Orthopedics is a highly specialized branch of medicine that covers the musculoskeletal system of the human body.  The musculoskeletal system covers bones, joints, ligaments, muscles, nerves and tendons.  Orthopedic surgeons are focus on diagnosing, treating and repairing injuries to these parts of the human body.

Being a highly specialized area, a typical orthopedic surgeon will spend up to 14 years of formal education to get the necessary qualifications.  In addition he or she will be expected to spend a great deal of time in updating skills and knowledge in addition to the 14 years of formal education to keep up to date with new trends and ideas.

It is quite common for a orthopedists to specialize in a particular type of injury or part of the body such as the hands, feet, knees or hips.

In the past orthopedists were mainly involved in treating crippled children.  However, this has now changed and covers the diagnosis and treatment of a wide range of musculoskeletal injuries and disorders in people from all age groups.

These days we often hear about joint replacement surgery.  This is very common treatment performed by orthopedic surgeons but there is a wide range of other conditions and injuries that come under their expertise.  These include such things as sports injuries like cruciate ligament repair, pulled muscles, broken bones, arthritis, carpal tunnel syndrome and some spinal injuries. Some specialize in problems associated with growth and development of children.  Things like scoliosis and limb length problems as well as fractures and sprains and the like that children may suffer while still in their growing and developmental stages.

Some of the work of an orthopedic surgeon may also extend to physical therapy, the prescribing of medications to treat diseases like osteoarthritis and injuries like sprains and strains.  In addition they often work with and advise physical therapists on treatments of certain conditions.

Broadly speaking the role of an orthopedic surgeon could be summarized as covering four main areas.  These are:

•    diagnosis of the injury or condition
•    putting together a treatment plan that might include medication, exercise or as a last resort, surgery.
•    Rehabilitation which could include physical therapy or exercises with the aim of restoring strength and function.
•    Prevention are supplying information and recommendations to prevent injury or slow the advancement of disease.

I can personally attest to the value of orthopedic surgeons after having recently been referred to one following breaking my ankle.  With his expertise in treating the fracture and in putting together a rehabilitation plan to strengthen and get the joints moving properly, my ankle healed beautifully and I have had no subsequent problems.  I can only imagine how someone must feel if they’ve had a major joint replaced that may have dramatically changed their life and all because of the expertise of their orthopedic surgeon.

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Runner’s Knee or patellofemoral pain syndrome is probably one of the most common ailments that affects not only runners but any athlete who participates in sports that require a lot of knee bending.  This covers sports such as cycling, walking, jumping as well as running.

At the bottom of this post is a great video that goes into runner’s knee in detail but first, let’s go over briefly what this condition is.

Although it sounds like a specific knee problem, runner’s knee is, in fact, a general term that covers several knee conditions that result from varying causes.  Diagnosis of runner’s knee is not a simple matter and should be carried out by a professional.

CAUSES OF RUNNER”S KNEE

The main causes of this condition are:

• Injury – if the knee is knocked or hit directly
• Foot problems – overpronation (flat feet or fallen arches)
• Overuse
• Muscle weakness

SYMPTOMS of RUNNER’S KNEE:

• Pain when the knee is bent
• Walking downhill or down stairs intensifies the pain
• Swelling around the knee joint
• Pain in the vicinity of the kneecap, sometimes from behind the kneecap
• When the knee is bent, there is a sensation of grinding or popping in the knee.

TREATMENT FOR RUNNER’S KNEE

There are several treatments for this condition ranging from rest to strengthening exercises to taking anti-inflammatory drugs.

Here is an excellent video that goes into detail about what runner’s knee is and explain some of the treatments for it.  It’s a long video (about 22 minutes) but if yuou are suffering from knee pain and suspect runner’s knee then I highly recommend watching it.  I hope it helps. It certainly answered a few of my questions.

KNEE PAIN – Alternatives to Knee Surgery

If you suffer from knee pain in the last thing you want to hear is that you will need to undergo knee surgery. Fortunately knee surgery is now treated as a last resort and there are several other treatments to help relieve knee pain symptoms.

