What is Total Knee Replacement?
Total knee prosthesis (String platinum fitting) is the creation of artificial joints by covering the worn joint faces with materials made of metal and polyethylene material, special parts designed for painless joint movement.
Who is Total Knee Replacement?
Due to knee cartilage damage,
Despite the treatment methods such as fluid depletion among people, such as resting, medications, cane use and intra-articular injections, knee pain cannot be controlled, walking,
Total knee prosthesis is applied in patients whose daily life activities such as climbing stairs are severely restricted and the joint cartilage is more damaged. It is preferable that the patient is between the ages of 60 and 80, but in some special cases, such as rheumatoid arthritis and osteonecrosis, prostheses can also be made at an earlier age.
Total knee prosthesis (String platinum fitting) is the creation of artificial joints by covering the worn joint faces with materials made of metal and polyethylene material, special parts designed for painless joint movement.
Who is Total Knee Replacement?
Due to knee cartilage damage,
Despite the treatment methods such as fluid depletion among people, such as resting, medications, cane use and intra-articular injections, knee pain cannot be controlled, walking,
Total knee prosthesis is applied in patients whose daily life activities such as climbing stairs are severely restricted and the joint cartilage is more damaged. It is preferable that the patient is between the ages of 60 and 80, but in some special cases, such as rheumatoid arthritis and osteonecrosis, prostheses can also be made at an earlier age.
How is Total Knee Replacement?
According to the patient's age and general health status, after performing general anesthesia or appropriate regional anesthesia from the waist, the knee joint is reached through an incision made in front of the knee. The worn cartilage tissue of the three bones (femur, tibia and patella) that contact each other are cut together with a thin layer of bone, then the selected pieces of prosthesis are attached to the prepared bone surfaces using a filler called bone cement (polymethyl methacrylate). . Thus, the joint faces are re-coated with parts made of metal and plastic. The surgery takes between 1-2 hours. Epidural (placed at the waist) or intravenously administered medication pumps are used for post-operative pain control. The next day, knee movements are started and standing up with help. When you can walk comfortably in the room and corridor, you can be discharged from the hospital. This period can vary from 3 to 7 days, although it varies greatly from patient to patient.
According to the patient's age and general health status, after performing general anesthesia or appropriate regional anesthesia from the waist, the knee joint is reached through an incision made in front of the knee. The worn cartilage tissue of the three bones (femur, tibia and patella) that contact each other are cut together with a thin layer of bone, then the selected pieces of prosthesis are attached to the prepared bone surfaces using a filler called bone cement (polymethyl methacrylate). . Thus, the joint faces are re-coated with parts made of metal and plastic. The surgery takes between 1-2 hours. Epidural (placed at the waist) or intravenously administered medication pumps are used for post-operative pain control. The next day, knee movements are started and standing up with help. When you can walk comfortably in the room and corridor, you can be discharged from the hospital. This period can vary from 3 to 7 days, although it varies greatly from patient to patient.
What should I expect after Total Knee Replacement Surgery?
In over 90% of patients with total knee replacement, a marked reduction in knee pain and a significant improvement in daily life activities such as walking / climbing stairs are achieved. When you are discharged from the hospital, you will be able to walk inside the house using a support. Your pain is noticeably improved and going out on an independent street is different for each patient, but is between 4 and 8 weeks. It is not suitable to do sports that require running, jumping, and heavy work after total knee replacement, such activities will shorten the life of the prosthesis. Non-compulsory sports such as walking, golf, swimming can be done. There is no problem driving a car.
The curvature and deformities that existed in your leg before surgery are corrected during surgery, this will prolong the life of the knee prosthesis. However, this range of motion is less, especially in overweight patients. The average range of motion is around 115 degrees, so it is often not possible to squat or pray on the ground after the knee replacement. Although techniques and designs that increase knee range of motion have been applied in recent years, it may be inconvenient for patients to sit under their feet and sit for long-term survival of the knee prosthesis.
