Category: Knee Surgery

Signs That It Is Time For A Knee Replacement

If you hear that click and pop from your knee when you get up from a chair, it could be one of the signs that it is time for a knee replacement. If your activities are limited and the pain keeps you from enjoying life, it could be time to speak to Nevada Orthopedic & Spine Center about knee replacement surgery.

Continue reading “Signs That It Is Time For A Knee Replacement”

Chondromalacia patella

Chondromalacia patella (or patellae), also referred to as “runner’s knee” is a condition in which the cartilage cushioning the area under the patella (kneecap) begins to deteriorate and wear out. Due to this, the kneecap may start to rub against the femur (thigh bone) and cause discomfort or pain. This condition is often common among young athletes or sports people do to increased activity and action involving the knees. The condition can also occur in adults who are suffering from arthritis.

Chondromalacia patella can often occur due to misalignment of the knee or as a result of overuse, which can be seen it treated by a few days of rest. In the case of improper knee alignment, resting will not be enough and physiotherapy or surgery may be necessary to correct it.

Causes

Chondromalacia patella is most common in teenagers and young adult, usually affecting women more than it does men. It is
not fully known the reason why it occurs, but studies have indicated that when the patella (kneecap) rubs against the
femur (thigh bone) this can damage the cartilage underneath the patella, which is necessary for cushioning and reducing friction between the bones and joint. The main causes for this condition are usually:

Alignment problems with the knee or foot.

  • Overuse of the knee
  • Wear and tear as part of the aging process
  • Arthritis of the knee
  • Hypermobile joints
  • Imbalance of thigh muscles surrounding the knee

There are also certain risk factors, which increase the likelihood of having “runner’s knee” (chondromalacia patella), these include:

  • Age – growth spurts can often lead to imbalances between the bones and
    muscles
  • Flat feet – those with flat feet are more likely to have more pressure placed
    on the knee
  • Prior injury – previous injury to the knee region may increase the risk of
    runner’s knee
  • Gender – women are said to be more likely to develop this condition as
    they generally have less muscle mass than their male counterpart causing
    more lateral pressure on the patella.
  • High movement – participating in sports that require a high level of
    movement can increase the wear on the knees and joints increasing the
    risk of injury.

Symptoms

Individuals suffering from chondromalacia patella will often record similar symptoms to other conditions in the knee. The common symptoms being:

  • Pain and swelling around the kneecap
  • Clicking or grinding noise when bending or straightening the knee
  • Discomfort when walking up or down stairs
  • Discomfort when in a seated position for a long duration (it can be
    sometimes referred to as ‘theatre knee’ or ‘movie-goers knee’)

Diagnosis

A provisional diagnosis of chondromalacia patella is usually made after an examination by a doctor or qualified physiotherapist. It is usually an active diagnosis as it requires further follow ups, due to lack of access to the cartilage. If the initial signs show no proof of damage to the cartilage then the doctor is likely to view the injury as patellofemoral pain syndrome rather than runner’s knees.

Based on the results of the tests there are provided, different levels and of severity that can be experienced.

  • Grade 1 – softening of the cartilage around the knee
  • Grade 2 – softened cartilage alongside erosion of the tissue and an uneven surface
  • Grade 3 – increased deterioration with thinning of the cartilage
  • Grade 4 – bone exposure and significant deterioration of the cartilage tissue. In this event the bones are likely to be rubbing against each other and surgery may be required

If a diagnosis cannot be gathered from the initial physical examination by the doctor or it is unclear, then further tests may be carried out in certain situations. Tests that may be carried out include:

  • X-ray – this alongside standard blood tests can help in ruling out any
    underlying issues such as inflammation or arthritis
  • Arthroscopy – this is usually carried out to provide a direct look into the actual state of the cartilage. In this procedure, a small flexible camera is inserted into a keyhole through the knee
  • MRI scan – this provides a more detailed view of the knee and surrounding joints, it is usually the most flexible method of confirming chondromalacia patella.