Treat Knee Pain With Orthotics & Knee Braces

Sometimes the best knee pain treatment can also be the simplest. The simple thing such as changing your posture or ceasing a particular activity can be all that’s needed. In my case it was using orthotics that resulted in complete knee pain relief. All this did was to slightly change the way I walk which changed how my knee was working and the rest is history. Of course, it’s not always that easy.

Some people find using a knee brace can be a great knee pain reliever. The brace works in a similar way to orthotics in your shoes in that it changes and corrects the way the knee moves and in many cases can reduce knee joint pain greatly.

Knee Pain Relief Using Corticosteroids

In the medicinal world there are some highly effective knee joint pain relief products. One that is widely used in the treatment of knee pain and also for other types of pain is corticosteroid injections. In this treatment the knee is injected directly with the medication. Although usually not permanent, many people get relief from their joint and knee pain which lasts sometimes many months. It may not be suitable for every patient. Your medical practitioner or specialist will advise if the procedure would be of benefit.

Effective Creams For Knee Pain Relief

There are also creams which in some cases can be effective knee pain treatments. Again they may not be suitable to treat all types of knee pain but can be effective pain treatment in many cases. Thee creams are based on cetylated fatty acids. There have been studies that have shown creams such as these can be very effective with good results happening quickly and continuing with ongoing use of the knee pain relief cream. One such cream is called Celadrin.

There are alternatives to using a cream such as supplements or patches.

We all know that as we age joint problems become more likely and because our knees are subject to a lot of stress, especially if you’ve been active, knee joint problems are very likely. However, in this day and age, it is not necessary to put up with the pain associated with knee joint problems.

Even with knee pain from arthritis there is usually a way of treating the pain. It is important, if you have sore knee joints to consult with your doctor who should be able to point you in the right direction whether it is to consult a foot specialist for orthotics or a brace, use of a cream or supplement or to see a specialist for a more complicated treatment.

Even if orthopedic knee surgery is recommended, with all the advances in modern medicine and technology, the results can be nothing short of miraculous and the thought of knee joint surgery should not scare you. Just remember that knee surgery is a last resort and there are many other non-surgical options to give you relief from knee pain.

Knee Surgery for Alexander Rodriguez – The A-Rod

Alexander Rodriguez, nicknamed “A-Rod” is one of America’s most successful professional baseball players and is considered to be one of the best baseball players of all time.  He plays third base for the New York Yankees but has also played for the Seattle Mariners and the Texas Rangers.

A=Rodto have Knee Surgery

A-Rod is the youngest player to make 500 home runs, a record not broken since 1939 and beat Babe Ruth’s record of 600 by over one year.

Now he is due to have knee surgery to repair damage to his knee. Here is an article that outlines his knee injury.

By: Staff Writer

Posted: 07/11/2011 1:00 AM

Runner’s Knee – Chondromalacia

Chondromalacia or Runner’s Knee is really a common problem in young sports people. In the following document we discuss the causes, symptoms and treatment options of this complaint which a great number of younger sports people will probably go through at some period in their lives. Treatments can vary from pain killers to knee surgery.

Chondromalacia is a term used to describe the wearing down of the cartilage underneath the kneecap. If the cartilage material under the kneecap deteriorates and wears away it can result in pain. Healthy cartilage works like a shock absorber but if subjected to too much stress can wear away.

Soreness felt in the knee when squatting or climbing stairs is a very common sign of Runner’s Knee. Chondromalacia is not a affliction limited to older individuals but is common in younger people, and in particular, athletes. People taking part in sports activities such as volleyball, running, cycling and rowing, to name a few, are candidates for Runner’s Knee. Also people whose employment depends on using their legs and knees to a significant degree could suffer from this condition.

Runner’s Knee can also develop if the knee or patella has been subjected to an accident or trauma.

Symptoms and Signs of Chondromalacia – Runner’s Knee

The principal symptom associated with Chondromalacia is pain in the front of the knee. Frequently the front of the knee can feel sensitive accompanied by a dull ache. If you are suffering from Chondromalacia, you can quite often hear a grinding noise coming from the knee as the cartilage and bone rub. This is most noticeable when you fold your legs. Chondromalacia can also result in swelling of the knee area.