In over 90% of patients with total knee replacement, a marked reduction in knee pain and a significant improvement in daily life activities such as walking / climbing stairs are achieved. When you are discharged from the hospital, you will be able to walk inside the house using a support. Your pain is noticeably improved and going out on an independent street is different for each patient, but is between 4 and 8 weeks. It is not suitable to do sports that require running, jumping, and heavy work after total knee replacement, such activities will shorten the life of the prosthesis. Non-compulsory sports such as walking, golf, swimming can be done. There is no problem driving a car.
The curvature and deformities that existed in your leg before surgery are corrected during surgery, this will prolong the life of the knee prosthesis. However, this range of motion is less, especially in overweight patients. The average range of motion is around 115 degrees, so it is often not possible to squat or pray on the ground after the knee replacement. Although techniques and designs that increase knee range of motion have been applied in recent years, it may be inconvenient for patients to sit under their feet and sit for long-term survival of the knee prosthesis.
Can magnetic resonance imaging (MR) be performed after Total Knee Replacement?
Most modern total knee prostheses are made of chromium cobalt alloy, an MR compatible metal. Although the tissues in the neighboring neighborhood of the knee cannot be displayed, there is no problem with the MR of another region. If you have a knee prosthesis placed before 1990, it is appropriate to consult your doctor about the brand or metal alloy for MR compatibility.
How many years does the Total Knee Replacement last?
The metal and plastic parts that make up the total knee prosthesis wear out over time due to the friction that occurs during movement. The parts of the knee prosthesis can detach from the bone that it is attached and loosen by the body's response to the metal and plastic parts that are exposed to wear and are invisibly small. The life of knee prostheses made using appropriate surgical techniques and modern prosthetic designs has been extended up to 15-20 years today.
The relaxed knee prostheses can be removed and replaced by a second operation in most patients, but the life of the second prosthesis is not as long as the first one. In order to diagnose problems such as wear and relaxation, it is appropriate to check your knee prosthesis with regular examinations and x-ray examinations even if you do not have complaints. Your doctor will tell you when to come for a checkup.
What complications can be seen?
Serious complications after total knee replacement surgery occur at a very low rate. The most common problem is a blood clot in your veins (deep vein thrombosis) due to the slowing of blood flow in your leg. After the operation, preventive treatment is applied with drugs that dilute the blood. This treatment can be extended up to 20 days if necessary. Starting knee motion and walking in the early postoperative period and avoiding immobility will reduce this risk. After total knee replacement, infection, ie inflammation of the prosthesis, is between 0.1% and 2%. Infection elsewhere in the body (eg, urinary tract, teeth), presence of diabetes and other chronic diseases may increase this risk. It is necessary to treat infections that may occur elsewhere in the body prior to surgery. Preventive antibiotic treatment is performed during surgery and the risk of infection is reduced by taking special precautions during surgery. If infection develops in the total knee prosthesis, repetitive surgeries, removal of the prosthesis and antibiotic treatment, and re-placement after a certain period of time may be necessary. Apart from the above, complications such as wound healing problems, vascular or nerve injuries, dislocation of some parts of the prosthesis, fractures around the prosthesis, fractures in the prosthesis itself are very rare.
What should be done to prevent infection after total knee replacement?
Even if it is low, there is a risk that bacteria that enter the blood reach your knee prosthesis and settle there and cause infection. If you are going to have a dental or urinary tract operation in the first two years after prosthetic surgery, you should definitely use antibiotics beforehand. It is important to prevent infection with an appropriate antibiotic one hour before procedures such as tooth extraction, stone cleaning and canal treatment. It will be appropriate to consult your orthopedic doctor for the dosage and duration of the antibiotic. You should also pay attention to foot care, and inform your orthopedic doctor if signs of foot and nail infections occur.
Most modern total knee prostheses are made of chromium cobalt alloy, an MR compatible metal. Although the tissues in the neighboring neighborhood of the knee cannot be displayed, there is no problem with the MR of another region. If you have a knee prosthesis placed before 1990, it is appropriate to consult your doctor about the brand or metal alloy for MR compatibility.
