As the largest joint in the body, the knee is easily injured and is susceptible to aging, arthritis, and “wear and tear” complications.
Arthritis causes stiffness, pain, and swelling in joints. It affects several different parts of a joint including cartilage, which is a tough shock-absorbing material that covers the ends of our bones to prevent friction and bone on bone contact. Sometimes arthritis causes the cartilage to wear away leading to extremely painful bone on bone friction inside the joint.
Symptoms of knee arthritis can be managed by many with medications and lifestyle adjustments but some cases are more severe and require a knee replacement surgery to restore functionality and remove pain. During a knee replacement surgery also known as knee arthroplasty the damage portion of the knee joint is removed and is replaced with artificial implants or prosthetics. Knee replacement is a common joint replacement surgery with a high success rate at reducing pain and restoring function.
Symptoms
Severe knee arthritis is moderate to severely painful that can cause pain while moving or at rest. In some cases the pain is so severe that it can prevent restful sleep. The knee is often stiff, swollen, and unstable and might angle inward or outward instead of being straight.
Knee pain and mobility with severe arthritis can limit your everyday activities like walking, climbing stairs, and getting in and out of chairs. With this kind of arthritis pain medications, physical therapy, and rest may not provide relief.
Diagnosis
Through a physical examination and cross referencing medical records, Dr. Alani can diagnose knee arthritis. During the examination process, you will need to provide answers to questions about pain, mobility, and medical history. You will also be asked to perform simple movements of the knees and may have to take blood and laboratory tests to assess the type of arthritis you have. X-ray and MRI scan may also be ordered to give Dr. Alani a clear roadmap of your knee joint and the specific areas that are causing problems.
Treatment
After medication, rest, and physical therapy have been tried and your arthritis has progressed beyond your ability to live a normal daily life knee arthroplasty is recommended. Once non-surgical treatments fail to relief symptoms replacement surgery is the next step.
Surgery
Knee Replacement Surgery (Knee Arthroplasty) is the removing of the damaged area of the knee joint and replacing it with an artificial implant. This process, depending on the case, can be a short one or two-day inpatient procedure or sometimes is outpatient and you’re home the same day.
During surgery, you will have either general anesthesia or spinal anesthesia. The main difference is general anesthesia puts you to sleep where spinal anesthesia numbs the body from the waist down. Dr. Alani will discuss these with you and help you decide which is best.
There are several kinds of artificial knee joints and Dr. Alani will choose which one best suits your specific case based on age, weight, activity level, and health. These artificial joints consist of three parts. The new piece for the end of your femur is made of highly polished metal. The tibial component, for the top of your leg, is made of metal and plastic. The patellar part is made of plastic and fits inside of your kneecap. These may be cemented in place and once healed will allow for pain free movement of the joint.
Recovery
During recovery, you will have several medications for pain, swelling, and to prevent blood clots. The doctor may prescribe blood thinners and special support stockings. Elevation of the leg and movement of the foot and ankle is required. Dr. Alani might prescribe a compression boot and Continuous Passive Motion Machine to gently squeeze your leg to aid with blood circulation. The Continuous Passive Motion Machine will move your leg in a cycling motion while in bed to improve circulation, reduce swelling, and restore movement to the knee joint.
Exercise is extremely important for recovery and you will be walking almost immediately after surgery. Most likely you will start working with a physical therapist the day after surgery with a walker or crutches. Your physical therapist will help you strengthen your knee and re-teach you how to walk and traverse stairs.
During your first few days at home you may need a bit of help getting around. If you don’t have someone that can help you speak with your physician about alternative arrangements. In about three to six weeks you should be able to resume most regular activities. Generally, a majority of patients see a dramatic reduction in knee pain and an increase in overall strength and mobility after surgery. After successfully performing over 5000 knee arthroplasty surgeries, Dr. Alani is a highly skilled expert.