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Knee replacement (prosthesis)

Knee prosthesis: what do we talk about?
The knee or knee replacement operation is to replace the knee joint with a prosthesis.
The current knee prostheses mainly use metal materials and / or polyethylene.
At the knee, the lower part of the femur and the tibia part and the parts are replaced articular bones are replaced by the prosthesis, consisting of a metal part fixed to the lower end of the femur and another part of the upper end of the tibia.

The knee pain and improves joint mobility.

Knee replacement surgery is performed by an orthopedic surgeon and requires postoperative rehabilitation.

What are the risks and health issues of the knee prosthesis?

The main cause of total knee replacement is osteoarthritis at an advanced stage, it affects patients aged 55 to 75 years.

Other causes also lead to surgery as different forms of inflammatory arthritis, including rheumatoid arthritis, damage to cartilage and bone of the knee. Patients with these inflammatory diseases are operated at a younger age.

The estimated number of total knee prostheses are asked each year to 120 000 in the United States and 20,000.

What are the mechanisms of knee replacement?

Within a joint, the cartilage has the function to absorb shock and promote sliding of two surfaces, without pain or friction.

This cartilage tissue regenerates very slowly and even osteoarthritis slows regeneration and repair microblessures.

Cells are not replaced and the cartilage erodes, causing friction and pain from bone surfaces. Inflammatory phenomena occur, further exacerbating the damage.

In rheumatoid arthritis, chronic inflammation is immune to reason and because the attack cartilage and bone.

In 2 cases, the cartilage is destroyed when the only solution is replacing the hinge knee arthroplasty.

Arthroplasty Prevention

How does this manifest itself on?

The pain is caused by inflammation of the joint called in medical term "arthritis".
Osteoarthritis Arthritis is the most common and is a degenerative disorder that worsens over time.

Arthritis is characterized by local heat, swelling of the joint, redness and pain especially becomes chronic.
The indication for surgery depends mainly on the so-called functional discomfort: walking difficult or impossible, possible distance traveled (known walking distance), up and down stairs, sitting possible or difficult joint deformity , importance of edema and pain ...

With what should we be confused?

It should not be confused partial denture and total knee replacement.
There are in fact two types of prostheses.
The partial knee replacement designed to replace the worn one part of the joint
while knee replacement surgery is to replace the entire knee, including the patella as the case using a patellar insert.

Is there a prevention possible?

Arthroplasty is reserved for advanced stages of joint damage when the pain is permanent (walking, resting) or functional impairment is important, making walking impossible.

At an earlier stage osteoarthritis of the knee may benefit from a treatment called conservative and preventive measures to delay progression. This treatment focuses on the management of pain (medications, splints, massage, acupuncture ...), strengthening exercises and stretching.

Factors promoting and osteoarthritis can be prevented, trauma, eg related to sport (football ...) are important to consider. Similarly, the fight against overweight can limit knee osteoarthritis.

Arthroplasty Consultation

When to consult?

It is necessary to consult early in case of joint pain or swelling.
In fact, exacerbate local inflammation and cartilage destruction symptoms, precipitating the need for surgery.
The early treatment reduces inflammation and pain, and consider conservative treatment.

What is the doctor?

Physician and orthopedic surgeon evaluated by clinical examination and questioning the impact of the infringement.
Complementary radiological examinations (radiographs, CT or magnetic resonance imaging [MRI]) provide for their more accurate images of the lesions.

If the intervention is decided, it takes place in a hospital a few days and requires a general anesthetic or a spinal or epidural anesthesia (lower body numb).
It is also recommended that the physician prescribes 10 preoperative physiotherapy to establish a first contact and start a pre-treatment.

The total knee arthroplasty is proposed in osteoarthritis or arthritis important, partial knee arthroplasty is performed on it if osteoarthritis affects only one compartment of the joint. Only then it will be replaced. The incision is smaller for the partial operation with a shorter convalescence.

Depending on the type of replacement chosen intervention lasts 1 to 2 hours with a duration of hospitalization of 3 to 10 days.

Rehabilitation is extremely important in the postoperative period. Physiotherapy allows the artificial knee function and prevent stiffness and muscle weakness. This rehabilitation can take place in a hospital or in a specialized outpatient.

How to prepare my next visit?

It is normal after the operation the knee is stiff and painful.
The pain is supported by analgesics, must be taken before evil (regular hours before exercise ...) and by small means (raise the leg to reduce swelling, apply ice ... ).
Exercises allow for their fight against the stiffness: contract the muscles of the thigh and range of motion exercises (leg fold and unfold ...), stretch the joint ...

Avoid at all costs to remain immobile and inactive.

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