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Recent Medical Video

Total Knee Arthroplasty Print E-mail
 

In order to schematically see how total knee arthroplasty (TKA) is performed press here

What is to be expected by a knee arthroplasty?

When all other treatments (medication, physiotherapy, weight loss) are unable to fight knee pain in advanced arthritis or bone necrosis situations, knee arthroplasty may offer relief from pain and improvement of the patient’s mobility.

Which patients are candidates for knee arthroplasty?

Knee arthroplasty is, in most cases, the outcome of knee osteoarthritis. You should consider arthroplasty if :

  • You feel pain which restricts your daily activities, such as going up and down the stairs or you feel pain at night or at rest.
     
  • You feel knee movement restriction or knee swelling which does not allow you full knee flexion and extension.
  • All conservative measures for relieving your symptoms (rest, weight loss, physiotherapy, walking with a stick, medication) have failed.
  • You present knee deformation (Varus or valgus).

Knee arthroplasty also addresses patients with knee trauma, rheumatoid arthritis and other situations as femoral condyle aseptic necrosis.

Which patients’ age addresses knee arthroplasty?

Initially, knee arthroplasty addressed patients over 55. As technology advances, more powerful and of greater life expectancy artificial knee joints are being created, suitable for younger and more active patients. 

How to prepare for a knee arthroplasty?

Before surgical operation, you need to contact your orthopaedic surgeon for a clinical examination. Your orthopaedic will ask you about your medical history and the medication you probably receive, in order to certify that your health state allows the conduction of the arthroplasty. Also, he will examine your knee (range of motion, around the knee muscular condition) and will order all the necessary blood and urine examinations as well as x-rays. In this appointment you may ask the doctor whatever you need to know about the operation.

End stage knee osteoarthritis, in varus axis

 

How does knee arthroplasty is performed?

Knee arthroplasty includes the replacement of the suffering joint with a metal prothesis. Since the joint’s bones (femur, tibia and patella) are shaped accordingly and any possible axial deformations are corrected, the metal parts of the artificial joint are stabilized either with acrylic cement or through impaction. Finally, the specific plastic part that intermediates between the metal parts (on which the joint’s movement takes place) is adjusted.
The prothesis parts assemble the normal anatomy of the knee and function as a normal joint. The parts of the artificial joint created consist of specific durable plastic (polyethylene) and really durable alloys of steel and titanium, which are absolutely compatible with human body.

 

Total knee arthroplasty


 

In order to schematically see how total knee arthroplasty (TKA) is performed press here

Total knee arthroplasty usually lasts 1-1.5h. In this time the patient remains under anesthesia (general or regional) and does not feel any pain. After the operation the patient remains in resuscitation area for an hour where he is closely observed by the anesthesiologist and his nurse assistant, until he recovers from the anesthesia.

After the operation

The first night after the operation, the patient remains bedridden and has urinary catheter, a drain wound tube which drains the joint blood as well as an intravenous catheter from which he receives all the necessary medication (antibiotics, painkillers, etc). Also, he has an epidural catheter connected to a continuous injection pump through which painkilling medication is administered, in order not to feel any pain.

Knee mobilization begins immediately. On the second day after surgery, the drainages are removed and the patient rises from the bed and walks with the help of a pair of cratches or walker. On the following days, a physiotherapy program is designed according to every patients needs, which is daily implemented from our associate physiotherapists. On the sixth day the patient exits the clinic fully mobilized, with written instructions about the recovery period.

The results of knee arthroplasty

After the operation, the patient is mobilized without gross pain and with the help of two cratces (for the first month), one (for the second month) and none from the third month and on. Slowly, the patient may walk great distances without pain, swim, and drive, ride a bicycle and do other everyday activities.

Expected Surgical Outcome
1) Commence exercises on post operative day.
2) Mobilise 1st post-operative day
3) Home within a week.
4) Stair climbing by home discharge.
5) Three months full recovery.
6) Flexion to 100 degrees minimum.

 

Knee arthroplasty complications

Serious knee arthroplasty complications percentage in international bibliography is lower than 1%.

  • Pulmonary embolism: blood clots created during the operation may enter blood circulation and provoke embolism to the lungs resulting serious respiratory distress. Embolism is rarely clinically serious. Precocious anticoagulant medication is used.
  • Inflammation: wound infection may occur and dealt with the administration of the proper antibiotics.
  • Nerve Palsy
  • Postopeartive joint stiffness

 

Frequently Asked Questions - For Total Knee Arthroplasty

How long will I be in Hospital?

On average 5-7 days. This will depend on how fit you were before surgery and if you have any other arthritic joints. Some patients will take a little longer to get going.

What is the prosthesis made of?

Cobalt Chrome and Titanium. The is also a polyethylene insert on the tibial side.

How soon can I drive?

As soon as you can sit comfortably in the car with the knee flexed and pain satisfactorily controlled.

How long will the prosthesis last?

The Total Knee Replacement that i use, with a fixed bearing surface should last 15 years in 95% of cases and hopefully longer. The survival of the prosthesis is dependent on many factors such as initial deformity, activity levels and body habitus.

Can I have both joints replaced at the same time?

Yes you can and patients with severe deformity in both knees are better off with this procedure. However this is associated with higher risks than a single joint replacement. Your medical health would need to be considered before proceeding with this option.

 
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