQ ABOUT KNEE REPLACEMENT SURGERY:

How long does a knee implant last?

Even though knee implants have a limited life, current materials are increasingly resistant.

The main duration of a knee implant is estimated to be between 15 and 20 years, even when subjected to regular physical activity.

Factors that may influence its duration are the material and fixation used, the patients’ weight, and physical activity. A knee implant can last considerably less when complications arise. But there are also cases where a knee arthroplasty can go up to 25 years.

Can I undergo knee replacement surgery if I am allergic to metals?

If you are allergic to metals, orthopaedic surgeons will identify which metals you are allergic to through a series of tests and decide on the most suitable alloy.

There are knee implants made with different alloys and materials (titanium, aluminum, chrome, cobalt), and it is possible to use hypoallergenic materials.

Can both knees be operated at the same time?

It is possible to operate both knees but not at the same time. Each intervention requires its rehabilitation process. Therefore, the surgery will always be carried out in two stages.

Surgeons advise waiting 4-6 months between the first knee surgery and the second one. Everything will depend on your recovery.

What are the benefits of minimally invasive surgery techniques?

The minimally invasive surgical techniques currently used for knee replacement surgery allow for a shorter hospital stay. The average stay is four days.

Minimally invasive techniques greatly decrease the risk of bleeding. Also, recovery is faster and less painful. Forty-eight hours after surgery, most patients can start walking with caution and control pain with paracetamol or OTC pain medications.

KNEE SPECIALISTS AT DIAGONAL CLINIC (BARCELONA, SPAIN)

Doctor Martín Casola, Daniel

Doctor Martín Casola, Daniel

Specialist in arthroplasty, knee replacement, osteosynthesis, arthroscopy acromioplasty and stem cell transplantation
Doctor Aláez Penina, Jaume

Doctor Aláez Penina, Jaume

Specialist in arthroplasty, knee and shoulder replacement and treatment of scapulohumeral periarthritis
Doctor Norberto Bayona, Eduard

Doctor Norberto Bayona, Eduard

Specialist in arthroplasty, knee replacement and fracture surgery
Doctor Salvans Giralt, Xavier

Doctor Salvans Giralt, Xavier

Specialist in arthroscopic surgery, arthroplasty, knee replacement, osteosynthesis and sports orthopedics
Doctor Valls Elias, Artur

Doctor Valls Elias, Artur

Specialist in arthroscopic surgery, arthroplasty, knee replacement, osteosynthesis and sports orthopaedics
Doctor Sánchez Navés, Rubén

Doctor Sánchez Navés, Rubén

Specialist in upper limb surgery, arthroscopy and knee replacement surgery
Doctor Garcia Bonet, Jordi

Doctor Garcia Bonet, Jordi

Specialist in arthroscopic surgery, arthroplasty, knee replacement, foot surgery (halux valgus, finger deformities) and pediatric orthopedics
Doctor González Navarro, Albert

Doctor González Navarro, Albert

Specialist in arthroscopic surgery, arthroplasty, knee replacement and osteosynthesis
Doctor Ruiz Nasarre, Alberto

Doctor Ruiz Nasarre, Alberto

Specialist in foot and ankle surgery
Doctor Bial Vellvé, Xavier

Doctor Bial Vellvé, Xavier

Specialist in knee arthroscopy and ligament injuries
Doctor Rios Torondell, Joan

Doctor Rios Torondell, Joan

Specialist in arthroscopic surgery, arthroplasty and knee replacement

Other articles that may interest you – External links – Bibliography

Total knee arthroplasty: improving outcomes with a multidisciplinary approach. James E Feng, David Novikov, Afshin A Anoushiravani, and Ran Schwarzkopf J Multidiscip Healthc. 2018

Management of bone loss in revision total knee arthroplasty: therapeutic options and results. E. Carlos Rodríguez-Merchán, Primitivo Gómez-Cardero, Carlos A. Encinas-Ullán EFORT Open Rev. 2021

Unicompartmental knee arthroplasty: Current indications, technical issues and results. Carlos Rodríguez-Merchán, Primitivo Gómez-Cardero. EFORT Open Rev. 2018

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    Diagonal Clinic - Barcelona Espain - traumatology and orthopedic surgery - Clínica Diagonal

    Diagonal Clinic

    Carrer de Sant Mateu 24, 08950 Esplugues de Llobregat (Barcelona, Spain)

    Nearest Metro Stations: Can Vidalet / Pubilla Cases

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