Treatment

The initial mode of treatment for injuries such as chondromalacia patella after diagnosis is the application of the R.I.C.E principle (Rest, Ice, Compress, and Elevate). Although applying this in itself will not cure chondromalacia patella, it will help in reducing the discomfort, swelling or pain associated with the injury. It is essential to understand and correct the initial cause(s) of the injury and the treatment program that is recommended may be a mixture or one of the following:

  • Painkillers and anti-inflammatory medication – apart from the application of the RICE principle, the health professional may also recommend the use of NSAIDs and other anti-inflammatory medication which can aid in reducing the pain also.
  • Physiotherapy – exercises and a range of movement to strengthen the surrounding muscles and joints can help in the rehabilitation of the knee. Improving the lateral quadriceps structure leading to the knee can help in reducing pressure on the knee and cartilage and prevent further injury to the knee.
  • Patella taping – this treatment form can help to lessen the pain by preventing the rubbing together of the kneecap and the sore spot which causes the pain. The adhesive tapes are placed along either side of the affected knee, helping to guide and correct the movement of the patella. There are two main forms of patella taping techniques including the controlling technique for new injuries and the correct tracking technique for those looking to get back into sports activities. Knee supports specially designed for the patella can also help in relieving pain and pressure.
  • Surgery – this is usually not common for this kind of injury and only occurs when other treatment methods or rehabilitation have proved to be unsuccessful. The surgical procedure is usually simple and involves the use of an arthroscopy or keyhole surgery, whereby the damaged or deteriorated cartilage is either removed or shaved.

Prevention

To avoid a repeat of chondromalacia patella or to prevent it from occurring in the first instance, the following steps can be followed to prevent the likelihood:

  • Wearing the correct footwear can help to improve the arch of the feet, which is particularly useful for those with flat feet. As the pressure on the kneecap is reduced, it may help with the proper alignment of the kneecap.
  • Use of knee pads and patella supports, especially during repeated use can help reduce the likelihood of injury.
  • Performing regular strengthening exercises can help with muscle balance, especially for the hamstrings, quadriceps, adductors, and abductors.
  • Lowering body weight can reduce overall stress and pressure on the knees lowering the risk of chondromalacia patella. Reducing overall calorie intake and eating a balanced diet alongside regular exercising can help in keeping the knees and joints healthy in the long run.

If you are experiencing knee pain, chondromalacia may be the cause. Please make an appointment to be seen in my clinic and we can explore the issues and design a treatment plan for your unique needs.

Ronald Hillock MD
Fellow American Academy of Orthopedic Surgeons
Diplomat American Board of Orthopedic Surgery
Adult Reconstruction and Orthopedic Oncology

 

Total Knee Replacement

Ronald Hillock MD
Fellow American Academy of Orthopedic Surgeons
Diplomat American Board of Orthopedic Surgery
Adult Reconstruction and Orthopedic Oncology

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.

If nonsurgical treatments like medications and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help you resume normal activities.

Knee replacement surgery was first performed in 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. Total knee replacements are one of the most successful procedures in all of medicine. According to the Agency for Healthcare Research and Quality, more than 600,000 knee replacements are performed each year in the United States.

Whether you have just begun exploring treatment options or have already decided to have total knee replacement surgery, this article will help you understand more about this valuable procedure.

The knee is the largest joint in the body and having healthy knees is required to perform most everyday activities.

The knee is made up of the lower end of the thighbone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). The ends of these three bones where they touch are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily.

The menisci are located between the femur and tibia. These C-shaped wedges act as “shock absorbers” that cushion the joint.

Large ligaments hold the femur and tibia together and provide stability. The long thigh muscles give the knee strength.

All remaining surfaces of the knee are covered by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage, reducing friction to nearly zero in a healthy knee.

Normally, all of these components work in harmony. But disease or injury can disrupt this harmony, resulting in pain, muscle weakness, and reduced function.

Cause

The most common cause of chronic knee pain and disability is arthritis. Although there are many types of arthritis, most knee pain is caused by just three types: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.

  • Osteoarthritis. This is an age-related “wear and tear” type of arthritis. It usually occurs in people 50 years of age and older, but may occur in younger people, too. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
  • Rheumatoid arthritis. This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”
  • Post-traumatic arthritis. This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

Diagram of knee pain caused by osteoarthritis

Is Total Knee Replacement for You?

The decision to have total knee replacement surgery should be a cooperative one between you, your family, your family physician, and your orthopedic surgeon. Your physician may refer you to an orthopedic surgeon for a thorough evaluation to determine if you might benefit from this surgery.

When Surgery Is Recommended

Bowed knee deformity. Varus

Knocked knee deformity. Valgus

There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:

  • Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker
  • Moderate or severe knee pain while resting, either day or night
  • Chronic knee inflammation and swelling that does not improve with rest or medications
  • Knee deformity — a bowing in or out of your knee
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries

Candidates for Surgery

There are no absolute age or weight restrictions for total knee replacement surgery.