Causes of Chondromalacia or Runner’s Knee

Stressing the knee by subjecting it to overuse is the major cause. In the case of young people it is commonly brought on by some kind of trauma to knee area thus leading to the knee pain. Landing on the feet awkwardly and turning the feet inwards causing the knee to twist laterally could possibly also cause Runner’s Knee.

Badly fitted shoes can be an additional cause of Runner’s knee particularly if sport is involved and the knee is subjected to extra strain due to the footwear.

Arthritis is one more reason for this problem, especially in older people. Age may result in wearing the cartilage away bringing about pain and soreness.

Treatment of Chondromalacia – Runner’s Knee

Treating Chondromalacia begins with halting most physical activities and resting the knee. It is strongly recommended to stop any activities that induce soreness or swelling of the knee.

SHORT TERM RELIEF OF RUNNER’S KNEE

It’s quite common for pain-killers to be recommended to help reduce the pain.

Short-term relief can be obtained by using ice packs and pain relieving creams.

LONG TERM RELIEF FOR RUNNER’S KNEE

However, for long term relief, your doctor will usually recommend specific workout plans that can strengthen the muscles around the knee. These are specially designed to not strain or stress the knee.

Knee surgery to scrape the cartilage could possibly be suggested as a last resort. Called arthroscopy this has proven to be highly effective when nothing else gives relief. Sometimes surgeons also open the kneecap and realign the kneecap as well as reduce the pressure on the cartilage.

Maintaining a solid level of fitness and incorporating stretching exercises into your fitness routine will help to keep your knee joints healthy so that Chondromalacia will not become a problem.

KNEE REPLACEMENT SURGERY IMPLANT FIXATION METHODS

There are four ligaments that will ensure the knee joint works correctly. Their job is to assist hold the bones in place. When the knee is sound then they are very effective. However, when a knee joint deteriorates, say due to joint disease, damage and scarring can develop to these ligaments. The objective of knee replacement surgery is to replace some or all of these ligaments and also the surfaces of the knee joint by synthetic components or prostheses. These prostheses need help to stay in place and two types of implant fixation techniques can be used – cemented or cementless.  With both methods knee rehabilitation exercises to help speed up recovery are important.

CEMENTLESS FIXATION METHOD

Cementless fixation was first unveiled in the 1980′s and entails making use of implants whose surfaces are attractive to new bone growth so that they would attach to the bone without using any kind of cement or adhesive. In other words the new bone grows into the specially coated surface of the implant. Cementless implants do require using screws to aid the stability of the implant until the new bone grows sufficiently to provide adequate support. Because it is essential to wait for the new bone to grow into the implant and because of the use of the supporting screws, recovery time is more lengthy than if using a cemented fixation technique. Even though this procedure has proved as effective as cemented fixation in many cases, it has not solved the problems a result of bone reduction and wear in the implant (see below).

CEMENTED FIXATION METHOD

The most common method these days is cemented fixation in which a polymethylmethacrylate cement, a special fast curing bone cement, is used to hold them in place. Knee replacements performed using this method have had excellent outcomes with an expected life of 15 to 20 years. In the other method, cementless fixation, the actual bone is encouraged to actually grow into the surface of the implant.  Bone reduction and wear of the implant is also an issue with this method.  Nonetheless, despite these issues, which are rare but not unknown, cemented fixation has turned out to be to be a most reliable technique in total knee replacement in most cases including in young patients who have an energetic lifestyle and where joint disease was relatively advanced.

ISSUES

How long a knee replacement lasts and how well it functions are determined by the overall health and weight of the recipient as well as the amount of use the knee joint gets and the stresses placed on it by this use. Weight management is very important in reducing wear and in lessening the risk of other conditions.

When orthopedic knee replacement surgery is carried out, the harder bone at the top of the tibia or shinbone is removed. The softer more porous bone that is left must absorb the stresses that your knee joint is put under, which under normal use can be considerable. If these stresses are greater than this bone is capable of absorbing then the metal alloy components of the prosthesis can loosen. Over a period of time, these kinds of excessive loads may well cause the prosthesis to sink into the softer bone tissue or loosen its adhesion to the bone.

