Derek L. Hill, D.O.

Fellowship-Trained Orthopedic Surgeon and Specialist

Knee Replacement Surgery – 8 Tips To Move You Toward Recovery

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oakland-surgical-centerWhen you think about the procedure, knee replacement surgery can be intimidating. But the majority of people who have a complete knee replaced experience vast improvement and return comfortably to their normal lives. With that in mind, there are some simple steps that will move you toward a smooth recovery.

1. Strengthen your body now

If you don’t already have a workout routine, begin strengthening your leg and arm muscles at least 6 months prior to surgery. Consider all of the ways you will be moving during recovery, from pushing off the bed to walking around.

2. Set-up delivery services and assistance

You won’t be allowed to drive for 4-6 weeks after your surgery, so coordinate with friends and family in advance to assist you in picking up and delivering your children to school, practices, games, etc. You will also need a ride to your follow-up appointments and physical therapy sessions.

3. Prepare for your post-surgery needs

The more independent you are after surgery, the better. Purchase what you think you will need beforehand. Do your laundry. Run important errands. Freeze some meals. Place your needs and wants next to your bed within easy reach. You may or may not need all of these things: ice packs (frozen peas) or an ice machine, walker, shower bench, elevated toilet seat, extra pillows, snacks, water, tissues, paper, pen, book, reading glasses, tablet, laptop, phone, electric chargers.

4. Keep a positive attitude

Think of your surgery as an improvement, and any pain as only temporary. Focus on your progress and where you will be in the coming months. Healing is as much in the mind as it is in the rest of your body.

5. Stay ahead of your pain killers

If you need pain killers, set a timed schedule and take your medicine as it is prescribed, at least initially. Consult your doctor, of course, but as your pain lessens, you should be able to begin weaning yourself off of your meds by extending the blocks of time between doses. The sooner you are off of your meds and gain your leg strength, the sooner you will be able to drive.

6. Keep moving

With the assistance of a nurse or walker, you should be up and walking the day of your surgery. Continue to move around your house after you get home. Follow your therapist’s guidelines. A body in motion stays in motion, and laying around all day isn’t helping you heal.

7. Focus on bending and straightening

Bend until you feel a little pain, back off for 10-15 counts, and then try again. Don’t try to jam your leg back before your knee is ready. Work on a consistent schedule, and you will eventually reach your goal.

8. Get plenty of rest

When you sleep, your body actually repairs and restores itself, so take naps and get a full night’s sleep for months after surgery. Resting will help your body heal faster.

Written by: Angela Russ-Ayon, Owner at AbridgeClub Entertainment

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About the Author

Angela Russ is a mom-preneur, children’s author, public speaker, and award-winning artist/producer of interactive music for young children. She speaks nationwide on the subject of child development and is the sole-owner of the Russ InVision record label, on the web at AbridgeClub.com © 2015 Russ InVision. All rights reserved.

Knee Replacement Options

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Senior Couple Talking With A ConsultantKnee replacement surgery is an operation which is performed when the joint is destroyed by conditions like arthritis and cancer. In this procedure the damaged bones and cartilages are removed and replaced with artificial implants made of metal and plastics according to Mayo Clinic.

Knee replacement surgery can be total, partial or minimally invasive. During total knee replacement, the patient is given anesthesia to block pain before the orthopedic surgeon makes a cut on the skin over the joint, removes the destroyed tissues and replaces them with a prosthetic joint. This implant is secured in position with bone cement and the wound closed with sutures or stitches.

The U.S. National Library of Medicine states that partial knee replacement surgery involves removing the damaged tissues from only one side or compartment of the knee. Candidates for partial knee replacement surgery are those with minor deformities of the knee who still have a good range of joint motion. Though most of these patients are relatively inactive older patients, they are not morbidly obese.

According to the American Academy of Orthopedic Surgeons minimally invasive knee replacement surgery utilizes a smaller incision on the skin and the cutting of fewer muscles to expose and replace the damaged joint. Though the same implants are used for both total knee replacement and minimally invasive replacement, special surgical instruments are used to prepare the bones and insert them. Candidates for minimally invasive knee replacement are younger and healthier than those who undergo the traditional surgery. They are also not very muscular or overweight and they tend to never have had prior knee operations.