Recommendations for surgery are based on a patient’s pain and disability, not age. Most patients who undergo total knee replacement are age 50 to 80, but Dr Hillock will evaluate patients individually. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

Orthopedic Evaluation

An evaluation with an orthopedic surgeon such as Dr. Hillock will consists of several components:

  • A medical history to gather information about your general health and ask you about the extent of your knee pain and your ability to function.
  • A physical examination. This will assess knee motion, stability, strength, and overall leg alignment.
  • X-rays. These images help to determine the extent of damage and deformity in your knee.
  • Other tests. Occasionally blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your knee.

Dr Hillock will review the results of your evaluation with you and discuss whether total knee replacement is the best method to relieve your pain and improve your function. Other treatment options — including medications, injections, physical therapy, or other types of surgery — will also be considered and discussed.

In addition, Dr Hillock will explain the potential risks and complications of total knee replacement, including those related to the surgery itself and those that can occur over time after your surgery.

Deciding to Have Knee Replacement Surgery

Realistic Expectations

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and cannot do.

More than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not allow you to do more than you could before you developed arthritis.

With normal use and activity, every knee replacement implant begins to wear in its plastic spacer. Excessive activity or weight may speed up this normal wear and may cause the knee replacement to loosen and become painful. Therefore, most surgeons advise against high-impact activities such as running, jogging, jumping, or other high-impact sports for the rest of your life after surgery.

Realistic activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports.

With appropriate activity modification, knee replacements can last for many years.

Possible Complications of Surgery

The complication rate following total knee replacement is low. Serious complications, such as a knee joint infection, occur in fewer than 2% of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit full recovery.

  • Discuss your concerns thoroughly with your primary doctor, your family and Dr Hillock prior to surgery.
  • Infection. Infection may occur in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. It may even occur years later. Minor infections in the wound area are generally treated with antibiotics. Major or deep infections may require more surgery and removal of the prosthesis. Any infection in your body can spread to your joint replacement.
  • Blood clots. Blood clots in the leg veins are one of the most common complications of knee replacement surgery. These clots can be life-threatening if they break free and travel to your lungs. Your orthopedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings, and medication to thin your blood.
  • Implant problems. Although implant designs and materials, as well as surgical techniques, continue to advance, implant surfaces may wear down and the components may loosen. Additionally, although an average of 115° of motion is generally anticipated after surgery, scarring of the knee can occasionally occur, and motion may be more limited, particularly in patients with limited motion before surgery.
  • Continued pain. A small number of patients continue to have pain after a knee replacement. This complication is rare, however, and the vast majority of patients experience excellent pain relief following knee replacement.
  • Neurovascular injury. While rare, injury to the nerves or blood vessels around the knee can occur during surgery.

Preparing for Surgery

Medical Evaluation

If you decide to have total knee replacement surgery, your orthopedic surgeon may ask you to schedule a complete physical examination with your family physician several weeks before the operation. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process. Many patients with chronic medical conditions, like heart disease, may also be evaluated by a specialist, such as a cardiologist, before the surgery.

Tests

Several tests, such as blood and urine samples, and an electrocardiogram, may be needed to help your orthopedic surgeon plan your surgery.

Medications

Tell your orthopedic surgeon about the medications you are taking. He or she will tell you which medications you should stop taking and which you should continue to take before surgery.

Dental Evaluation

Although the incidence of infection after knee replacement is very low, an infection can occur if bacteria enter your bloodstream. To reduce the risk of infection, major dental procedures (such as tooth extractions and periodontal work) should be completed before your total knee replacement surgery.

Urinary Evaluations

People with a history of recent or frequent urinary infections should have a urological evaluation before surgery. Older men with prostate disease should consider completing required treatment before undertaking knee replacement surgery.

Social Planning

Although you will be able to walk on crutches or a walker soon after surgery, you will need help for several weeks with such tasks as cooking, shopping, bathing, and doing laundry.

If you live alone, your orthopedic surgeon’s office, a social worker, or a discharge planner at the hospital can help you make advance arrangements to have someone assist you at home. They also can help you arrange for a short stay in an extended care facility during your recovery, if this option works best for you.

Home Planning

Several modifications can make your home easier to navigate during your recovery. The following items may help with daily activities:

  • Safety bars or a secure handrail in your shower or bath
  • Secure handrails along your stairways
  • A stable chair for your early recovery with a firm seat cushion (and a height of 18 to 20 inches), a firm back, two arms, and a footstool for intermittent leg elevation
  • A toilet seat riser with arms, if you have a low toilet
  • A stable shower bench or chair for bathing
  • Removing all loose carpets and cords
  • A temporary living space on the same floor because walking up or down stairs will be more difficult during your early recovery

YOUR SURGERY

You will most likely be admitted to the hospital on the day of your surgery.

