What is knee replacement and when is it done?

The knee is our largest joint that carries almost our entire body and it works just like a hinge. The knee joint joins the upper part of the shinbone and the lower end of the femur, that is, the thigh bone, in a movable socket called the kneecap. In the knee joint, which is made up of the combination of three bones, there is articular cartilage, which acts as a cushion for the mobility of the bones when they come into contact with each other.

The remaining parts of the knee joint are covered by the synovial membrane, which is a thin and soft tissue. The synovial membrane secretes a special fluid that lubricates the kneecap and minimizes friction.

It is thanks to this fluid and cartilage that a healthy knee bends easily, carries the load on the joint, and moves easily. Cracks and abrasions begin in the cartilage over time, and the knee joint begins to lose its load-bearing ability. The limited ability of the knee to regenerate causes the damage to increase day by day. The complaints that start with stiffness in the knees are replaced by pain as the friction of the bones increases.

What is Knee Replacement?

A knee prosthesis is an artificial joint that is surgically attached to the knee of the patient in order to maintain painless joint mobility, allowing a painless and quality life.

The knee joint wears out over time due to calcification, excess weight or unknown reasons, and the joint surfaces rub against each other during walking, causing pain and suffering, which seriously reduces the quality of life. The pain and pain that occurs as a result of this abrasion restricts the movements of the person, especially walking. Knee prosthesis made of metal and polyethylene is the most effective method of eliminating these problems.

In Which Situations Is Knee Prosthesis Performed?

For knee prosthesis application, the patient’s pain should limit his daily life. Although the most important factor for knee replacement surgery is knee pain, the extent of the deformation is also of great importance. By using advanced imaging techniques such as MRI (knee MRI), tomography, the degree of deterioration in the joint is determined and it is decided whether the problems can be solved with joint-preserving treatment. Before knee surgery, if possible, the priority is joint sparing treatment.

The joints are covered with a gel-like fluid to provide mobility, and this pain decreases over time, causing the bones to rub against each other with each movement. Joint deformity causes difficulties in the daily life of the patient. The patient begins to have serious pains when walking, going up and down stairs, and even sitting up. If the knee joint is so impaired that it cannot be treated with drugs and physical therapy, the only remaining treatment option is knee replacement surgery. The patient’s age and general health are very important for knee replacement surgery. Whether the patient can handle the surgery depends on these factors.

Knee prosthesis has a lifespan of 15-20 years in the human body. For us, it is more appropriate for patients to be between the ages of 50-80 for knee replacement surgery. Surgery is not recommended as much as possible in patients under the age of 50, and treatment is tried to be done with drugs and physical therapy methods.

In order to decide on surgery in patients under the age of 50, the patient’s presence of inflammatory rheumatic diseases, serious intra-articular fractures due to trauma, conditions make us physicians consider surgery.

Knee surgery is not something we recommend for patients aged 80 and over, and knee replacement surgery is decided by considering the activity level of the patient in his daily life.

Problems arising from the general health status of the patient due to the age of the patient, chronic diseases such as heart and blood pressure, and advanced bone resorption not only prolong the postoperative recovery period, but also reduce the success rate of the surgery.

When Should Knee Replacement Be Done?

The patient’s pain level is very important for knee replacement surgery. Unbearable knee pain is the most important reason for deciding on surgery.

Findings such as the patient’s inability to bend his knees and inability to open and close the kneecap are evaluated by the physician and a treatment plan is created accordingly. Our priority is to apply physical therapy and drug therapy to the patient, but if a positive result is not obtained, surgery, that is, knee replacement surgery, is inevitable.

How should a person continue his/her life after knee prosthesis is applied?

Knee replacement surgery literally means that the patient lives with an artificial knee joint. Although the life of the knee prosthesis is 15-20 years, it is very important for the patient to avoid sudden movements that shorten the life of the prosthesis, such as jumping from height and falling, after knee surgery.

The purpose of the use of knee prosthesis is to enable the patient to maintain his daily life.

What Are the Risks of Knee Replacement Surgery?

After knee replacement surgery

Infection,

Embolism (blood clotting in the leg veins, damaging vital organs)

Pain

Incompatibility that may occur after prosthesis application, etc. Technical problems such as knee surgery are among the risks after surgery.

The risk of complications after surgery is very low. However, many precautions are taken before the surgery to avoid these risks. Before knee surgery, if the patient has a urinary tract infection or a different infectious disease, it is treated. Heart, blood pressure etc. The patient is prepared before the operation by taking such diseases under control.

Blood thinners are used to prevent embolism. At the same time, the risk of embolism is minimized by applying compression stockings and foot-leg exercises to the patient after the surgery.

What are the Knee Prosthesis Types?

Knee prosthesis is the name given to the process of replacing the bone surfaces that make up the knee joint with metal surfaces that are fully compatible with the body.

Different types of knee prosthesis are used according to the wear in the knee joint. Total knee prosthesis and unicompartmental knee prosthesis are used according to the number of replaced surfaces. Knee prosthesis also has different types such as cemented, uncemented, and ligament-preserving, ligamentous.

How Long Does the Pain Last After Knee Replacement Surgery?

On the first day after the surgery, the intensity of pain is high and the reason for this pain is due to the surgery. However, various pain relief treatments are applied to the patient in order to reduce the pain in the hospital. The pain decreases with each passing fall and loses its intensity.

Knee replacement surgery is preferred for wear in the last stage. If calcification and wear are still at an early stage, alternative treatments such as PRP & stem cell application, hyaluronic acid treatment are applied to the knees.

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