Loosening of the prosthesis and sometimes bone reduction can be a result of the polyethylene layer between the metal components wearing unevenly. This may be caused by an uneven gait where by the knee is subjected to uneven loads leading one side of the knee implant to push into the bone whilst the other side lifts off from the bone. This uneven wear may also cause tiny particles of the polyethylene layer to rub off. This “debris” may cause the body to set off a biological reaction that could cause further movement of the knee implant. Bone loss may also be a direct result this. What happens then is that the surrounding cells absorb these minute particles. The body’s immune system senses this and attempts to eliminate them by triggering an inflammatory response. This response may also cause osteolysis, a condition where the cells essentially take away some of the bone from around the prosthesis. As wear increases so does the bone loss and the weakened bone causes the implant to loosen more.

CONCLUSION

It seems that both methods are successful in total knee replacement surgery. Having said that, the use of cementless implants has only been relatively recent and so long term comparisons of the two methods are unavailable but in the short term, it would seem that the success rates are comparable.

Technorati Tags: implant fixation techniques, joint disease, knee replacement surgery, orthopedic knee surgery, total knee replacement surgery

Arthroscopic knee surgery was first performed in the US in 1968.  It has since proved to be one of the most important surgical procedures in orthopedics of the 20th century and, with major advances in surgical techniques and materials, has become very highly effective.  In the US there are over three hundred thousand knee operations performed annually generally with impressive results.

Arthroscopic knee surgery is knee joint replacement surgery.  Basically there are two types of arthroscopic knee procedures:

• Total joint arthroplasty where both sides (shinbone and femur) of the knee joint are replaced and

• Hemiarthroplasty or partial knee replacement in which only one side of the knee joint is replaced.

Arthroscopic knee surgery is used to replace a damaged or diseased knee joint with an artificial joint.  This prosthesis is made from surgical grade plastics and metal alloys and is designed to work in the same way as bone and cartilage does and to behave in the same way as a healthy joint.

In this surgery, the orthopedic surgeon will remove the damaged or diseased parts of the bones that make up the knee joint.  In a healthy knee joint the surfaces of these bones rub together using cartilage to act as the buffer between them.  In total knee replacement surgery the surgeon will remove the damaged surfaces of the three bones that rub together (the kneecap or patella, the thighbone or femur and the shinbone or tibia) and replace them the plastic or metal prostheses.  .  The surgery usually takes between 1 and 2 hours.

The components used in knee joint replacement surgery are designed to match the original bones that they replace.  The section of the femur or thighbone that is replaced is made of rounded metal alloy that is designed to closely match the curve of the natural femur.  A very smooth long wearing polyethylene plastic is used to replace the surface of the shinbone and act as knee cartilage.  This same material is used to replace the cartilage on the back of the kneecap.

The ultimate aim of this surgery is to replace the painful surfaces of the knee joint with new surfaces made from artificial materials.  The knee joint is then no longer painful and mobility is increased.  An added benefit is that joint deformities can sometimes also be corrected at the same time.

Knee surgery recovery is relatively quick and knee joint rehabilitation commences almost immediately after the orthopedic knee surgery.  Walking with the aid of crutches or a walker and knee physical therapy usually start within 24 hours of the operation and can take several weeks.  Generally many normal activities like climbing stairs and getting in and out of chairs can be attempted within a few days.  Knee replacement exercises are an important part of rehabilitation.

Orthopedic knee replacement surgery has a success rate of up to 95% with most knee implants functioning well for many years after surgery.  Most knee implants should last for about 15 years with moderate levels of activity.  However, continual strenuous activity can reduce the life of the knee implant.

Technorati Tags: arthroscopic knee surgery, knee cartilage, knee joint replacement surgery, knee operation, knee physical, knee replacement exercises, Knee Surgery Recovery, orthopedic surgeon, total knee replacement surgery

Orthopedic terminology – when you visit your orthopedic physician, you will hear some new and confusing terminology.   Words like patella, fibula, medial, ACL and many more are common in the orthopedic surgeon’s vocabulary.  But what do they mean in layman’s terms?   They certainly can be very confusing.