Anesthesia

After admission, you will be evaluated by a member of the anesthesia team. The most common types of anesthesia are general anesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake but your body is numb from the waist down). The anesthesia team, with your input, will determine which type of anesthesia will be best for you.

Procedure

The procedure itself takes approximately 1 to 2 hours. Dr hillock will remove the damaged cartilage and bone, and then position the new metal and plastic implants to restore the alignment and function of your knee.

After surgery, you will be moved to the recovery room, where you will remain for several hours while your recovery from anesthesia is monitored. After you wake up, you will be taken to your hospital room.

Your Hospital Stay

You will most likely stay in the hospital for several days.

Pain Management

After surgery, you will feel some pain. This is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster.

Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.

Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. Opioid dependency and overdose has become a critical public health issue in the U.S. It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not begun to improve within a few days of your surgery.

Blood Clot Prevention

Your Treatment team may prescribe one or more measures to prevent blood clots and decrease leg swelling. These may include special support hose, inflatable leg coverings (compression boots), and blood thinners.

Foot and ankle movement also is encouraged immediately following surgery to increase blood flow in your leg muscles to help prevent leg swelling and blood clots.

Physical Therapy

Most patients begin exercising their knee the day after surgery. In some cases, patients begin moving their knee on the actual day of surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement to allow walking and other normal daily activities soon after your surgery.

To restore movement in your knee and leg, your surgeon may use a knee support that slowly moves your knee while you are in bed.

Preventing Pneumonia

It is common for patients to have shallow breathing in the early postoperative period. This is usually due to the effects of anesthesia, pain medications, and increased time spent in bed. This shallow breathing can lead to a partial collapse of the lungs (termed “atelectasis”) which can make patients susceptible to pneumonia. To help prevent this, it is important to take frequent deep breaths. Your nurse may provide a simple breathing apparatus called a spirometer to encourage you to take deep breaths.

Your Recovery at Home

The success of your surgery will depend largely on how well you follow your discharge instructions at home during the first few weeks after surgery.

Wound Care

You will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal.

Avoid soaking the wound in water until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing or support stockings.

Diet

Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to help your wound heal and to restore muscle strength.

Activity

Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within 3 to 6 weeks following surgery. Some pain with activity and at night is common for several weeks after surgery.

Your activity program should include:

  • A graduated walking program to slowly increase your mobility, initially in your home and later outside
  • Resuming other normal household activities, such as sitting, standing, and climbing stairs
  • Specific exercises several times a day to restore movement and strengthen your knee. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery.

You will most likely be able to resume driving when your knee bends enough that you can enter and sit comfortably in your car, and when your muscle control provides adequate reaction time for braking and acceleration. Most people resume driving approximately 4 to 6 weeks after surgery.

Avoiding Problems After Surgery

Blood Clot Prevention

Follow your orthopedic surgeon’s instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. He or she may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.

Warning signs of blood clots. The warning signs of possible blood clots in your leg include:

  • Increasing pain in your calf
  • Tenderness or redness above or below your knee
  • New or increasing swelling in your calf, ankle, and foot

Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:

  • Sudden shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing

 Preventing Infection

A common cause of infection following total knee replacement surgery is from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your knee replacement and cause an infection.

After knee replacement, patients with certain risk factors may need to take antibiotics prior to dental work, including dental cleanings, or before any surgical procedure that could allow bacteria to enter the bloodstream. Your treatment team will discuss with you whether taking preventive antibiotics before dental procedures is needed in your situation.

Warning signs of infection. Notify your doctor immediately if you develop any of the following signs of a possible knee replacement infection:

  • Persistent fever (higher than 100.5°F orally)
  • Shaking chills
  • Increasing redness, tenderness, or swelling of the knee wound
  • Drainage from the knee wound
  • Increasing knee pain with both activity and rest

 Avoiding Falls

A fall during the first few weeks after surgery can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile. You should use a cane, crutches, a walker, hand rails, or have someone to help you until you have improved your balance, flexibility, and strength.

Dr Hillock and physical therapist will help you decide what assistive aides will be required following surgery and when those aides can safely be discontinued.

OUTCOMES

How Your New Knee Is Different

Improvement of knee motion is a goal of total knee replacement, but restoration of full motion is uncommon. The motion of your knee replacement after surgery can be predicted by the range of motion you have in your knee before surgery. Most patients can expect to be able to almost fully straighten the replaced knee and to bend the knee sufficiently to climb stairs and get in and out of a car. Kneeling is sometimes uncomfortable, but it is not harmful.

Most people feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending activities.

Most people also feel or hear some clicking of the metal and plastic with knee bending or walking. This is a normal. These differences often diminish with time and most patients find them to be tolerable when compared with the pain and limited function they experienced prior to surgery.

