Surgery for knee replacement (Arthroplasty)
What you need to know about the surgery to replace the knee joint: training and rehabilitation
The knee joint is designed to perform complex functions. The patellar, tibial and femoral bones are connected by ligaments and the surface of them is covered with smooth cartilage that allows for easy movement.
As soon as there is any disease that violates the integrity of the capsule of the joint, not only becomes more difficult to move the limb, but all actions begin to accompanied by pain.
Gradually deformation begins to undergo all the joint tissues. When the disease progresses and gradually lost the ability to use the limb to help the endoprosthesis.
Indications and contraindications for surgery
Surgical intervention may be appointed in the presence of certain diseases:
- Osteoarthritis. With this disease the elasticity of the surface is reduced, resulting in damaged articular cartilage. Typical symptoms are intense pain, as well as to limit the amplitude of possible movements. Deforming type of arthritis can occur due to abrasion of the surface of the joint;
- Arthritis. The inflammatory process that occurs in the joint.
- Dysplastic arthrosis. Abnormal anatomy or lack of development of the joint.
- Rheumatoid arthritis. Inflammation that occurs in small joints.
- Post-traumatic arthrosis. Lowering the elasticity of the tissue after injury.
- Osteoarthritis. Process deposits in the joints of heavy salts.
- Aseptic necrosis. Bone tissue begins to die.
Contraindications to surgical intervention
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Such interference very seriously and therefore there is a list of contraindications for knee replacement. This includes such diseases as:
- diabetes a severe form;
- renal failure or cardiopulmonary;
- developed rheumatism;
- diseases associated with vorachivaetsya blood;
- neuropsychiatric disease.
Preparing for surgery
Before surgery, the patient undergoes an intensive course of training. A few weeks before he carried out a special survey.
Collect the necessary tests, the doctor conducts questioning and examination. Preoperative examination is important because after it will be based in the selection of anesthesia.
For surgery should get medical clearance, because it is recommended to conduct additional consultation with a General practitioner.
It is necessary to identify certain diseases that can affect the body when the endoprosthesis.
Sometimes the doctor will help to adjust treatment. For example, when hypertension is very important to try to bring pressure on a single rule before the intervention.
Diet with the aim of stabilizing the level of blood sugar is important if you have diabetes, but if it occurs in the body any chronic disease, collaboration with Dr. it is important to optimize the treatment.
Preparation to replace the knee joint includes the following steps:
- The weight control. To consistently support him need if he’s okay. If there is excess weight, you should immediately start to lose weight. This will allow not to overload the prosthesis.
- Workout. They must begin under medical observation. Exercises will focus on the development of the muscles of the arms, the torso, making it easier to move around on crutches. Strengthening leg muscles is just as important as in this case decreases the time of rehabilitation.
- Visit to the dentist. The elimination of chronic foci of infection that may be in your mouth, is important since it eliminates the risk of inflammation after surgery. Complete restoration needed, but if it is not possible, then after surgery are always important in the course of the year to visit the dentist.
- To quit Smoking. This point is important to improve saulemai wounds and also to prevent the development of lung problems after knee replacement.
- Training with crutches. These exercises will help to move better and allow you to recover faster.
- The blood drive. It is required for transfusion. If the surgeon would recommend to do this, assuming that after replacement of this measure will need, the blood must pass.
- Termination of certain medication. In the preparation phase it is important to report all medications being taken. It is important to note, even those that are dispensed without a prescription. Some of them, the surgeon may recommend to abandon or replace them. This is especially true of drugs that can affect svorachivanie blood.
To the hospital should take the following things:
- sustainable shoes;
- epilating cream;
- list of drugs, including those the reception of which was recently terminated.
- glasses, if worn contact lenses;
- phone and device charge;
- a little bit of cash for personal needs;
- magazine or book;
- hearing aid, dentures if it is necessary for them to need to take a separate container;
- allowed to take a laptop, player.
The day before surgery
As a rule, surgery to replace the knee joint supposed on the next day after the scheduled hospitalization. On this day, the doctor conducts another inspection, checks the tests, then starts the paperwork.
It is important to remember that if the operation be conducted at the expense of budget funds of the state, then they should be prepared earlier.
After the pit’s start medical history and the patient is placed in the chamber. This medical documentation will be filled in by the doctor, conducting the conversation. He will explain the plan and the progress of the operation, its possible shortcomings, the positive things.
Such a procedure is called informed consent for treatment. At the end of the interview the patient should sign it if you agree to surgery.
After the anesthesiologist will discuss with the patient the type of anesthesia to be used.
The night before my surgery
In the evening it is better to refuse from eating the food. Drinking is also prohibited. When you thirst you can rinse throat with water, but do not swallow it.