Your orthopedic surgeon should explain these terms to you but even then they can still be quite confusing.  Below is a list of common terms and their meanings that are often used by .

ANTERIOR – at the front of the body.

Anterior Cruciate Ligament – usually abbreviated to ACL is the ligament that connects the femur to the tibia.  Responsible for a large proportion of knee injuries.

ARTICULAR CARTILAGE – the covering of the moving inside surfaces of the knee.
ARTHROSCOPY – minimally invasive surgery routinely used in knee surgery to repair the knee or remove debris from the knee joint.

BONE SPURS  or Osteophytes – abnormal projections of bone most commonly caused by excessive stress on the ends of the bones.

CARTILAGE – the covering of the bones in a joint that allows the joint to move and also cushions the bone.

FEMUR - the thigh bone.

FIBULA – the outer bone in the leg between the ankle and the knee.

HAMSTRINGS – the muscles at the back of the thighs.

LIGAMENTS – the tissue that connects one bone to another.

MENISCUS – the cartilage that gives further cushioning to the knee joint.

MENISECTOMY – arthroscopic surgery to remove part of the meniscus.

OSTEOPHYTES – see bone spurs.

PATELLA – the kneecap, the flat bone at the front of the knee.

PATELLO FEMORAL JOINT – the joint under the kneecap.

PATELLA LIGAMENT – the ligament that secures the patella (knee cap) over the front of the knee joint.

POSTERIOR CRUCIATE LIGAMENT – usually abbreviated to PCL and is found behind the Cruciate ligament.

QUADRICEPS – the muscles located at the front of thighs.

SYNOVIAL MEMBRANE – the membrane that produces a lubricant (synovial fluid) to help knee move smoothly.

TIBIA – The shin bone.

These are the most common terms that your orthopaedic surgeon or the surgeon’s assistant may use but there are many more. 

Although orthopedic terminology can be confusing, the knowledge of a few of the more common terms will help in your understanding of the complex knee joint and impending orthopedic knee surgery.

Major knee surgery set for Leafs’ Van Ryn

CBC.ca Major knee surgery set for Leafs ‘ Van Ryn SportingNews.com Defenseman Mike Van Ryn will have major knee surgery in late October

Adam Vinatieri Has Knee Surgery

Colts kicker Adam Vinatieri was forced to undergo surgery on his right knee to remove some cartilage. Early Wednesday, the Colts announced the surgery. 

Knee Surgery Common Among Young Patients

Chronic pain management and support group dealing with Fibromyalgia, degenerative joint disease and other neurological disorders. 

Extensive Knee Surgery Ahead For Mike Van Ryn

Defenceman Mike Van Ryn is expected to announce that he has decided to undergo extensive knee surgery which could potentially spell the end of the 30-year old’s NHL career. continued.

Technorati Tags: knee, orthopedic, orthopedic knee surgery, Orthopedic physicians, Orthopedic Terminology, physicians, surgery, terminology

This article is about  Orthoscopic Knee Surgery and also outlines other types of orthopaedic knee surgery.

The most common reasons for knee surgery are arthritis and injury. Osteoarthritis is a degenerative disease that slowly wears away cartilage. Rheumatoid arthritis is inflammation of the knee, causing damage to the cartilage.

Arthritis can develop in people of all ages but is more commonly found in the older segment of the population. Injury can occur following a blow to the knee and is commonly a result of sports related injuries. This type of injury is often found in younger people who are involved in activities with a lot of stress to the knee, sudden shifting of positions, or potential for the knee to be hit. There are several types of surgery to repair damage done to the knee.

Synovectomy is the process where the lining of the knee is replaced. This surgery often helps reduce progression of knee problems and can delay the need for more invasive surgery. This type of surgery shows success only if the problems were diagnosed early and the damage is not severe. Prolonged diagnosis or advanced injury will not likely be conducive to this type of surgery.

An osteotomy is a procedure is where the bones are cut and realigned to redistribute weight. If this type of surgery is performed, it may reduce the necessity for a knee replacement. In order for it to be successful, though; early detection is crucial. Even in more advanced cases, this surgery can prolong the need for knee replacement by up to ten years.

