Knee surgery Cleveland can relieve pain and improve knee function in people with damaged cartilage or bone. But doctors warn patients against high-impact activities, like jogging and jumping, to help prevent the knee implant from loosening or breaking.
Before you have knee replacement surgery, find out about hospital charges and payment options. Learn how to reduce your hospital bill by negotiating with the billing department or taking advantage of financial programs.
How It Works
In general, your surgeon will begin by opening up the knee and exposing the bones within. The damaged cartilage and bone are then removed using specialised tools. The end of your femur, or thighbone, is then cut to size and the first part of your artificial knee (called the femoral component) is fitted. A polyethylene insert, which acts as a buffer between the metal and your tibia, is then snapped into place and sealed with bone cement.
Your surgeon may also replace the top of your lower leg bone (the tibia) and the back of your kneecap (patella) with man-made parts. This is called a total knee replacement. It is more common in older people because it usually provides better results than a partial knee replacement. It can also help you stay active longer. However, it doesn’t always ease pain as well as a natural knee and isn’t suitable for everyone. It is sometimes combined with other surgery or procedures to treat other problems in your knee.
Total Knee Replacement
A healthy knee joint has thick cartilage that covers and protects the ends of the bones in the knee joint and acts as a cushion between them. In a total knee replacement the damaged cartilage and bone are replaced with metal and plastic components.
You will usually have the operation under general anaesthetic (you are asleep during the surgery) or spinal anaesthetic (you feel no sensation from the waist down). You will be given antibiotics before the operation to reduce the risk of infection and blood clots.
An incision is made up to 30cm long, extending from just above the kneecap (patella) to below it. The kneecap is often left intact, but sometimes surgeons remove the under surface of the patella to give more stability to the new knee joint. The new knee component is then fixed into place using either a special type of glue or cement, or the surface of the component facing your knee may be textured or coated to encourage bone growth over it for a stronger bond.
Partial Knee Replacement
In the past surgeons favored a procedure known as osteotomy for those with severe knee arthritis that limited their ability to move and whose pain could not be controlled by medications (both anti-inflammatory and analgesic such as acetaminophen which is sold under the brand name Tylenol). But in the last few years doctors have become excited about a new surgical approach to partial knee replacement that can decrease recovery time and make this option more attractive to people who want to return to a high level of activity.
During this operation the damaged compartment is exposed through a small incision and the patella is moved out of the way to provide access to the area around the joint. The cartilage is removed and the underlying bone cut and shaped to accommodate the plastic component.
This process is complex and requires considerable experience with minimally invasive techniques. When done well in properly selected patients this surgery provides excellent pain relief and function similar to that obtained from total knee replacement.
Recovery
Most people who have a knee replacement can leave the hospital on the same day, or very soon after. Your doctor will give you instructions on how to take care of your knee while you're at home.
You'll have a bandage over the surgical site. Your doctor will remove any staples or skin glue after 2 weeks.
Some people have pain that gradually gets better after surgery. Others have continued pain that may need to be treated with medicine.
It's important to follow your doctor's orders for physical therapy and exercise. This is the key to a successful recovery and getting back to your regular activities. You should avoid putting too much stress on your new knee. Use a chair with a firm seat cushion and back, and get a footstool or a stable plastic chair for sitting in the tub and shower. Also, make sure you have a raised toilet seat and a stable bath bench or commode chair.