Effectiveness of Total Knee Replacement

Total knee replacement

Long considered as the “gold standard” surgery for knee arthritis, total knee replacement is still by far the most commonly performed joint replacement process. It is appropriate for middle-aged and older people who have arthritis in more than one compartment of the knee and who do not expect to return to high-impact athletics or heavy labor work. Results of this process are usually outstanding with 95% of total knee replacements continuing to function well for more than 10 years after operation.

Effectiveness of total knee replacement

Current research suggests that when total knee replacements are performed well in right selected patients, success is achieved in large majority of patients and the implant serves the patient well for several years. Many researches show that 90-95 percent of total knee replacements are still functioning very well even after 10 years of surgery. Most patients walk without the help of a cane, most of them can climb stairs, sit and get up easily from chairs, and most of them resume their desired level of recreational activity.

In many cases, the total knee replacement requires re-operation sometime in the future; it can always be revised (re-done) successfully. However, results of revised knee replacement are usually not as good as first-time knee replacements. There is good evidence that the experience of the knee surgeon correlates with outcome in total knee replacement surgery. It is best to have the initial surgery done by an experienced surgeon. Surgeons with several years of experience have been shown to have fewer complications and better results. It is therefore significant that the surgeon performing the technique just not be a good orthopedic surgeon, but a specialist in knee replacement surgery.

Precaution to be taken after knee replacement surgery

After operation, you’re wheeled to a recovery room for at least one to two hours. You’re then moved to your hospital room, where you usually stay for a couple of days. You might feel little pain, but medications prescribed by your surgeon should help to control it. During the hospital stay, you’re encouraged to move your ankle and foot, which will increase the blood flow to your leg muscles and will help to prevent swelling and blood clots. You might need blood thinners, support hose or even compression boots to further protect against swelling and clotting.

The day after operation, a physical therapist shows you how to exercise with your new knee. During the first few weeks after operation, a good recovery is more likely to take place if you follow all the orthopedic surgeon’s instructions which are concerned with wound care, diet and exercise. Your physical activity program will comprise of:

  • A graduated walking program: first indoors, then outdoors, will help to increase your mobility
  • You need to slowly resume to other household activities, which include: walking up and down stairs
  • Knee-strengthening exercises which are recommended by the hospital physical therapist, should be performed several times a day

The Role of Orthopedic Surgeons

Orthopedics is the branch of medicine related to diseases, damages and conditions of the musculoskeletal system or the body’s muscles and skeleton. This structure also comprises of the joints, tendons, ligaments and nerves. Meanwhile, orthopedic surgeons are the medical specialists who are responsible for preventive and surgical treatment of the musculoskeletal system.

About Orthopedic Surgery and Surgeon

Experts insist that the exact name of this medical specialty is actually orthopedic surgery and not orthopedics. However, orthopedics is the commonly known and accepted term for the purpose. As a line of specialists, orthopedic surgery is made up of surgeons (knee specialist, shoulder specialist and so on) and other healthcare professionals who provide comprehensive orthopedic services.This line of expertise provides treatment for diseases, damages, fractures and pain. In addition, orthopedists also take care of rehabilitation programs for the physically disabled and participate in ongoing musculoskeletal study.

Orthopedic Surgeons/Physicians – Key Roles

The main roles of an orthopedic surgeon/physician can be divided into the following sub-heads:

Diagnostic and assessment technique Treatment Research

Here we have discussed each and every role in detail to facilitate a better understanding of an orthopedic surgeon/physician’s role and functions.

Diagnostic Role

A vast number of patients visit their orthopedic surgeon/physicians every year for a series of ailments, disorders and medical conditions. There are a vast number of conditions that have an impact on our body’s musculoskeletal system, which need clinical care by an orthopedic surgeon.

What does an Orthopedic Surgeon Treat?

An orthopedic surgeon treats musculoskeletal conditions without operation, by using medications, exercise and other rehabilitative or alternative therapies. If required, he/she may also recommend surgical treatment.

Some of the conditions and diseases an orthopedic surgeon treatment includes:

  • Abnormalities of the fingers and toes
  • Osteoarthritis
  • Osteoporosis
  • Ruptured disks, Back pain, sciatica and scoliosis
  • Bone tumors, muscular dystrophy and cerebral palsy
  • Fractures and dislocations
  • Growth abnormalities
  • Tendon injuries, pulled muscles, bursitis and torn cartilage
  • Torn ligaments, sprains and strains
  • Club foot, bunions, bow legs, knock knees and unequal leg length
  • Rheumatoid arthritis
  • Sports or work-related injuries

Arthroscopy: A Surgical Procedure

Arthroscopy is a surgical method that orthopedic surgeons use to visualize, diagnose, and treat injuries inside a joint. The word Arthroscopy comes from two Greek words that are: “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joint.”

