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Having healthy knees is vital to carrying out day-to-day chores. Our knee is the largest joint in the body and comprises three parts: the femur, tibia, and patella. The femur is the lower end of the thighbone. The tibia is the upper end of the shinbone, and the patella is the kneecap. A smooth substance known as articulate cartilage protects the ends of these bones and allows the leg to move comfortably.
Between the femur and tibia, c-shaped wedges, aka menisci, act as “shock absorbers” that shield the joints. Not only this, there are large ligaments that hold the femur and tibia together and provide strength and stability to the knees.
A synovial membrane covers all the left sections of the knee. This membrane is a thin lining and releases a fluid that polishes the cartilage, lessening the friction in a healthy knee.
Typically, these components work in accordance. However, if it gets infected by some disease or injury, the outcome will be painful, and the muscle will get weak and diminish its functioning.
Total Knee Replacement is a type of knee replacement that includes separating the femoral condyles and tibial plateau of the knee joint with highly cross-linked polyethylene plastic and smooth metal. This replacement focuses on refining the quality of life of individuals with end-stage osteoarthritis by lessening the discomfort and escalating the function. Total knee replacement surgeries have grown in developed countries, with younger patients having this issue.
Arthritis is the standard root for chronic knee disability and pain. There are various kinds of arthritis, but mainly there are three types of arthritis that cause knee pain:-
Osteoarthritis: Osteoarthritis is the prime cause of why patients go for knee replacement surgery. This issue generally happens to people who are either fifty or above. In this, the cushion between the bone joints and knee breaks down.
Rheumatoid arthritis: In Rheumatoid arthritis, the synovial membrane that encompasses the joint turns thickened and inflamed. This chronic inflammation can harm the cartilage and, in time, results in cartilage loss, pain, and becoming stiff. This arthritis is the most standard type of disorder known as “inflammatory arthritis.”
Post-traumatic arthritis: Post-traumatic arthritis happens when there is severe knee damage. In this, fractures of the bones adjoining the knee possibly can harm the articular cartilage above time, which results in knee pain and restricts knee function.
Step 1: The orthopedic surgeon creates a small cut in the knee and locomotes the kneecap to the side. If any tiny bony extensions are present in osteoarthritis, they will be separated.
Step 2: The surgeon then removes the two menisci present between the femur and tibia. In the significant phase of the operation, the surgeon makes the incision and separates the cartilage and some bone from the upper part of the tibia and lower parts of the femur. The femoral sections eliminate the femoral condyles. The tibia and femur are then be crowned with metal insertion to form a new exterior for the joint. The surface of the femoral units will impersonate the shape of the natural femoral condyles. If the kneecap has also debased, the base on its underside may also be separated and changed with a polyethylene insertion.
Step 3: When everything is done and fixed, the surgeon then mends the several layers of tissue with the help of dissolvable sutures, and the small cut done at the beginning of the process is secure with surgical staples. Lastly, the doctor will cover the wound with a bandage and take it to rehabilitation.
The Do’s
*As you resume your daily activities, place your knee with ease.
*Ensure that you regularly follow the recommended exercises and waking
*If pain persists or you feel that you have extreme swelling, then always prefer an ice pack.
*Keep in mind that you will high up your leg for one hour at least twice a day.
*Before taking the help of a walker and cane for walking, you should be well instructed by your physiotherapist on the proper use.
*After your total knee replacement, always go to Western toilets whenever you feel like you need to go to the washroom.
The Don’ts
*Make sure that you don’t twist your knee.
*Whenever you want to walk or move, always make sure that you don’t put any unwanted stress on your knee.
*Whenever you lie down in bed, keep in mind to place your knee straight and avoid placing the pillow under your knee.
*Prefer not to sit in a cross-leg posture.
*For at least six to eight weeks, avoid driving any vehicle. When you are fully recovered and feel no pain around your treated leg then only think about driving.