Written by: Marian Kim, FizzNiche Staff Writer

What Happens During a Total Knee Replacement

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physician-referralsFor any person considering a total knee replacement, understanding the process is very important. It will give you a greater understanding of the procedure and recovery. Total joint placement, also known as arthroplasty, involves hospitalization to surgically remove the diseased or damaged knee joint. The damaged joint is replaced, during a less than two hour process if no complications, with an artificial one also known as prosthesis. As long as the surgery is a success, patients are usually standing and walking with crutches or a walker the following day and hospitalized for 3-5 days. After total knee replacement mobility is restored and pain relief can be felt almost immediately to the knee.

There are some situations that cause people to postpone knee replacement surgery, including fear. According to Johns Hopkins Medicine (2014) “Many people put off having knee replacement surgery, even when their doctor has assured them that surgery is an appropriate option. Often they feel their pain isn’t bad enough to warrant joint repair. But studies show that waiting until your pain and loss of function are substantial can make joint surgery more difficult and reduce your chance of re-gaining good function.” Even though people believe that fear is a good reason to put off total knee replacement, obesity makes more sense medically. Obesity makes any surgery more risky due to health issues both known and underlying.

Surgery for anyone can result in complications, including blood clots in the legs, or worse, and infection at the surgical site. If caught in time most infections can be treated with antibiotics, but if it spreads down to the joint it may need to be removed and replaced. The possibility of infection can arise for up to two years after surgery, even though preventive actions may only decrease infection rates by up to 3%. Overall, it’s still important to take oral antibiotics for any infection, before dental work and even before urinary exams.

After release from the hospital the patient is still responsible for participating in rehabilitation to help continue building strength and regaining flexibility. Additional techniques are used by your therapist, like massage and applications of cold to help minimize swelling. Recovery from knee replacement, with rehabilitation, is usually about 80% complete within four weeks. It takes about a year or better for full recovery.

Medical Disclaimer: Always consult with your physician and therapist before starting a new exercise routine or if you have any health care-related questions.

References:
Johns Hopkins Medicine: What Happens During Knee Replacement (n.d.). Retrieved from
http://www.johnshopkinshealthalerts.com/reports/knee-replacement-surgery/What-Happens-During-Knee-Replacement_6072-1.html.

Weighing the Pros and Cons of Knee Replacement Surgery (n.d.). Retrieved from
http://www.johnshopkinshealthalerts.com/reports/knee-replacement-surgery/weighing-pros-and-cons-knee-replacement-surgery_6083-1.html.

Written by: Jamacia Taylor, FizzNiche Staff Writer

Caring For a Patient After Knee Replacement Surgery

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knee-replacementMayo Clinic defines knee replacement surgery as an operation in which the bones and cartilages that have been damaged by arthritis are removed from the knee, and replaced with a metal and plastic joint. This is a relatively major operation and most patients are discharged home three to ten days after it.

Once they get home, the first few days are the most challenging for them because of pain, post-surgery fatigue and frustrations arising from their inability to move independently.

When caring for such a patient at home, understand that they need patience as they readjust to their surroundings and their lost independence. Simple things you can do to ease their transition include rearranging the furniture to make it easier for them to maneuver their walker or crutches and removing area rugs that may make them slip. Consider also installing shower chairs, gripping bars and raised toilets to help them groom themselves in dignity.

Helping them exercise, per the recommendations of their physical therapist, is another thing you can do to help them recover faster and regain their mobility.

The American Academy of Orthopedic Surgeons states that some patients can develop mild leg swelling after they are discharged. If this happens to the person you are caring for advise them to raise their leg, apply ice packs and wear compression hose.

If pain relieving, blood thinning or other medications were prescribed as they were being discharged, ensure that they take them as per the instructions. Monitor the dressings over the operation site and change them according to the hospital recommendations.

In addition, Johns Hopkins University recommends that the doctor should be notified immediately if the patient develops increased pain, swelling, redness or bleeding at the operation site.

At around six weeks after surgery, most patients are able to walk with minimal support according to the Cleveland Clinic. Help the patient you are caring for walk more confidently by holding their hand as they transition from using crutches and walkers.