How many years does the Total Knee Replacement last?
The metal and plastic parts that make up the total knee prosthesis wear out over time due to the friction that occurs during movement. The parts of the knee prosthesis can detach from the bone that it is attached and loosen by the body's response to the metal and plastic parts that are exposed to wear and are invisibly small. The life of knee prostheses made using appropriate surgical techniques and modern prosthetic designs has been extended up to 15-20 years today.
The relaxed knee prostheses can be removed and replaced by a second operation in most patients, but the life of the second prosthesis is not as long as the first one. In order to diagnose problems such as wear and relaxation, it is appropriate to check your knee prosthesis with regular examinations and x-ray examinations even if you do not have complaints. Your doctor will tell you when to come for a checkup.
What complications can be seen?
Serious complications after total knee replacement surgery occur at a very low rate. The most common problem is a blood clot in your veins (deep vein thrombosis) due to the slowing of blood flow in your leg. After the operation, preventive treatment is applied with drugs that dilute the blood. This treatment can be extended up to 20 days if necessary. Starting knee motion and walking in the early postoperative period and avoiding immobility will reduce this risk. After total knee replacement, infection, ie inflammation of the prosthesis, is between 0.1% and 2%. Infection elsewhere in the body (eg, urinary tract, teeth), presence of diabetes and other chronic diseases may increase this risk. It is necessary to treat infections that may occur elsewhere in the body prior to surgery. Preventive antibiotic treatment is performed during surgery and the risk of infection is reduced by taking special precautions during surgery. If infection develops in the total knee prosthesis, repetitive surgeries, removal of the prosthesis and antibiotic treatment, and re-placement after a certain period of time may be necessary. Apart from the above, complications such as wound healing problems, vascular or nerve injuries, dislocation of some parts of the prosthesis, fractures around the prosthesis, fractures in the prosthesis itself are very rare.
What should be done to prevent infection after total knee replacement?
Even if it is low, there is a risk that bacteria that enter the blood reach your knee prosthesis and settle there and cause infection. If you are going to have a dental or urinary tract operation in the first two years after prosthetic surgery, you should definitely use antibiotics beforehand. It is important to prevent infection with an appropriate antibiotic one hour before procedures such as tooth extraction, stone cleaning and canal treatment. It will be appropriate to consult your orthopedic doctor for the dosage and duration of the antibiotic. You should also pay attention to foot care, and inform your orthopedic doctor if signs of foot and nail infections occur.
What is a total hip replacement?
Total hip replacement is the operation of replacing the calcified joint with an artificial joint in patients whose hip joint is severely damaged. The hip prosthesis consists of main parts made of cobalt chromium or titanium and plastic, metal or ceramic spacers where they join. The hip replacement can be attached to the bone in two ways. In patients with weak bone tightness, prosthesis is fixed to the bone with a filler called bone cement. This type of prosthesis is called cemented hip replacement. In younger patients with good bone tightness, the prostheses covered with a porous substance are placed very tightly inside the bone, and then the bone of the body advances through the pores on the prosthesis and provides fixation. This type of prosthesis is called a cementless hip replacement.
Total hip replacement is the operation of replacing the calcified joint with an artificial joint in patients whose hip joint is severely damaged. The hip prosthesis consists of main parts made of cobalt chromium or titanium and plastic, metal or ceramic spacers where they join. The hip replacement can be attached to the bone in two ways. In patients with weak bone tightness, prosthesis is fixed to the bone with a filler called bone cement. This type of prosthesis is called cemented hip replacement. In younger patients with good bone tightness, the prostheses covered with a porous substance are placed very tightly inside the bone, and then the bone of the body advances through the pores on the prosthesis and provides fixation. This type of prosthesis is called a cementless hip replacement.
Who is the Total Hip Replacement?