What is an arthroscopic surgery?

Arthroscopy is a technique for diagnosing and treating joint problems. A surgeon inserts a very narrow tube attached to a fiber-optic video camera through a small incision — about the size of a buttonhole. The vision inside your joint is transmitted to a high-definition video monitor. Arthroscopy lets the surgeon to see inside your joint without making a large incision. Orthopaedic Surgeons can even repair some types of joint injuries during arthroscopy, with pencil-thin surgical instruments inserted through additional small incisions.

When is knee arthroscopy recommended?

Your doctor may recommend knee arthroscopy if you have painful condition that does not respond to nonsurgical treatment. Some reasons for undergoing arthroscopic knee surgery include:

  1. Removal or a repair of a torn meniscus
  2. Reconstruction of a torn anterior cruciate ligament
  3. Removal of inflamed synovial tissue
  4. Trimming of damaged articular cartilage
  5. Removal of loose fragments of bones or cartilage
  6. Treatment of patella (kneecap) problems
  7. Knee sepsis (infection)

When is shoulder arthroscopy recommended?

Your doctor may recommend shoulder arthroscopy if you have painful condition that does not respond to nonsurgical treatment. Some reasons for undergoing arthroscopic shoulder surgery include

  1. Bankart Repair
  2. Rotator Cuff Repair
  3. Slap Repair
  4. Capsulotomy for Adhesive capsulitis
  5. AC Joint Resection

How is arthroscopy performed?

Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, still requires the use of anesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal, or a local anesthetic, depending on the joint or suspected problem.

A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Several other incisions may be made to see other parts of the joint or insert other instruments.

Recovering from an arthroscopy:

After your arthroscopy, you’ll be taken to a room to get better from the effects of the general anesthetics, if it was used during the process. Depending on the type of method you had, you may require a temporary sling, splint or crutches to support and guard the joint while you recover. Some people are given special pumps or compression bandages to improve their blood flow.

Recovery advice by surgeons

  1. Ensure that you elevate the joint and apply ice packs to help with swelling when you get home, only if advised to do so. You should also carry out any joint exercises that have been suggested for you.
  2. Any dressings which have been done during the process will need to be kept as dry as possible.
  3. Your wounds should start to recover within a few days. If non-dissolvable stiches were used to close them, they need to be removed after a week or two.
  4. You’ll normally be asked to be present at a follow-up appointment a few weeks after the surgery to discuss the results of the operation, your recovery, and any additional treatment you may need.

Shoulder Surgery – Solution to Let You Perform Greater in Sport Field

What Are Sports Injuries?

The term “sports injury,” in the broadest sense, actually refers to the kinds of injuries that mostly occur during sports or workout. Some sports damages result from accidents; others are due to poor workout training practices, wrong equipment, lack of conditioning, or inadequate warm-up and stretching.

Following are the most common sports injuries:

Common Types of Sports Injuries are:

  1. Tears of the ligaments that hold joints together
  2. Tears of the tendons that support joints and help them to move
  3. Dislocated joints
  4. Muscle sprains and strains
  5. Fractured bones; including vertebrae.

What Is the Difference Between Acute and Chronic Injuries?

Irrespective of the specific structure affected, musculoskeletal sports injuries can usually be classified in one of two ways: acute or chronic.

Acute Injuries

Acute injuries, such as a sprained ankle, strained back or fractured hand, happen suddenly during any physical activity. Signs of an acute injury include the following:

  1. Sudden and extreme pain
  2. Inability to place weight on a lower limb
  3. Swelling
  4. Extreme painfulness in an upper limb
  5. Extreme limb weakness
  6. Visible dislocation
  7. Inability to move a joint through its full range of motion

Chronic Injuries

Chronic injuries generally result from overusing one area of the body while playing a sport or exercising over a longer period of time. The following are signs of a chronic injury:

  1. Pain when performing an activity or sports
  2. A dull pain when at rest
  3. Swelling

Rotator cuff repair (RCR) is a common technique performed by Shoulder surgeons via arthroscopic, or mini-open techniques. While this operation is considered to be of low morbidity, numerous potential complications can arise either intraoperative or during the postoperative time. Some of these problems are related to the surgical method (arthroscopic or open). Many of these problems can be managed through non-operative means; however, initial recognition and timely treatment is important in limiting the long-term sequel and improving patient outcome.

