The knee is a hinge joint involving the thigh bone (femur) and the shin bone (tibia). Knee replacement surgery which is also known as knee arthroplasty is a technique that removes a diseased/ arthritic knee joint and replaces it with an artificial joint.
Among many other joints, the knee is the most commonly replaced joint in the human body.
Adults of any age can be considered for a knee replacement, although most are carried out on people between the ages of 60 and 80.
Types of knee replacement surgery
There are 2 main types of surgery:
Total knee replacement – Replace the whole knee joint. Total knee replacement is a common orthopedic surgery that involves replacing the articular surfaces (femoral condyles and tibial plateau) of the knee joint with smooth metal and highly cross-linked polyethylene plastic.
Partial knee replacement – A partial knee replacement is a surgical procedure to replace only one part of a damaged knee.
Partial knee replacement has several advantages over total knee replacement, including shorter recovery time and more range of motion preserved after surgery.
Types of partial knee replacement
There are 3 main types of partial knee replacement surgeries.
Unicondylar Knee Replacement
Unicondylar Knee Replacement is a procedure that replaces only the single affected compartment of the knee, either the medial or lateral compartment.
Patellofemoral Knee Replacement
Patellofemoral Knee Replacement is a procedure that replaces the worn patella (the kneecap) and the trochlea (the groove at the end of the thighbone).
Bicompartmental Knee Replacement
Bicompartmental Knee Replacement is a procedure that replaces two compartments of the knee, the medial and patellofemoral compartments.
Conditions that can be treated with knee replacement surgery
Knee replacement surgery is usually necessary when the knee joint is worn or damaged so that your mobility is reduced and you are in pain even while resting.
The most common reason for knee replacement surgery is osteoarthritis.
Other health conditions that cause knee damage include
Severe osteoarthritis
Ligament damage or infection that leads to severe osteoarthritis
Rheumatoid arthritis
Haemophilia
Gout
Avascular necrosis – the death of bone following the loss of blood supply
Bone dysplasias – disorders of the growth of bone.
Importance of physiotherapy before going for the knee replacement surgery
Pre-operative preparation begins immediately following surgical consultation and lasts approximately one month before the surgery.
Physical therapists are movement experts who improve quality of life through hands-on care, patient education, and prescribed movement. The physical therapist is an integral part of the team of health care professionals who help people receiving a total knee replacement regain movement and function and return to daily activities.
Your physical therapist can help you prepare for and recover from surgery and develop an individualized treatment program to get you moving again most safely and effectively possible.
A recent study has shown that even 1 visit with a physical therapist before surgery can help reduce the need for short-term care after surgery.
Before surgery, your physical therapist may:
Teach you exercises to improve the strength and flexibility of the knee joint and surrounding muscles.
Demonstrate how you will walk with assistance after your surgery, and prepare you for the use of an assistive device, such as a walker.
Discuss precautions and home adaptations with you, such as removing loose accent rugs that could cause you to “catch” your leg on them when maneuvering with an assistive device, or strategically placing a chair so that you can sit instead of squatting to get something out of a low cabinet. It is always easier to make these modifications before you have knee replacement surgery.
And many more.
Longer-term adjustments that are recommended before surgery include:
Stop smoking
Seek assistance to stop smoking, as your schedule and plan for your surgery. Being tobacco-free will improve your healing process following surgery.
Losing weight
Losing excess body weight may help you recover more quickly, and help improve your function and overall results following surgery
Benefits of physiotherapy before a knee replacement surgery.
Prepare for surgery both mentally and physically
Shorten hospital stays
Reduce pain and inflammation
Restore range of motion
Improve your muscular control of the injured joint
Normalize movement patterns and muscle memory before surgery
Improve overall health and fitness levels
Familiarize oneself with the exercises that you will perform immediately after surgery
Reduce complications after the surgery
References
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/knee-replacement-surgery
https://www.nhs.uk/conditions/knee-replacement/
Shehan Akalanka
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