In patients who are severely damaged due to hip joint arthritis, hip dislocation, fracture or vascularization disorder, hip prosthesis is applied if other treatment methods (drugs, physical therapy, intra-articular injections, cane use) are not achieved. Hip prosthesis is the best treatment option in cases of severe pain, limitation of movement and shortness that prevent daily life activities. It is preferable that the patient is over 60 years of age, but where necessary (eg rheumatoid arthritis) it can also be applied to younger patients. Attempts made with larger incisions and injuries of large muscle groups, today, smaller incisions and hip circumference can be done by taking care of soft tissues. This facilitated the return to daily life activities after surgery. Thanks to the improvements in post-operative pain control, hospital stay has been shortened.
What does Total Hip Replacement make?
After hip replacement surgery, hip pain completely disappears in most of the patients, and significant improvement is provided in daily life activities such as walking and climbing stairs. Leg shortness between 2-3 cm can be removed. It is not appropriate to do activities such as running, jumping, and heavy work after prosthetics. These will lead to premature wear of the prosthesis. It is not appropriate to sit on low chairs and cross your legs, especially in the first 6 months after the prosthesis. You should not sit on the floor table and the Turkish toilet for life. Such excessive movements can lead to dislocation of the hip joint and repeated surgeries. If you pray, you have to do this by sitting in the chair. You can drive 6-8 weeks after surgery, but the driver's seat should be high and the hip joint should not be bent excessively. Your doctor will inform you about this. There should be a pillow between your legs while lying for six weeks. Some of these restrictions may not apply to hip designs that are newly designed and have large head structures. You can do sports such as swimming, golf, walking, and exercise bikes 6 weeks after the prosthesis surgery. Sports such as tennis, football, basketball are not suitable.
Does Total Hip Replacement have a lifetime?
The parts that make up the total hip replacement wear out over time due to the friction that occurs during movement. Prostheses are separated from the bone they are attached to by the body's response against metal and plastic pieces that are exposed to abrasion and invisibly small. This leads to painful prosthesis relaxation. The lifetime of hip prostheses, which are made by using appropriate surgical techniques and modern prosthetic designs, has been extended up to 15-20 years today. It is expected that this period will be longer in the newly developed hip prostheses with ceramic and metal interfaces. Excessive weight and repetitive challenging activities will increase wear and shorten the life of the prosthesis. The relaxed prostheses can be removed and replaced by a second surgery in most patients, but the second surgery is more difficult, requires the use of larger dentures, and the life of the second prosthesis is not as long as the first.
In patients who are severely damaged due to hip joint arthritis, hip dislocation, fracture or vascularization disorder, hip prosthesis is applied if other treatment methods (drugs, physical therapy, intra-articular injections, cane use) are not achieved. Hip prosthesis is the best treatment option in cases of severe pain, limitation of movement and shortness that prevent daily life activities. It is preferable that the patient is over 60 years of age, but where necessary (eg rheumatoid arthritis) it can also be applied to younger patients. Attempts made with larger incisions and injuries of large muscle groups, today, smaller incisions and hip circumference can be done by taking care of soft tissues. This facilitated the return to daily life activities after surgery. Thanks to the improvements in post-operative pain control, hospital stay has been shortened.
What does Total Hip Replacement make?
After hip replacement surgery, hip pain completely disappears in most of the patients, and significant improvement is provided in daily life activities such as walking and climbing stairs. Leg shortness between 2-3 cm can be removed. It is not appropriate to do activities such as running, jumping, and heavy work after prosthetics. These will lead to premature wear of the prosthesis. It is not appropriate to sit on low chairs and cross your legs, especially in the first 6 months after the prosthesis. You should not sit on the floor table and the Turkish toilet for life. Such excessive movements can lead to dislocation of the hip joint and repeated surgeries. If you pray, you have to do this by sitting in the chair. You can drive 6-8 weeks after surgery, but the driver's seat should be high and the hip joint should not be bent excessively. Your doctor will inform you about this. There should be a pillow between your legs while lying for six weeks. Some of these restrictions may not apply to hip designs that are newly designed and have large head structures. You can do sports such as swimming, golf, walking, and exercise bikes 6 weeks after the prosthesis surgery. Sports such as tennis, football, basketball are not suitable.
