Endoprosthetics of the knee joint is caused, most often by arthrosis or arthritis. In the case of these diseases, the main symptoms are pain during movement and limitation of mobility. A sore knee can cause discomfort after a load during a night's sleep. For some time, the symptoms can be temporarily weakened by medications, as well as physiotherapy procedures.
However, if pain constantly causes a person suffering, endoprosthetics of the knee joint can be an effective treatment option.
The aim of the operation is to facilitate movement, reduce pain, improve the quality of life, return work capacity.
In case of partial injury of the knee joint, revision endoprosthesis is used, that is, a partial endoprosthesis is put. With complete defeat, a total knee replacement is performed.
Complications after surgery
- Bacterial infections of endoprostheses.
- Deep vein thrombosis of the lower extremities.
- Endoprosthesis offset.
To prevent infection, patients receive antibacterial treatment. To prevent thrombosis, prescribe a set of exercises that maintain the state of muscle tone, improve blood circulation. It is also recommended to wear compression stockings and taking antithrombotic medications.
The knee joint endoprosthesis consists of materials that do not wear out for a long time. Therefore, his shift, when all the recommendations of the doctor, the patient may not be threatened. When the prosthesis is displaced or worn out, replace it. However, the risk of a repeat operation can occur no earlier than 15 years.
Preparation for endoprosthetics
The operation to replace the knee joint requires careful preparation, since it exerts a strain on the patient's body. The better the patient will be, the sooner the rehabilitation period will be. Therefore, it is desirable to bring chronic diseases to a state of persistent remission. Especially if it is a disease of the cardiovascular or endocrine system.
In order to reduce the risk of infection of the prosthesis, the patient beforehand removes all possible foci of inflammation. So complicate the postoperative period can infection of the genitourinary and respiratory system, diseases of the oral cavity, nails, skin, as well as infected wounds.
Traditional methods of treatment of knee arthrosis
Before endoprosthetics, check the condition of the teeth and, if necessary, treat them. It is known that the centers of inflammation in the mouth can cause infection in the circulatory system. The operation can be postponed for at least a week if the tooth was removed during the treatment. The risk of complications can also be caused by latent infections of the teeth or intra-maxillary foci. For their detection, an x-ray examination of the jaws is prescribed. This applies to people who do not have their own teeth.
In order for the patient to recover more quickly after the operation, a diet is prescribed in advance. The food should be balanced with sufficient fluid intake. This can promote early healing of wounds and improve the immune response of tissues to a possible infection. Obesity can also complicate the postoperative period. Therefore, the patient is corrected for weight.
The operation can be postponed if the patient has skin lesions: diaper rash, ulcers, skin inflammation. Before the operation, all this must be eliminated. Therefore, it is recommended to contact the dermatologist for another month. Women are not advised to remove the hair on their body before the operation alone or in cosmetology salons. One of the stages of preparation for surgery is to strengthen the muscle tone and preserve the mobility of the joints. Physical exercises contribute to a quick recovery.
The effect of smoking and alcohol
It is recommended that smokers stop smoking in advance( no later than a month).Smoking and alcohol intake worsen blood circulation and can cause thrombosis, increase the risk of infection during rehabilitation, and worsen fixation of the endoprosthesis.
With strong dependence on tobacco, it is recommended to replace smoking with nicotine patch or special nicotine chewing gum. The same recommendations the patient must make regarding the intake of alcohol.
Admission to the hospital
When entering the hospital, the patient is interviewed, examined and informed about the forthcoming operation. It is mandatory in the pre-operative period, the patient is assigned blood and urine tests, chest X-ray examination, ECG( if necessary, ECHO), spirogram and other studies according to indications.
Before the operation, the anesthesiologist and surgeons assess the status of important patient systems, determine the risk of negative effects on the course of the operation and the postoperative period of diabetes and arthritis. The cost of surgery depends on the type of endoprosthesis and the condition of the knee joint.
The patient receives anesthesiologist-appointed medication on the day of surgery. The urinary catheter is already installed in the operating room. Anesthesiologist determines what anesthesia will be in the course of the operation. The time operation lasts approximately 2-4 hours, depending on the condition of the joint.