Your new knee may activate metal detectors required for security in airports and some buildings. Tell the security agent about your knee replacement if the alarm is activated.

Protecting Your Knee Replacement

After surgery, make sure you also do the following:

  • Participate in regular light exercise programs to maintain proper strength and mobility of your new knee.
  • Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery.
  • Make sure your dentist knows that you have a knee replacement. Talk with your Dr Hillock about whether you need to take antibiotics prior to dental procedures.  Usually Dr Hillock recommends antibiotic prophylaxis for the rest of your life following any total joint surgery.
  • See Dr Hillock or another surgeon periodically for a routine follow-up examination and x-rays

Extending the Life of Your Knee Implant

Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following Dr Hillock’s instructions after surgery and taking care to protect your knee replacement and your general health are important ways you can contribute to the final success of your surgery.

Knee Implants

5 Common Mistakes Patients Make When Getting a Knee Replacement

Knee replacement surgeries are a safe and effective way to help patients improve mobility, have less pain, and resume normal activities. In fact, many patients often wonder why they waited so long to finally address their pain.

On the other hand, there are those who are less than satisfied with their decision, and here are some of the biggest mistakes that led them to that unfortunate result.

Continue reading “5 Common Mistakes Patients Make When Getting a Knee Replacement”

How to Avoid Common Risks of Total Knee Replacement

Once you have weighed the risks versus the benefits and consulted with your physician, it’s crucial to know how to avoid common risks of total knee replacement.  

Reasons to Have a Total Knee Replacement

When osteoarthritis has damaged the knee joint, and other treatments like  physical therapy, injections, or medications have not given enough relief, Nevada Orthopedic & Spine Center may recommend knee surgery.

During surgery, the damaged cartilage and bone are removed, and your surgeon will implant an artificial joint made of metal, plastic, and other man-made materials.  The American Academy Of Orthopaedic Surgeons assures us that 90% of patients will experience significantly less pain post surgery and will enjoy better mobility.

Common Risks of Total Knee Replacement

Once you and your physician have made the decision to move forward with total knee replacement surgery, it is important to educate yourself on potential outcomes of the procedure and how you can help to ensure that your risk for complications are as low as possible.

General Anesthesia

General anesthesia makes one unconscious until surgery is complete and can cause side effects from mild to quite serious. Headaches, nausea, drowsiness, and a sore throat are some of the milder side effects. Having a heart attack, blood clots, or stroke are among the most serious side effects of general anesthesia, and these more commonly occur when the patient has other health issues like heart disease or lung problems.

Doctor showing picture of Total knee replacement on tablet screen against blurred operating room.

Regional Anesthesia

Regional anesthesia only numbs the leg or lower body accompanied by sedation to relax the patient as they remain awake during the surgery. The complications or risks are less worrisome, but can still lead to trouble urinating, allergic reactions, headaches, and possible nerve damage at the needle injection site.

Tell the anesthesiologist if you smoke, take drugs, or drink alcohol as these may make you more susceptible to problems from anesthesia.

Infection

The risk of infection is always present since the skin is opened, which can allow bacteria to enter the body. After you return home from your knee replacement, be aware of the common symptoms of infection like swelling, fever and chills, redness, discharge from the site, and warmness. In addition, make sure to carefully follow all instructions given by your surgeon at Nevada Orthopedic & Spine Center about how to keep the wound clean to prevent infection.

Pain and Swelling

These are common after knee surgery and normally a patient is prescribed pain medications for a short period of time to manage their discomfort. If the knee, foot and ankle begin to swell, apply ice and engage in some light exercise to encourage healthy blood flow.

Blood Clots

Having a blood clot is one of the most serious complications after total knee replacement. If a blood vessel is damaged and a clot forms, it can be life threatening. You can reduce the risk by moving around as soon as possible after surgery and wearing some kind of compression device to prevent a clot from forming.

Allergic Reactions

Occasionally a person can develop an allergic reaction to the metal in the implant. It shows up as a rash, swelling, or blisters. If you have had issues with metal jewelry, talk with your knee specialist about whether you should have allergen tests completed prior to surgery.

The best way to avoid any of the possible risks after a total knee replacement is to:

  • Follow all the doctors instructions
  • Move around and get on your feet as soon as you can
  • Use the knee but avoid doing too much too fast
  • Stay active and perform exercises per the doctor
  • Maintain or reduce your weight

If you are having severe knee pain and are unable to perform everyday activities, see your knee specialist  for treatment options.

As always, if you have any further questions, please contact us by phone or request an appointment online.