Menisectomy is where pieces of cartilage are removed to help promote a pain free experience. This procedure is an arthroscopic process resulting in less recovery time and lowered post operative pain. In approximately sixty percent of patients, this procedure can provide maximum relief for up to five years. It has a high success rate.

Total knee replacement surgery is the most radical type of surgery of the knee. It is usually a last resort and will occur only with progressive advancement of damage or in cases of severe distress. This procedure is still in its early stages of development but advances are made continually. This type of surgery is proven to be highly effective and can provide permanent relief from pain and stiffness.

Damage to the knee can cause pain and stiffness. This may hamper a person’s ability to walk or perform routine exercises comfortably. Surgery is a viable option for reducing the effects of knee arthritis or injury. Most physicians recommend utilizing the least invasive form of surgery possible. This will provide relief and delay the necessity for more radical surgery.

By: Gray Rollins -

Article Directory: http://www.articledashboard.com

UCLA’s Morgan Recovering From Knee Surgery

UCLA’s Morgan recovering from knee surgery. The Associated Press. 3:35 p.m. April 16, 2009. LOS ANGELES — UCLA center J’mison Morgan has undergone arthroscopic knee surgery. 

Arthroscopic Surgery for Knee Osteoarthritis?

Arthroscopic surgery for knee osteoarthritis? Just say no: for most patients with osteoarthritis of the knee, arthroscopic surgery offers little benefit.

Lugo to Have Arthroscopic Surgery on Knee Tuesday

Julio Lugo will likely have arthroscopic surgery on his sore right knee Tuesday to determine the extent of the damage there, and could be back on the field in less than a month if all goes well. 

Arthroscopic Knee Surgery Does Not Bring Expected Benefits

And recent research published in the New England Journal of Medicine has revealed that arthroscopic knee surgery, which is the most commonly performed orthopedic surgery in the United States, may not bring any desired benefits.

Knee surgery

Arthroscopic knee surgery was developed to treat torn cartilege and ligaments, and it works beautifully for these acute injuries. 

Technorati Tags: arthritis, knee, knee replacement, menisectomy, orthopedic knee surgery, orthoscopic, orthoscopic knee surgery, osteoarthritis, osteotomy, replacement, surgery, total knee replacement surgery

Avoiding total joint replacement surgery on the knee or hip with physical therapy is the best road to recovery.

If you suffer from arthritis is highly likely that you will need either a total hip replacement or knee joint replacement surgery when you get older.

I undertaking a pain management course, under the instruction of a trained physical therapist, and learning pain management skills along with stretches and exercises that improve muscle function many people are preventing or delaying such surgery.

In order to customize the program that meets your abilities and rehabilitation needs, physical therapists will firstly evaluate your condition.  In addition you will learn how to minimize stress on your joints that are injured with a view to minimize the pain.

If joint replacement surgery is unavoidable, it is recommended that in order to know what to expect after surgery, you begin working with an experienced Physical Therapist prior to your surgery.

After  total joint replacement surgery, why is Physical Therapy so essential?

If partial or total joint replacement surgery cannot be avoided, it’s very important to go into this with your eyes open so that you’ll know what to expect after the operation.  The best way to do this is to start working with your physical therapist before you have the surgery.

The importance of undertaking an exercise regimen after joint surgery cannot be over emphasized as it will ensure quick recovery and use of the new joint.  Without an exercise plan, it is possible that you won’t regain full strength and range of motion in the joint which can inhibit movement and be a source of pain.  The type of flexibility and strengthening exercises that you will need after surgery are dependent on the type of surgery that was before.

In your physical therapist should prescribe exercises to strengthen your core, hip and leg muscles and encourage flexibility.  Your rehabilitation program should also include some form of balance training to improve muscular coordination.
In addition your physical therapist or medical practitioner will advise you how to reduce any effects of post surgical scar tissue and muscle imbalance to ensure the fullest possible recovery.

New Concerns About Minimally Invasive Knee Replacement

This is the primary concern of those opposed to minimally invasive knee replacement surgery–by not exposing the knee joint as well, the implants are not being properly placed, and therefore more likely to wear out quickly.