After the surgery, your leg muscles may feel weak. This is because you could not use your leg muscles because of knee problems. So, to bring the same strength and motion back to your leg, there are some home exercises you can follow:-
Quadriceps Sets: Secure your thigh muscles and straighten your knee as much as possible. Keep the knee in the same position for five to ten seconds. Redo it around ten times. While doing this take a one-minute break and then repeat. Until you feel like you are feeling fatigued in your thigh, continue doing this.
Walking: Little bit of walking every day can actually help the patient in getting recover faster and better. Start walking with the help of crutches and a walker. The patient should ask the doctor about the amount of weight allowed them.
Knee Straighten exercises: For this exercise, keep a mini towel precisely over your heel. This will helps in preventing the back of the knee to touch the bed. Make sure that the legs are completely straightened for five to ten seconds. Stop only when your thighs feel fatigued.
Bed-supported knee bends: The patient should place the foot on their buttocks, curve the knee and place their heel on the bed. Grip the knee in a bent position for at least five to ten seconds. Straighten the leg and keep on doing it until the patient completely curves their knees.
Sitting Supported Knee Bends: The patient requires to sit on a chair with their thigh supported. Slide the foot behind the heel of the operated knee for the holdup. The patient then steadily curves the knee as much as possible. Then the patient needs to grip the knee for around five to ten seconds. Don’t stop until the legs get tired.
There are certain risks in total knee replacement surgery that the patient should understand before making any decision:
General Anesthesia:- In a total knee replacement, the doctor injects the patient with anesthesia which is of four types - General anesthesia, regional anesthesia, sedation, and local anesthesia. Using General anesthesia can have side effects:-
*Nausea
*Headache
*A sore throat
*Drowsiness
*A heart attack or stroke
Infection: There are big chances of getting bacteria through the incisions which are done during the surgery. This can result in infection. Although during surgery, the surgeon usually makes sure that they minimize this risk.
The difference in Size: After the surgery, there can be chances that the leg can slightly be of different lengths.
Stiff Knee: After the surgery, generally, people can bend their knees at least 115 degrees. However, there are patients who feel that their new knee is pretty stiff. This happens when they develop scar tissue that hampers flexibility. And if the patient has limited flexibility before the surgery then it is normal for them to have limited flexibility even after the surgery.
Dr. Darsh Goyal is a renowned Orthopedic Surgeon who has experience of nearly two decades in knee and shoulder surgery. He has worked in some of the finest hospitals across the globe. He has successfully treated more than nine thousand patients. Dr. Darsh has received training from some of the most respected institutes worldwide - NHS England, Hss New York, USA, and Munich, Germany. He has written many books and international papers. Dr. Goyal’s Bones & Joint Centre is among the best centers for advanced Arthroscopy/Laser Surgery for knee and shoulder and Fast track Total knee Replacement.
Q1) Is total knee replacement considered major surgery?
Yes, the total knee replacement is considered to be major surgery. In fact, it is really not an easy decision to make. Typically, patients opt for total knee replacement surgery when they experienced extreme pain due to arthritis and don’t want to live their whole life like that.
Q2) How long does it take to recover from a total knee replacement?
Generally, the standard recovery time after a total knee replacement surgery is around six months. But it also depends on the person's body and health which can also lead someone to take twelve months to fully recover.
Q3) how long does it take to bend your knee after surgery?
After your total knee replacement surgery is done, in one to three weeks you may be able to straighten your knees at 90 degrees and can walk for approx 10 following minutes in the course of physical therapy.
Q4) Why does my knee click after total knee replacement?
If you hear or feel that your knee is clicking after the total knee replacement then don’t worry because it is completely normal. The clicking sound is usually anticipated as it is the sound that is coming from the action of plastic and metal parts of the replacement knee motioning against each other.
Q5)How should I sleep after knee surgery?
When you are sleeping, remember to sleep on your back. This posture is considered to be the best way because in this position it is simple to retain your leg straight during your sleep duration. This lets complete blood flow to the surgery area.