What Should I Do If I Suffer an Injury?

Whether damage is acute or chronic, there is never a good reason to try to “work through” the pain of damage. When you have ache from a particular movement or activity, you need to stop doing them immediately. Continuing the activity only causes further damage. Some injuries require prompt medical attention like total shoulder replacement, while others can be self-treated. Here’s what you need to know about both types:

When to Seek Medical Treatment?

  1. You should call a health professional
  2. The injury causes extreme pain, swelling, or numbness.
  3. If you are not able to bear any weight on the area, you need to visit your physician immediately.
  4. The pain or dull ache of an old damage is accompanied by increased swelling or joint abnormality or instability.

Shoulder Surgery – Solution to Let You Perform Greater in Sport Field

What Are Sports Injuries?

The term “sports injury,” in the broadest sense, actually refers to the kinds of injuries that mostly occur during sports or workout. Some sports damages result from accidents; others are due to poor workout training practices, wrong equipment, lack of conditioning, or inadequate warm-up and stretching.

Following are the most common sports injuries:

Common Types of Sports Injuries are:

  1. Tears of the ligaments that hold joints together
  2. Tears of the tendons that support joints and help them to move
  3. Dislocated joints
  4. Muscle sprains and strains
  5. Fractured bones; including vertebrae.

What Is the Difference Between Acute and Chronic Injuries?

Irrespective of the specific structure affected, musculoskeletal sports injuries can usually be classified in one of two ways: acute or chronic.

Acute Injuries

Acute injuries, such as a sprained ankle, strained back or fractured hand, happen suddenly during any physical activity. Signs of an acute injury include the following:

  1. Sudden and extreme pain
  2. Inability to place weight on a lower limb
  3. Swelling
  4. Extremepainfulness in an upper limb
  5. Extreme limb weakness
  6. Visible dislocation
  7. Inability to move a joint through its full range of motion

Chronic Injuries

Chronic injuries generally result from overusing one area of the body while playing a sport or exercising over a longer period of time. The following are signs of a chronic injury:

  1. Pain when performing an activity or sports
  2. A dull pain when at rest
  3. Swelling

Rotator cuff repair (RCR) is a common technique performed by Shoulder surgeons via arthroscopic, or mini-open techniques. While this operation is considered to be of low morbidity, numerous potential complications can arise either intraoperative or during the postoperative time. Some of these problems are related to the surgical method (arthroscopic or open). Many of these problems can be managed through non-operative means; however, initial recognition and timely treatment is important in limiting the long-term sequel and improving patient outcome.

What Should I Do If I Suffer an Injury?

Whether damage is acute or chronic, there is never a good reason to try to “work through” the pain of damage. When you have ache from a particular movement or activity, you need to stop doing them immediately. Continuing the activity only causes further damage. Some injuries require prompt medical attention like total shoulder replacement, while others can be self-treated. Here’s what you need to know about both types:

When to Seek Medical Treatment?

  1. You should call a health professional
  2. The injury causes extreme pain, swelling, or numbness.
  3. If you are not able to bearany weight on the area, you need to visit your physician immediately.
  4. The pain or dull ache of an old damage is accompanied by increased swelling or joint abnormality or instability.

Knee Pain Relief: an ACL Injury & the Role of Reconstructive Surgery

Tears or ruptures of the Anterior Cruciate Ligament (ACL) are common damages in athletes of different ages and activity levels.  ACL tears are treatable using arthroscopy and nominally invasive surgical methods. The medical success rates for ACL reconstruction exceed 95%. The anterior cruciate ligament is one of the main supportive ligaments in the knee. It runs from the lower leg bone (tibia) to the thigh bone (femur) at the knee. This ligament provides knee immovability by preventing extreme forward movement of the tibia in relation to the femur and is also significant in controlling rotation of the two bones.