During the operation, the affected segments of the joint are replaced with a prosthesis, which is selected individually, taking into account the state of bone tissue, as well as the peculiarities of the structure of the knee joint. Endoprosthesis of the knee joint is fixed with a special cement.
After endoprosthetics, the patient is under the supervision of the resuscitator or anesthesiologist for several hours( possibly until the next morning) in the intensive care unit, then, in the absence of complications, is transferred to his department.
Postoperative treatment of
After surgery, the patient will need two crutches, dressing devices. The patient before the operation has a sense to think about how he will cope at home with small household matters, since after the operation he will have to use crutches for a long time.
To prevent thrombosis appoint special medications that are administered throughout the period of stay in the hospital and after discharge for 2-3 weeks. Drugs are administered under the control of blood coagulability. To prevent thrombosis, it is necessary to perform active foot movements.
To reduce the intensity of pain, the patient is prescribed analgesics. In the intensive care unit, the patient is prescribed intravenous nutrition until the next day. In the future, the patient is transferred to a common table. To prevent swelling of the operated joint and control the outflow of fluid, postoperative drainage is established. Usually, it is removed as early as the second day after surgery.
To prevent venous congestion and edema, treatment with a position is recommended. Under the foot, put a pillow, avoid prolonged standing in one pose, maximally straighten legs in a state of rest. With a small puffiness, local cold treatment is performed and a set of exercises for flexion and extension of the feet is prescribed.
Physiotherapeutic procedures and walking
On the second day after the operation, the patient is allowed to stand under the supervision of a nurse and a physiotherapist. The operated leg is allowed to be loaded before the onset of pain. Also in the recovery complex include exercises to strengthen the muscles of the hip.
If there are no complications, exercise is prescribed in walking. Their duration will increase as the patient feels better. In addition, the patients are trained to correctly perform the flexion and extension of the knee joints. If necessary, it is recommended to use devices that will help to bend and unbend the knees. The goal of complex exercise therapy is to improve mobility in the joints, so that the patient could feel more confident after discharge and independently perform gymnastics.
After the operation, you need to learn to walk on crutches. If only one joint is operated, it is correct to move with support on one leg, if both joints - move with an alternating step( first the right crutch and the left leg, then the left crutch and the right leg are removed).To step on the operated leg is necessary from the heel.
Restoration after operation at home
If there are no complications, and the patient feels satisfactory, the discharge can be as early as a week after the operation. At endoprosthetics of both joints - after 10 days. The condition for discharge from the hospital is also the independent movement of the patient.
The patient is given complete instructions for continuing recovery at home. After discharge from the hospital, you need to register with the clinic. It is important to monitor your health. If there is severe pain or inflammation of the wound surface, you should immediately contact an operating surgeon.
According to the recommendations received in the hospital, it is necessary to perform a set of physical exercises. Only after the patient has stopped limping, it is allowed not to use crutches. A month after the operation, it is recommended to practice aquatic gymnastics. However, you should be as cautious as possible, going down to the pool on the stairs. Recommend walking on skis. An important aspect in the rehabilitation period is weight control.
You can not engage in those sports that can trigger a joint displacement - ball game, jumping, running. If, during the performance of the recommended exercises, the operated leg begins to ache or swell, the intensity of training should be reduced.
Recommendations for patients
To avoid injury in winter, use special shoes or use crutches( also with attachments) when walking on a slippery surface. The car can be driven as soon as the overall condition permits. A certificate stating the presence of an endoprosthesis should be taken with you when planning your flights.
About your prosthesis should be reported to the dentist, because through the wound surface in the treatment of teeth, the infection can with blood flow get into the endoprosthesis. The same should be done when treating internal organs from other specialists.
For the perfect service of the prosthesis of the knee joint and the maximum period of its operation it is necessary to conduct periodic preventive examinations at the doctor. This can prevent possible changes in the prosthesis. Usually, an X-ray examination of the operated joint is performed every two or three years.
- Possible complications
- Preparation for endoprosthetics
- Admission to the hospital
- Postoperative treatment
- Physiotherapy procedures and walking
- Home rehabilitation
- Recommendations for patients