Does Total Hip Replacement have a lifetime?
The parts that make up the total hip replacement wear out over time due to the friction that occurs during movement. Prostheses are separated from the bone they are attached to by the body's response against metal and plastic pieces that are exposed to abrasion and invisibly small. This leads to painful prosthesis relaxation. The lifetime of hip prostheses, which are made by using appropriate surgical techniques and modern prosthetic designs, has been extended up to 15-20 years today. It is expected that this period will be longer in the newly developed hip prostheses with ceramic and metal interfaces. Excessive weight and repetitive challenging activities will increase wear and shorten the life of the prosthesis. The relaxed prostheses can be removed and replaced by a second surgery in most patients, but the second surgery is more difficult, requires the use of larger dentures, and the life of the second prosthesis is not as long as the first.
How will my Hip Replacement Surgery be?
Total hip prosthesis can be done with general or epidural (waist numb) anesthesia. The surgery takes around 2 hours. Epidural or intravenous pain pumps are used to prevent pain after surgery. Blood can be given through the vein for the blood you lost during and after the operation. In the first few days, a V-shaped pillow can be placed between your legs. Respiratory exercises are started after being sober. You will stand up on the day after the operation. You can walk short distances using a walker or crutch. Since it is not appropriate to sit in low places, you should use toilet riser devices in the hospital and at home. It may be necessary to avoid putting a full load on your operated leg for a certain period of time, in accordance with your doctor's recommendations. The hospital stay is between 3-7 days. After discharge, it is very important to do the exercises recommended to you at home. To prevent blood clots from forming on your legs, it may be necessary to use blood-thinning medications for a while after leaving the hospital.
Avoid after surgery !!
• Do not cross your legs for at least 8 weeks.
• Do not lean forward while sitting and take anything off the ground
• Do not raise your knees above hips.
• Do not sit on the Turkish toilet
• Do not lean forward excessively while sitting and standing up
What complications can happen after a total hip replacement?
Serious complications after total hip replacement surgery occur at a very low rate. The most common problem is a blood clot in your veins (deep vein thrombosis) due to the slowing of blood flow in your leg. To prevent this, protective treatment is applied with drugs that dilute the blood after surgery. This treatment can be extended up to 20 days if necessary. Starting walks in the early postoperative period and avoiding standing still will reduce this risk. Use of varicose socks is useful After total hip replacement, infection, ie inflammation of the prosthesis, is seen between 0.1% and 1.5%. Infection elsewhere in the body (eg, urinary tract, teeth), presence of diabetes and other chronic diseases may increase this risk. It is necessary to treat infections that may occur elsewhere in the body prior to surgery. Preventive antibiotic treatment is performed during surgery and the risk of infection is reduced by taking special precautions during surgery. If an infection develops in the hip prosthesis, repetitive surgeries, procedures such as removal of the prosthesis and re-placement after a certain period of time may be necessary. After total hip replacement, displacement of the prosthesis occurs between 5-8%. It is very important to avoid certain movements, especially during the first 6 weeks after surgery. With the advances in surgical techniques and prosthetic design, dislocation rates have decreased compared to previous years. Special measures are taken to eliminate height inequality between the legs during the operation. However, in some cases, it may be necessary to lengthen the leg length to maintain the soft tissue balance in the hip and prevent the risk of dislocations. It does not cause any problem as the length differences up to 2 cm will be balanced by the body. If necessary, the problem can be solved by placing a height in the shoe. Apart from the above, complications such as wound healing problems, vascular or nerve injuries, dislocation of some parts of the prosthesis, fractures around the prosthesis, fractures in the prosthesis itself are very rare.
What should I do to prevent infection after total hip replacement?
