Knee Replacement
NORMAL KNEE WORKS.

The Knee joint is the largest joint in the body and made up of the lower end of the thigh bone(femur),which rotates on the upper end of the shin bone(tibia) and knee cap(patella)which slides in a groove on the end of the cartilage of femur. Cartilate of the joint is a smooth substance that cushions the bones and enables them to move easily & friction free.

All remaining surfaces of the knee are covered by a thin,smooth tissue liner called the synovial membrane. This membrane releases a special fluid that lubricates the knee which reduces friction to nearly zero.

ARTHRITIS OF THE KNEE JOINT

The most common cause of chronic knee pain and disability is arthritis. Arthritis is nothing but wear & tear of the cartilage of the joint & leaving the joint surface rough with exposed bone ends. Osteoarthritis(wear and tear arthritis), rheumatoid arthritis(inflammatory form of arthritis) and post traumatic arthritis are the most common forms.

Management of knee arthritis .
 
Lifestyle modification – don’t sit on floor, don’t squatt, don’t climb stairs, use of support while walking – stic, walker
Weight Control
Exercise and physical therapy-Q-drill,hip&knee flexion,ankle-toe movement.
Anti-inflammatory medication ( pain killers – cautious use)
Joint nourishing medicines – dietary supplements – glucosamine, chondroitin, diacerin etc.
Steroid Injection ( intraarticular) – recommened only for old age patients where surgery is not possible
Joint fluid therapy (hyaluronic acid) – recommended only in young age patients with early or very early osteoarthritis
Arthroscopic lavage of joint – recommended early degenerative knee & young patients
Valgus osteotomy – recommended only in isolated medial compartment osteoarthritis
Knee Replacement.

Total Knee Replacement(TKR) when ?

•    Experience significant pain.
•    Loss of Knee function.
•    Little or no mobility.
•    Leading to desability.
•    Poor Quality of Life due to pain & restrictions.
•    Grade 3 & 4 types of osteoarthritis

AIMS :

•    To Restore normal joint line.
•    To restore mechanical axis of lower limb.

Objective :

•    To relevie pain
•    To Provide painless gait.
•    To offer maximum rang of motion.
•    To settle normal mobile life.

Technique :

To Replace only articular surface of lower end of femur & upper end tibia & patella removal of cartilage and replacing it with artificial material. improvement in surgical materials and techniques since then have greatly increased its effectiveness.whether you are exploring treatment options or have already decided with your orthopedic surgeon to have total knee replacement surgery.

Type of Implants :

1. Function wise  
  •  cruciate retaining(CR)  
  • cruciate sacrificing(PS)  
2. Material Wise  
  •  All Poly.  
  •  Metal back-(Regular ,Hi flex & super flex)
•  Metal back with prolong poly.
   
  •  Metal back with higly-polished tibia.
•  Metal back with higly-polished tibia.
   

Type of Implants :

•   36 hrs confined to bed.
•   After 36 hrs mobilization(walking) with support.
•   3rd day walking without support.
•   4th & 5th day discharge.
•   At home mild exercise & day to day activity(no rest).
•   Between 12th -15th days stitch removal.
•   As per prognosis & recovery continuation of exercise at home fore further 1 to 3 weeks.
•   Enjoy free,mobile,painless life after 1 month.
•   As such no regular follow-ups are required but can be done as and when require.

Note:

No Newer technology (implant design)is yet registered internationally which physiotherapy exercises are not require.

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