Kneeprothesis

Kneeprothesis complaints

A knee replacement means that the knee joint is replaced with artificial material. Pain in osteoarthritis is the most common complaint leading to a knee prosthesis

Pain caused by osteoarthritis of the knee lead to:

Limited walking distance
Disturbed sleep
Walking stairs is difficult
Swollen knee
Dis-alignment of the leg may be an "O" or "X" position
Obstruction in bending of the knee

If the above symptoms limit your life, you can consider a knee prosthesis.

For information concerning a revision of your kneeprosthesis, click here.

Treatment

The procedure of a knee prosthesis surgery is as follows:

The operation is performed under general anesthesia or spinal anesthesia
Once the damaged bone has been removed, the artificial parts can be inserted and with the bone prepared to fit and stabilize the knee
With the parts inserted, the knee joint performance is examined and finally placed in position.
The wound is applied with a drain for excess of blood and/or fluid disposal, local anesthesia and closed with stitches
After 14 days the wound is inspected and stitches removed

We use the latest techniques to minimize tissue damage so that recovery is progressing at a fast pace after surgery.

Preparation

Prior to your surgery, you will have a physical examination. You visit the doctor's assistant and / or anesthesiologist to determine whether the operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.
Finally the day of surgery of is scheduled. The total hospital stay is planned for two or three days. You arrive on the day of surgery at the clinic. The days after surgery are used to recover and to receive instructions and exercise from the physiotherapist.
You should borrow crutches as you will need them to walk following your surgery. For more information click www.thuiszorgwinkel.nl.
Usually it takes the two weeks to walk with a crutch at home. If you have lack of help at home please discuss this with the transfer nurse of the Vlietland hospital or home care setting of your home.

To undergo a knee replacement is not a daily matter. A knee replacement is major surgery with an extended recovery period. It is important to consider all consequences. The better your physical condition before your treatment, the better your recovery after surgery.

Day of surgery

At your arrival please wear comfortable clothing and shoes. Bring your personal items such as medicines, clean clothes, toilet articles and your crutches with you. Leave valuables at home as much as possible.

You appear sober at the hospital
After your medical preparation prior to surgery you will positioned and treated in the operating suite
After surgery you will be moved to the recovery room to recover from your anesthesia
Back on the ward the nurse checks you out. During the immediate recovery period you are given intravenous fluids and pain medication.

The day after your surgery, the physical therapist will show you how to exercise and walking with crutches

Recovery after a knee prosthesis

The recovery period after a knee replacement comprises several months.

The days after surgery you are still hospitalized. You get pain medication and you start physical therapy immediately with instructions for home practice. After two days, the wound dressing will be removed and the wound assessed.
After a few days the pain is usually bearable and pain medication will be reduced. Additionally, blood thinners will be prescribed to prevent thrombosis and pulmonary embolism.
Two weeks after surgery you use two crutches and while progressing in recovering occur you use one crutch, used on the unoperated side.
The stitches will be removed about 14 days after surgery
Do not drive a car by yourself or ride a bike.
During 6 weeks you use the supporting stocking, day and night
During the recovery process, you will return to a more active and normal lifestyle within 6 to 12 months. The recovery period depends on the patient and his or her condition.

Complications

Even the most minor of surgical operations carries some risk of complications occurring. Knee replacement surgery is very successful, and complications are relatively uncommon, considering the complexity of the procedure. Complications may be related to anesthesia. For information, click here.

The most common complication is blood clots in the legs. The most serious complication is infection. The most important long-term complication is loosening.

Consult your surgeon with the following complications:

Bleeding in the knee after surgery
The wound remain sensitive sometimes long after surgery
There may be a thrombosis or pulmonary embolism occur
Instability of the knee prosthesis
The prosthesis ‘clicks’ during movements
Infection of the knee caused by the knee prosthesis
Damage to the knee prosthesis structures around the knee, such as nerves or blood vessels, which is very rare.

Expectations

Sometimes the outcome of knee surgery is not what you had expected, for example chronic pain sensations. Important: an infection elsewhere in the body (dental) pose a risk to your prosthesis. Please consult your surgeon or general practitioner

Frequent asked questions (FAQ)

How long takes a knee replacement procedure?
The average duration of a knee replacement session is between 45 and 75 minutes.

How often is knee replacement performed each year in the Netherlands?
About 18,000 knee prostheses each year. Our orthopedic surgeons are specialized in performing this procedure.

How long will a knee replacement last?
Research shows that 80% stays longer than 20 years. Each individual has potential differences, especially in relative young patients and heavy use can shorten the lifecycle.

Is a knee revision possible?
Replacing the replacement knee is usually more complicated and a longer procedure than the original surgery. There is no set limit to the number of times you can have revision surgery, but it is widely accepted that the artificial knee joint becomes less effective each time it is replaced.

What are the consequences of an infection of the knee replacement?
When a total joint replacement becomes infected, it may loosen, become painful, and need to be removed. When infections occur within 6 weeks after surgery it is treated by extensive rinsing of the knee and giving antibiotics. Unfortunately, even if the implant is washed clean during surgery, most types of infections require removal of the implant to cure the infection.

My knee makes clicking noises. Why is this and can it hurt?
In knee replacement, the ends of the bones that make up the knee joint are “resurfaced” with metal and plastic components. Because there is almost always some laxity in a replaced knee, clicking can sometimes be heard as a result of contact between the metal and plastic components during activity. Often it is heard during a transition from low or non-weight bearing to weight bearing. For example, a patient may hear the click while walking as the leg comes out of swing phase and makes contact at heal strike. For the most part, the clicking is usually not associated with any adverse conditions

Should I take antibiotics for treatment by the dentist if I have a knee replacement?
Patients who have joint replacement surgery are at risk for developing infections of the implanted joints. Once bacteria that has traveled through the bloodstream find implanted joints, the body's immune system has a difficult time fighting the infection. Because of concerns about the severity of infection of a joint replacement, the national guideline of the Association of Orthopedic specialists now recommends that antibiotics be given before an invasive dental procedure no matter how long it has been since the joint replacement procedure.

How old do I have a knee replacement to get?
For young people with arthritis (usually under age 40-50) it is desirable to avoid a joint replacement if possible, since patients in that age group are very likely to outlive the joint replacement. In those individuals, who represent a very unusual circumstance, there are other surgical options available. For people in "middle age" or older, a knee replacement is usually the best choice to relieve the pain of knee arthritis, and restore a reasonable level of function.

Do you use prosthesis called "Gender Knee Replacement"?
A gender-specific total knee replacement implant is a prosthesis that is specifically designed either for a male or a female. But there is no data to suggest that creating a gender-specific implant design will help achieve the goals of better function or improved durability. We use implants that already come in a variety of sizes that will accommodate almost any patient's anatomy.

Will I ‘beep’ at an airport, with knee prosthesis, as I go through the gate?
Not common but especially in thin patients or multiple implants it can happen.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.