Knee prosthesis
The hip, knee and ankle joints that allow us to walk, and the shoulder joint that allows us to use our hands and arms to do work, often undergo prosthesis surgery (arthroplasty). are our applied joints.
Of these; Hip and knee are the joints that most commonly undergo prosthetic surgery. Our leg joints, which enable us to carry out the movements we do in our daily lives such as carrying our body weight for years, doing sports, sitting and standing, begin to deteriorate and cause problems over time. It is used with an average of 4000-10,000 cycles. In a person doing sports, it increases up to 14-20 thousand cycles in a period of 15-20% of the day. Joint cartilages deteriorate over time due to aging, weight, daily use and genetic factors.
This deterioration limits the movements of the joint over time. It causes pain. It prevents us from performing our daily life movements.
Knee joint is the most common;
- Osteoarthritis (the disease popularly known as calcification),
- Rheumatoid arthritis (known as inflammatory rheumatism). )
- It deteriorates as a result of trauma (fractures and joint injuries).
Drug treatments and exercises are applied depending on the degree of deterioration and age. Then, physical therapy and intra-articular injection treatments are applied. If the deterioration does not improve with medical treatment; Meniscus surgeries, cartilage repairs, medical and biological solutions are applied. As the deterioration increases, the joint becomes difficult to perform normal daily activities. He/she begins to be unable to walk due to pain and has difficulty going up and down stairs.
Biological solution to protect the joint after this stage; It does not exist in today's conditions.
The thing to do is to decide on the lifestyle. It is either choosing to use medication continuously, accepting the reduction of daily activities, or, if the health condition allows, accepting the replacement of the knee joint with artificial materials (knee prosthesis).
In which cases knee prosthesis is used? Is it applied?
Knee prosthesis is applied for two reasons. Pain and limitation in daily life. Although pain is an important factor; To reveal the extent to which the joint is damaged and whether solutions to protect the joint are possible. must be ace. If treatments that will protect the joint are possible, these treatments should be applied first. If the joint becomes deformed over time and loses its movement, the patient will have difficulty in performing daily life. He/she begins to have difficulty walking, difficulty going up and down stairs, and difficulty sitting down and standing up. If the joint is damaged beyond repair, prosthesis surgery is recommended if age and health condition allow. The average lifespan of a knee prosthesis in the human body is 15-20 years.
Therefore, knee prosthesis application is recommended between the ages of 50-80. Under 50 years of age; We try not to perform knee prosthesis as much as possible. However, in cases of inflammatory rheumatic disease or serious intra-articular fractures, we sometimes perform knee prosthesis at an early age. We generally do not recommend knee prosthesis for people aged 80 and over. Due to the patient's general health condition, existing diseases and osteoporosis, the postoperative recovery period is prolonged and the rate of complications increases.
For these reasons; general condition and complications of knee prosthesis surgery after this age The decision is made by evaluating the activity level.
Are there complications of knee prosthesis surgery?
After knee prosthesis surgery, 4 main problems are encountered. These are;
Infection,
Intravascular blood clot in the leg veins and the resulting embolism
Pain
Pain
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Technical problems related to prosthesis application
We take various precautions to avoid these complications. The patient whose surgery is planned; If there is a dental abscess, urinary tract infection or any previous infectious disease, surgery is not performed until their treatment is completed. Necessary precautions are meticulously applied during the post-operative care period. In addition; Antibiotic treatment is applied to the patient who will undergo prosthesis surgery to prevent infection on the day of surgery.
Blood thinners are used to avoid thrombo-embolism or intravascular blood clotting in the leg veins and the resulting embolism problem. Additionally, mechanical measures are taken until the patient is able to stand up. Compression socks and foot-leg muscle exercises are started early.
Pain and technical problems related to prosthesis application may occur. other problems.
The incidence rate of all these complications does not exceed 10%.
Are there different types of knee prosthesis?
Knee prosthesis; It is the process of replacing the bone surfaces that form the joint with metal surfaces. According to the number of replaced surfaces; Total knee prosthesis and unicompartmental knee prosthesis are commonly performed. Cemented, uncemented; There are alternatives such as ligament preserving and ligament cutting.
How much pain will I have after knee prosthesis surgery, when will I be able to walk, when will I return to normal?
There is surgery-related pain on the first day after the surgery. To reduce this pain, patient-controlled pain pump, various painkillers and post-operative intra-articular painkiller combinations are applied.
Although the first day is somewhat painful, pain is generally at an acceptable level from the second day.
Rehabilitation after knee prosthesis
After surgery, cold application is applied to eliminate the problem of increased temperature in the front of the knee. Foot and leg pump exercises and in-bed exercises are started on the day of surgery. From the first day, muscle strengthening and joint range of motion exercises are started under the supervision of a physiotherapist.
Stand up and walk with the help of a walker begins in 24-48 hours. They are trained on how to perform daily activities such as getting out of bed, sitting, sitting on the toilet, and climbing stairs. The patient is discharged after achieving sufficient knee joint movement and being able to walk and perform daily activities at least partially.
Information is given about the exercises and practices to be performed at home.
This usually varies depending on the age and general condition of the patient. Together, the child becomes able to walk without a cane in 2-4 weeks. If sufficient joint movement cannot be achieved, 2-3. A physical therapy program is recommended for weeks.
After surgery, knee flexion becomes slightly less than in normal individuals. Although it is better than the amount of bending he had before the surgery, he has to pray in a chair, eat at the table, and go to the toilet on a seated Turkish toilet. Sitting cross-legged, which they could not do before the surgery, They cannot do it after surgery.
Is knee prosthesis a safe procedure?
Studies and our application results; has shown that knee prosthesis is a successful and reliable method with a rate of 90%. With appropriate patient selection, successful surgery technique and post-operative rehabilitation, the patient's life becomes more comfortable.
He can take his daily walks and does not have problems going up and down stairs.
Post-operatively, patients generally; They express their gratitude with feelings such as "why am I experiencing this pain? I'm glad I had surgery and I'm free from using medication every day."
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