In some cases, can make an exception, but more on that in advance you should talk with your doctor. Refusal of water and food necessary for anesthesia is better acted. In the evening, or before surgery you can take a shower.
If nurses are asked to remove hair with a razor to not be. In the presence of a scratch operation may be delayed, as it increases the risk of infection. It is better to use a special cream.
Night better have a good rest and try not to worry. Early morning you can brush your teeth, but swallow water should not be.
Training at home
Before surgery it is very important to prepare everything for the return home. Safety, convenience and comfort of these postulates should be followed.
It is important to do the following:
- Placing all important items in the rooms on level hands, to avoid the need to bend them or stretch.
- Rearrange the furniture to release the space needed for comfortable movement on the Walker or crutches.
- Buying cordless.
- Glue the sharp sides and corners of the furniture, clean the place of movement of all wires, mats, and everything about that can be tripped over. The edges of carpets can be glued with tape so they are not bullied. If parquet flooring, it is very important that neither Board did not drop out of it.
- If the house is two-storied, all the important items it is better to move down. At the same time is recommended to be converted into a bedroom room on the lower floor.
- Buying seats or chairs are not only strong and reliable arms, but also such that when sitting the knee joints below the hip bones.
- Small stool you can buy or build their own. On the seat should support the operated leg to have it rectified.
- For some time it is better to give Pets to friends or relatives.
- In one place it is better to install all the necessary items. TV, comfortable chair, radio, remote controls, phones, tablets, the jug and glass, books — let it all be there to was not having to constantly get up and walk over these items.
- The legs of chairs to prevent slipping, you need to wear rubber tips.
- In the bathroom is best to install handrails, as well as to buy seat, which when washing you can take. All toiletries need to be put in range.
Pre-assigned x-ray. This allows to determine the deformation of the joint. Next is arthroscopy. Through an incision introduces a special instrument, allowing to evaluate inside the extent of damage.
The knee joint would be to fully replicate natural form. Before installing it removed the surface of the tibia, femur and patella, and is performed after fixation of the prosthesis. Sometimes there is a natural joint, but with extensive lesions and it can be removed.
In addition to these measures also produced special events, to reduce the risk of complications after knee replacement — the emergence of infection or traces of blood.
After the replacement is done again x-ray that allows the surgeon to verify the correct formulation of the prosthesis. Permission to move the patient receives the next day.
In the video at the end of the article you can see how the knee replacement.
Exercises that you must perform after knee replacement, is necessary and important, as it decreases the possibility of developing blood clots. Initially, movements are difficult, so they should perform very slowly.
For each patient, the doctor selects the most appropriate exercises.
Are typically performed:
- The rotation of the ankle. Circular motion against and clockwise.
- The movement of the foot up and down, like when pumping the pump foot.
- To strain a muscle in my leg and try to straighten it.
- After putting a towel under the heel, it is also necessary to try to straighten the leg. You need to try the internal surface of the knee to touch the surface of the bed.
- Lift the straight leg.
- Flexion of the limb in the sitting position. One group performed exercise with a support on the bed and the other sitting on it.
All these exercises are performed slowly and should be repeated a few days after replacement.
The next day of rehabilitation after joint replacement of the knee joint is allowed to get up and walk with crutches.
In some cases, the surgeon may recommend a lower load on the foot, but it only happens individually.
Properly organized rehabilitation after knee replacement is of paramount importance and it should not be neglected.
Remaining after surgery requires adequate wound care to it did not get infections. It is superimposed seams, which would be removed in two weeks.
Once a day should be unstuck from the wound dressing, smear it a special saline solution. All dressings are medical professionals. If around the wound suddenly appear redness, this should immediately be reported to the doctor.
In the early stages of exercise after knee replacement can be performed while standing, but they should do very carefully. Sometimes first require assistance to maintain balance. Most effective flexion of the limb in a standing position.
At a late stage should perform exercises with weights, or bike. This makes it easier to develop its elasticity.
Along with weights, you can perform the lifts the legs, bend them, rotate limb. But when on a bike trainer is important so to adjust the seat height, you can only apply to socks.
Gradually therapy can become more intensive, it will be possible to walk and perform exercises. Their quality and quantity will depend on how soon it will be possible to return to normal life.
What complications are possible?
In some cases, may develop complications. May develop the following problems:
- heart attack;
- the appearance of thrombus;
- the infection;
- wear or loosening of the implant;
- nerve damage or blood vessel.
Each of these complications can be avoided if you perform exactly all recommendations of your doctor.
It is also important to note that due to a range of medicines and the high level of development of medicine, all these effects not only prevent, but also to prevent.
The price of the operation
In the Moscow clinics, the cost of knee replacement varies and will depend on how much willing to spend patient.
The minimum price for knee replacement surgery starts from 50 thousand rubles.