Knee-Joint Replacement

Manila Bulletin, March 28, 2007 | Go to article overview

Knee-Joint Replacement


Byline: Dr. Gary S. Sy

THE procedure of knee joint replacement is called a total knee arthroplasty (TKA). This surgery involves replacing your knee joint with a man-made one. Doctors may replace your knee joint to end pain, stiffness, and loss of function.

Knee Joint Replacement Causes

Both chronic osteoarthritis and rheumatoid arthritis commonly cause people to lose knee function to the degree that they need a knee joint replacement (total knee arthroplasty or TKA). But knee damage may also steam from injury or infection. Generally, people require a TKA a decade earlier due to rheumatoid arthritis as opposed to osteoarthritis. *

The most common problems with a knee joint replacement

* Fractures (breaks) of the new knee after a fall or other accident

* Pain from slippage and wear in the new joint

Other less common problems

* Infection of the joint

* Dislocation, either complete or pertial, of the new knee

* A blood clot in a vein (deep venous thrombosis) above or below the knee (Clots occur most commonly shortly after replacement surgery).

Knee Joint Replacement Symptoms

* Many people who fall after having a knee replacement break the bone below the new joint on which the new knee is anchored. Pain and swelling occur at or near the site of the knee join replacement.

* Pain can occur gradually as the new joint develops wear patterns that interfere with the smooth function of your knee.

* Slippage can cause bony surfaces to move opposite each other and cause pain.

* This pain increases the more steps you take and decreases when you sit.

* This pain of movement differs from the normal start-up pain that occurs in the first 3-6 months after knee replacement and that decreases over the first few steps.

* Infection will cause pain, along with frequent redness and swelling at the joint, even when you are at rest.

* Often fluid will collect at the knee joint from infection and cause a boggy swelling. Fluid may not accumulate with every infection.

* Fever may occur.

Dislocating the knee will cause pain.

* Deformity of the joint will be obvious.

* A dislocation may damage adjoining nerves, muscles, and blood vessels and impair their function. The popliteal artery, which carries the entire blood supply to your lower leg and foot, can be injured or pinched shot. Nerves to your lower leg can be cut or injured, causing your lower leg to become numb (paresthesia), week (paresis), or paralyzed. Arteries can be partially or totally blocked, eventually causing pain, the lower leg to turn pale and cold, poor or no pulse, and the leg to swell.

* Blood clots tend to form during the period ("post-op," or "post-operatively") when you cannot move following a

* knee replacement.

* Clots become progressively less common with time.

* A clot in your vein generally causes new pain, swelling, or redness in your lower leg.

* The greatest concern is that the clot will travel through your veins and could lodge in your lung (pulmonary embolism).

When to Seek Medical Care

Call your family doctor or orthopedist if you develop gradual pain that feels like slippage in your knee. This generally is an urgent problem, but not an emergency.

Call your doctor if you notice unexpected drainage from a poor healing of a recent surgery increasing swelling, or warmth.

Go to the hospital's emergency department if you experience any of the following:

* A fracture or dislocation after a fall

* New swelling

* New pain while resting

* Redness, or warmth at a joint suggesting infection

* Swelling, pain, or redness below your knee that suggests a clot in your vein (deep venous thrombosis or DVT)

Exams and Tests

Your doctor will base your diagnosis on clinical examination and X-rays. …

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