While the ACL is not the most usually injured knee ligament, tears of this ligament normally lead to chronic knee instability or “giving way. Anterior cruciate ligament tears most commonly result during athletics from vital cutting, landing, deceleration or twisting damages. It is less common for ACL tears to happen as a result of physical contact or collisions during athletics.Many patients who undergo an ACL tear will know immediately that something “feels wrong” with the knee. Several patients report feeling or hearing a “pop” linked with pain and a sense of the knee “giving out”. The joint will usually swell within several hours which results in limited motion of the knee. It will become painful to bear weight on the damaged leg, and the patient will prefer to walk with assertive devices for added support, such as crutches or a cane. Sometimes, the patient may know-how the knee “giving way” when stressed with simple activities such as walking or changing directions.

What Causes an ACL Injury?

An ACL injury is generally sports-related knee damage. About 85% of sports-related ACL tears are “non-contact” damages. This means that the damage occurs without the contact of another player, such as a tackle in football. Most often ACL tears happen when pivoting or landing from a jump. Your knee gives-out from under you once you tear your ACL. Female athletes are known to have a higher risk of an ACL tear, while contributing in competitive sports. Unfortunately, understanding why women are more inclined to to ACL injury is uncertain. There are some suggestions it is bio mechanical, power and hormonal related. In truth, it is possibly a factor of all three.

What are the Symptoms of an ACL Injury?

The diagnosis of an ACL tear is made by numerous methods. Patients who have an ACL tear generally sustain a sports-related knee injury. They may have felt or heard a “pop” in their knee, and the knee generally gives-out from under them. ACL tears cause knee swelling and pain.

How is an ACL Injury Diagnosed?

On clinical knee checkup, your physiotherapist or sports surgeon will look for signs of ACL ligament instability. These special ACL tests places stress on the anterior cruciate ligament, and can notice an ACL tear or rupture.

How is an ACL Injury Treated?

Many patients with an ACL tear start to feel healthier within a few days or weeks of ACL injury. These individuals may feel as though their knee is normal again, as their swelling has started to settle. However, this is when your problems with knee instability and giving way may start or worsen.ACL tears do not essentially require ACL reconstruction operation. There are several significant factors to consider before deciding to undertake ACL reconstruction operation.

  1. Your age
  2. If you regularly perform sports or activities that normally require a functional ACL
  3. If you experience knee instability
  4. You need to plan for the future

If you don’t contribute in a multi-directional sport that requires a patent ACL, and you don’t have an unstable knee, then you may not need ACL operation.

Facts about Bankart Repair Surgery

Background:
Shoulder instability is an important medical problem. Arthroscopic surgery is an established cure modality in shoulder instability, but it continues to be linked with a high rate of repetitions and complications. The cause of the study was to examine late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder unsteadiness and non-engaging Hill-Sachs lesion, with special attention on the incidence and causes of reappearances and complications. Glenohumeral instability can be considered by the direction of instability, the chronicity, and the etiology. Understanding the pathophysiology and etiology associated to the patient’s glenohumeral instability may aid in shaping their risk of recurrence and ultimately monitor management. A thorough history and physical checkup are essential. Age, activity level, athletic participation, and hand dominance should be noted. The examiner should ask about instability in the other joints, particularly the contralateral shoulder. If a painful event is related to the patient’s symptoms, the location of the arm and amount of energy involved during the result should be noted. If the patient cannot recall the position of the arm during the result, knowing the position of the arm that replicates symptoms is also useful.

Important Prevention to be taken post-surgery:
•Sleeping:
For the first three weeks your sling belt must be worn in bed. Sleeping can be little uncomfortable if you try and lie on the operated arm. We advise that you lie on your back or on the reverse side, as you choose. Ordinary pillows can be used to give you ease and support. If you are lying on your side one pillow a little folded under your neck gives enough care for most people. A pillow folded in half supports the arm in front and a pillow stuck along your back helps to avoid you rolling onto the operated shoulder during the night. If you are lying on your back, bond a pillow tightly in the middle or use a folded pillow to backing your neck. Place a folded pillow underneath the elbow of the operated arm to support that.

•Follow up Appointments:
An appointment will be made for you to see the shoulder surgeon or specialist therapist 4 weeks post-operatively.

•Daily Activities:
For the first two to three weeks most activities of daily living for example eating, dressing, cooking etc must be carried out by your un-operated arm. If suitable an occupational therapist will be available to give you guidance on how to do this.

•Leisure Activities:
Your physiotherapist and shoulder surgeon will advise you when it is safe to start again your leisure activities. This will vary according to your activity and level, as well as the period required to rehabilitate your shoulder muscles with physiotherapy.