Arizona Doctors Leading the Way With New Hip Replacement Technique

Arizona Orthopaedic Associates at Gateway now offers a minimally invasive hip replacement procedure that can reduce pain and cut recovery times by up to three months, thanks to a state-of-the-art operating table.

Learning the Direct Anterior Total Hip Arthroplasty

This is in contrast to minimally invasive hip surgery via a 2-incision approach that does not allow direct visualization of the femur and intraoperative recognition of calcar fractures that have been reported to occur in approximately [...]

Knee Surgery – Knee Joint Pain Relief

This minimally invasive surgical procedure involves replacement of only damaged parts of one compartment. This surgery is beneficial for people with severe knee arthritis. Major benefits of partial knee replacement surgery are smaller [...]

New Doubts About Popular Joint Surgery

Knee surgery is increasingly being done using smaller incisions (left), leaving more large muscles intact.

Knee Replacement in India

In minimally invasive knee surgery, the incision is only 4 to 6 inches long.

Technorati Tags: hip, Joint, joint replacement therapy, knee, knee joint replacement surgery, partial, physical therapy, replacement, surgery, total, total knee replacement

 When  non-surgical treatment options for knee arthritis  are not much helpful, knee surgery is recommended to relieve the symptoms of arthritis. Here is some useful information about knee surgery for arthritis treatment.Arthritis is a degenerative disorder of joints, which causes the breakdown of cartilage, resulting in inflammation and swelling of joints. Osteoarthritis is the common form of arthritis, which affects knee joints. Knee arthritis is also caused by gout, rheumatoid arthritis, post-traumatic arthritis or infection. Age (people above 50 years), being overweight, knee injuries, trauma, ligament damage, deposition of uric acid crystals and abnormal body structure are the risk factors for knee arthritis.

A person with knee arthritis may experience knee pain during activities, joint swelling and tenderness, stiffness of knee, cracking noise and limited range of motion.  Knee arthritis  is diagnosed with the help of physical examination and findings of imaging tests such as X-ray and MRI scan. Knee arthritis can be treated using non-steroidal anti-inflammatory drugs (NSAIDs), knee support braces, physical therapy, muscle relaxants and heat and cold treatments. Since obesity is one of the risk factors for knee arthritis, losing excess weight and maintaining a normal body weight is an important regimen for knee arthritis treatment. A well-planned exercise program can help to reduce the stiffness in knee joints and improve the range of motion. When these treatment options are not helpful in relieving the symptoms, an orthopedist may recommend the knee surgery. Read on to know about different surgical options for arthritis treatment.

Knee Surgery for Arthritis Treatment

Knee arthritis can be treated with various surgical methods such as synovectomy, osteotomy, arthroscopy, arthroplasty, unicompartmental knee replacement and total knee replacement. Knee surgery for arthritis treatment is aimed at relieving joint pain, reducing joint stiffness, and improving range of motion as well as appearance of deformed joints.

Arthroscopy: Arthroscopy is the surgical procedure, which provides a direct view of the joint structure with the help of arthroscope. Since arthroscope is attached to closed-circuit television, arthroscopic surgery can be used to determine the type of arthritis and the amount of damage to knee joint. Arthroscopic knee surgery can be performed under local anesthesia. Arthroscopic clean-out is beneficial in case of mild to moderate knee arthritis. However, the benefits of arthroscopic surgery are temporary and symptoms may reappear after some duration.

Synovectomy: This procedure can be performed as an open surgery or using an arthroscope. In this surgical procedure, diseased synovium (soft tissue joint lining) is removed. This helps to reduce joint pain and swelling of rheumatoid arthritis. But, the results may be temporary and synovium may grow back after some years.

Osteotomy: In most case of knee arthritis, some deformities of leg may develop such as bowleg or knock-knee, which can worsen the symptoms of knee arthritis. These deformities can be corrected with the help of osteotomy. This surgical procedure involves cutting and repositioning the bone, either tibia or femur bone, due to which the alignment of leg is improved. This helps to relieve pain and manage the symptoms of arthritis.

