| Replacing a worn knee joint |
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| You use your knee every time you take a step. Because of this, living with a worn or injured knee joint can be painful and frustrating. Even simple things, such as squatting to pick up the morning paper, may cause pain. But you don't have to live this way. In many cases, a knee surgeon can replace the damaged knee joint. The surgery is safe and effective. For many people, having a total knee replacement means a return to pain free movement. This booklet will help you learn what knee replacement means for you. It can also help answer many of your questions.
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| A Problem Knee |
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| No matter what your age, a problem with the knee joint may keep you away from activities you enjoy. Pain and stiffness may even limit the daily tasks you can do. Problems with the knee joint tend to build up over time. Your knee pain may be caused by any of the following : |
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- A bad injury that did not heal properly.
- A chronic illness
- Wear and tear from years of constant use
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| Surgery Can Help |
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You may not have to live with knee pain for the rest of your life. Total knee replacement surgery almost always reduces joint pain. During this surgery, your damaged knee joint is replaced with an artificial joint (called a prosthesis). Surgery can't make you young again, but it can bring real benefits.
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| Benefits of Knee Replacement |
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After a total knee replacement, you can look forward to moving more easily. Most people gain all of the benefits listed below. Knee replacement surgery almost always :
Stops or greatly reduces joint pain. Increases leg strength. Without knee pain, you'll be able to use your legs more. This will build up your muscles.
Improves your quality of life by allowing you to do daily tasks and low-impact activities in greater comfort.
Provides years of easier movement. Most total knee replacements last for many years.
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| How the Knee Works |
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| A healthy knee bends easily. The joint absorbs stress and glides smoothly. This allows you to walk, squat, and turn without pain. But when the knee is damaged, the joint may lose its ability to cushion stress. You may feel pain during movement. Sometimes a damaged knee joint will swell and hurt even when you are at rest. |
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| A Healthy Knee |
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| The knee is a hinge joint, formed where the thighbone and shinbone met. When the knee is healthy, the joint moves freely. This is because the joint is covered with slippery tissue and powered by larger muscles. |
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- Cartilage is a layer of smooth, soft tissue. It covers the ends of the thighbone, shinbone, and it lines the underside of the kneecap. Healthy cartilage absorbs stress and allows the knee to glide easily.
- Ligaments are another type of soft tissue. They hold the bones of the joint together.
- Muscles power the knee and leg for movement.
- Tendons attach the muscles to the bones.
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| A Damaged Knee |
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| When one or more parts of the knee are damaged, joint movements suffer. Over time, cartilage starts to crack or wear away. Because cartilage cannot fully repair itself, the damage may keep increasing. At first, your knee may just be a little stiff. But as the bones of the joint begin rubbing together, you're likely to feel pain. |
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| Osteoarthritis |
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| Years of normal use can cause cartilage to crack and wear away (Osteoarthritis). As exposed bones rub together, they become rough and pitted. The joint grinds. Being overweight or having an alignment problem, such as knocked or bowed knees, puts extra force on the joint. This may speed up the damage. |
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| Inflammatory Arthritis |
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| A chronic disease, such as rheumatoid arthritis or gout, can cause swelling and heat (inflammation) in the joint lining. As the disease progresses, cartilage may be worn away and the joint may stiffen. |
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| Injury |
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| A bad fall or blow to the knee can injure the joint. If the injury does not heal properly, extra force may be placed on the joint. Over time, this can cause the cartilage to wear away (traumatic arthritis). |
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| Is Surgery Right for you ? |
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| Your doctor may have tried to reduce your knee pain with medications, You may even have had minor surgery (arthroscopy) to help treat the problem. But if this didn't help enough, total joint replacement might be right for you. To find out, your surgeon will evaluate your knee joint. You'll have a full exam and x-rays. When forming a treatment plan, your surgeon thinks about how surgery can best benefit you over your lifetime. |
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| Your Medical History |
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| Your surgeon will ask you about any past medical problems. He or she is likely to ask where your knee hurts and what makes the pain worse. Tell your surgeon about any other joint problems or any injuries to your knee or leg. If any surgery seems likely, be sure to mention any past problems with anesthesia or bleeding. |
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| Your Physical Exam |
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Your surgeon will fully examine your knee. He or she will feel for swelling around the joint. Nearby muscles and tendons may also be checked. The joint itself will be tested for strength, stability, and range of motion. Your surgeon may also look for other problems, such as a pinched nerve, that may be causing pain in or near the knee.
The range of motion in your knee joint will be tested. Your surgeon wants to know how far the joint moves, where movement gets stiff, and when you feel pain.
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| X-rays |
| X-rays will be taken to provide an image of your knee joint. An x-ray may show changes in the size and shape of the joint. A build up of bone (bone spur), a cyst, or pitting in the bone may also show up. These problems often form where cartilage has worn away. X-rays can also help your surgeon plan your knee replacement. He or she may use x-rays to decide exactly where in the bone to place the prosthesis. |
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| Your Treatment Plan |
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| Your surgeon uses the results of your exam and tests to form a treatment plan that is right for you. Depending on your age and the amount of damage to your knee, surgery may offer the best answer to your problem. A total knee replacement lasts many years, and it can often be repeated if the first prosthesis wears out. But if you are still fairly young, your surgeon may suggest delaying surgery. In this case, medications or arthroscopy may help control your symptoms until the time is right for joint replacement. |
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| Getting Ready for Surgery |
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| Be sure to see your primary care doctor or dentist. Treating health and dental problems ahead of time helps improve healing after a joint replacement. If you're a smoker, do your best to stop or cut down. Your surgery risk and recovery rate will improve. Stop taking aspirin or blood-thinning tablets, at least 4-5 days before surgery. |
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| Prepare at Home |
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| Make life easier and safer after surgery. Reduce household hazards now. Also, limit the amount of reaching and stair climbing you'll have to do. Try these tips. |
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| Arrange for Help |
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After your knee replacement, you won't be able to drive for the first few weeks. Perhaps a family member or friend can deliver groceries and help you run errands. If you live alone, ask someone to stay with you for a few days after surgery. By planning ahead now, you'll have less to worry about during recovery.
Your Knee Replacement Surgery |
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