If they want to help around the house, let them do light tasks like dish washing while steering clear from those that involve heavy lifting like vacuuming.

Most outpatient checkups are at around six to eight weeks after the knee replacement operation. Accompany your patient for this checkup and ask the doctor any questions you may have.

Written by: Marian Kim, FizzNiche Staff Writer

Should I Have My Knee Replaced

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Couple sat by treeAccording to an article on www.zimmer.com, “ Total Knee replacement is a routine surgery performed on more than 600,000 people worldwide each year.” And more than 90% of those surgeries result in improved knee function and a lessening of pain. So if your knee is bothering you, how do you know it’s time to consider having it replaced? There are a couple of signs, the most obvious one being a change in quality of life because of the pain.

Arthritis is the most common reason for a total knee replacement, and involves 3 stages of suffering:

Stage 1

The first is gradual, may last for a couple of years, and consists mostly of a dull ache made worse by putting weight on the knee. This may lead to difficulty going from a sitting to a standing position, and may interfere with sleep.

Stage 2

The second stage is when daily activities are cut back due to pain.

Stage 3

The third stage is when it’s so bad that pain killers are needed. An article on www.bonesmart.org’s site (“How do I know if I need knee replacement surgery?”) suggests talking to a doctor at any point of the three stages. The doctor may suggest some more conservative, less invasive treatments to begin with such as medications, injections, braces, and physical therapy. If none of these help then a knee replacement may be the next suggestion.

Written by: Tricia Doane, FizzNiche Staff Writer

Total Knee & Hip Replacement Materials

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 Which One Is The Best?

knee-replacementHaving a knee or hip replaced? There are a couple of options, and the best option depends mainly on two things: you and your doctor. In fact, according to an article on www.healthline.com, (“Guide to Knee Replacement Implants and Their Manufacturers”), there are more than 150 different knee replacement devices available. The best one for you will depend on your age, weight, anatomy, and activity level. And as far as your doctor goes, he/she may be better trained in the use of one product than another, may have better access to one particular type of device, and will of course be in a good position to make a medically sound choice depending on your individual circumstances. So there’s a lot to consider, but to narrow it down a little, there are basically two materials from which knee replacement joint components are made.

  1. Metal: mostly titanium or cobalt-chromium alloys. Both are inert so won’t interact with the body, but an allergy to nickel is a concern with the cobalt-chromium versions.
  2. Plastic: “The most common material used to produce plastic components is ultra-high molecular weight polyethylene,” again, according to healthline.com. This material is popular because it closely mimics the way a real knee moves.

There’s also a third, newer material, Tantalum, and ceramic parts can be used in the case of metal allergies.  According to the article “Which Type of Implant is Right For You” on www.kneereplacementcosts.com tantalum is a key metal in a bone/metal mix called Trabecular Metal. This material is also very body friendly, and contains mesh that encourages natural bone growth around the implant.

As for a total hip replacement, the choices are similar, and according to www.bonesmart.org (“Hip Replacement Implant Materials”), there’s no real agreement within the orthopedic community regarding what’s best. There are four main combinations used:

  1. Metal/plastic (polyethylene or UHMWPE). This combination has been used in one form or another since the 1960s. It’s proven to be very durable and is also the least expensive option.
  2. Metal/metal (MoM). Even older than the metal/plastic, these have been used since the mid 50’s. These types will wear less quickly than the metal/plastic types.
  3. Ceramic/ceramic (CoC). These implants have been used in Europe since the 80’s, and were approved for use in the U.S. in the 90’s. The earlier ceramic implants had a problem with shattering, but this has been pretty much resolved. The only other issue with this type of replacement implant is that they may squeak (most of the time this will go away). It is however, the most durable and a good choice for a young or especially active recipient.
  4. Ceramic/plastic (UHMWPE). This is a highly durable combination, and while more expensive than the metal/metal versions, is less expensive than the ceramic/ceramic combinations.

Decisions, decisions.  Lots of choices and things to think about. The bottom line, I think, is to research your options and work with your doctor to find the best one for you. She/he will know what’s available for your individual situation, what may and may not work, what training is required to perform that particular surgery, and if he/she has that training.

 

Written by: Tricia Doane, FizzNiche Staff Writer