Even if it is low, there is a risk that microbes that enter the blood reach your hip prosthesis, settle there and cause infection. If you are going to undergo a dental or urinary tract surgery within the first two years after hip replacement surgery, you should definitely use antibiotics beforehand. It is important to prevent infection with an appropriate antibiotic one hour before procedures such as tooth extraction, stone cleaning and canal treatment. It will be appropriate to consult your orthopedic doctor for the dosage and duration of the antibiotic. You should also pay attention to foot care, and inform your orthopedic doctor if signs of foot and nail infections occur.
Kiss. Dr. Fecri FARM
Total hip prosthesis can be done with general or epidural (waist numb) anesthesia. The surgery takes around 2 hours. Epidural or intravenous pain pumps are used to prevent pain after surgery. Blood can be given through the vein for the blood you lost during and after the operation. In the first few days, a V-shaped pillow can be placed between your legs. Respiratory exercises are started after being sober. You will stand up on the day after the operation. You can walk short distances using a walker or crutch. Since it is not appropriate to sit in low places, you should use toilet riser devices in the hospital and at home. It may be necessary to avoid putting a full load on your operated leg for a certain period of time, in accordance with your doctor's recommendations. The hospital stay is between 3-7 days. After discharge, it is very important to do the exercises recommended to you at home. To prevent blood clots from forming on your legs, it may be necessary to use blood-thinning medications for a while after leaving the hospital.
Avoid after surgery !!
• Do not cross your legs for at least 8 weeks.
• Do not lean forward while sitting and take anything off the ground
• Do not raise your knees above hips.
• Do not sit on the Turkish toilet
• Do not lean forward excessively while sitting and standing up
What complications can happen after a total hip replacement?
Serious complications after total hip replacement surgery occur at a very low rate. The most common problem is a blood clot in your veins (deep vein thrombosis) due to the slowing of blood flow in your leg. To prevent this, protective treatment is applied with drugs that dilute the blood after surgery. This treatment can be extended up to 20 days if necessary. Starting walks in the early postoperative period and avoiding standing still will reduce this risk. Use of varicose socks is useful After total hip replacement, infection, ie inflammation of the prosthesis, is seen between 0.1% and 1.5%. Infection elsewhere in the body (eg, urinary tract, teeth), presence of diabetes and other chronic diseases may increase this risk. It is necessary to treat infections that may occur elsewhere in the body prior to surgery. Preventive antibiotic treatment is performed during surgery and the risk of infection is reduced by taking special precautions during surgery. If an infection develops in the hip prosthesis, repetitive surgeries, procedures such as removal of the prosthesis and re-placement after a certain period of time may be necessary. After total hip replacement, displacement of the prosthesis occurs between 5-8%. It is very important to avoid certain movements, especially during the first 6 weeks after surgery. With the advances in surgical techniques and prosthetic design, dislocation rates have decreased compared to previous years. Special measures are taken to eliminate height inequality between the legs during the operation. However, in some cases, it may be necessary to lengthen the leg length to maintain the soft tissue balance in the hip and prevent the risk of dislocations. It does not cause any problem as the length differences up to 2 cm will be balanced by the body. If necessary, the problem can be solved by placing a height in the shoe. Apart from the above, complications such as wound healing problems, vascular or nerve injuries, dislocation of some parts of the prosthesis, fractures around the prosthesis, fractures in the prosthesis itself are very rare.
What should I do to prevent infection after total hip replacement?
Even if it is low, there is a risk that microbes that enter the blood reach your hip prosthesis, settle there and cause infection. If you are going to undergo a dental or urinary tract surgery within the first two years after hip replacement surgery, you should definitely use antibiotics beforehand. It is important to prevent infection with an appropriate antibiotic one hour before procedures such as tooth extraction, stone cleaning and canal treatment. It will be appropriate to consult your orthopedic doctor for the dosage and duration of the antibiotic. You should also pay attention to foot care, and inform your orthopedic doctor if signs of foot and nail infections occur.
Kiss. Dr. Fecri FARM