Arthroplasty: Arthroplasty involves rebuilding of knee joints. It is also referred to as total joint replacement, in which a part or entire arthritic joint is removed. Generally, it is replaced with ceramic, plastic or metal parts. In this surgical procedure, the end of bone where cartilage has worn away is resurfaced. This procedure enables many disabled people to regain knee joint activity.

Unicompartmental knee replacement: It is also known as partial knee replacement. This surgical option is considered to be a good treatment option for osteoarthritis of knee joint. Out of two compartments of knee, only one compartment may be affected by arthritis, while other may be normal. This minimally invasive surgical procedure involves replacement of only damaged parts of one compartment. This surgery is beneficial for people with severe knee arthritis. Major benefits of partial knee replacement surgery are smaller incision, less blood loss and shorter duration for recovery. This surgery helps to reduce symptoms and improves range of motion. But, the main disadvantage of unicompartmental knee replacement surgery is that non-replaced knee compartment may deteriorate over time.

Total knee replacement: Total knee replacement is necessary in most cases of knee osteoarthritis. People with hampered joint mobility, malfunctioning knee joints and limited activities due to joint pain and swelling are recommended to undergo this surgery. In this surgical procedure, the ends of damaged lower leg bones and thighbones as well as kneecap are replaced with artificial implants made from plastic or metal. The artificial joint is connected to shin, thighbone and kneecap using cement or a special material. There are different types of knee replacement implants such as cemented knee replacements and press-fit knee replacements. The complete surfaces at the ends of thighbone and lower leg bone are replaced. Most often, general anesthesia is preferred for joint replacement surgery. Knee replacement implants can last for about 10-15 years in 90-95% of patients. Total knee replacement surgery helps to relive pain and stiffness in joints to improve mobility and functioning of knee joints.

Knee surgery is one of the most effective  options for arthritis treatment, which helps to relieve painful symptoms of arthritis and restore normal functions of knee joints. This enables a person to perform daily routine activities with much ease.

Technorati Tags: arthritis home remedy, arthritis natural remedies, arthritis natural remedy, info on knee replacement

Knee replacement is considered to be the area of Orthopedic surgeon but physiotherapists says that their voice is must before decision for treatment should be taken.

Knee replacement is used as a treatment option for a variety of different conditions including deformity, knee injury, bone tumor and arthritis. Both rheumatoid arthritis and osteoarthritis can bring about the onset of symptoms but osteoarthritic change is much more common than rheumatoid problems.

Knee replacement is usually considered once other therapies including pain medications and exercise programs have failed. Sometimes by the time a patient sees a consultant specialist however the degenerative changes are too severe to address the condition using conservative methods.

The symptoms

The symptoms of osteoarthritis of the knee can present at different times depending on the activities a person is carrying out at any given time. The description of the symptoms in the most general sense is that a person will experience knee pain or loss of flexibility. This pain often presents as follows:

* Pain resulting in loss of sleep at night
* Slight or no relief of pain when taking medications
* Problems going up and down flights of stairs
* Chronic stiffness and or swelling in the knee
* Being unable to participate in leisure activities due to knee pain

When these kind of symptoms become limiting on mobility and activities of daily living primary care practitioners (or General Practitioners) will make a referral to an orthopaedic specialist. The specialist, a consultant knee surgeon, will examine the knee, its movement and the strength of the muscles around the joint. An x-ray will be necessary to show the surgeon the extent of the osteoarthritic change and an MRI scan may be necessary.

These diagrams illustrate the effects and typical location of osteoarthritic change on the knee joint, showing a representation of a healthy knee and also with degeneration in both compartments (sides) of the knee.

When the arthritic changes occur to this extent it would indicate that a total knee replacement is required rather than a partial knee replacement, which is suitable only when single-compartment osteoarthritis is present.

The patellofemoral compartment is the part of the joint shown at the top in these illustrations beneath the patella (or kneecap) itself.

The two condyles, as they are called, extend down from the femur and are called the medial (in-side) and the lateral (outside) condyles. In each of these illustrations the medial condyle is on the left hand side and the lateral on the right hand side. The simple way to remember this is that the lateral compartment is above the fibula, the smaller bone in the lower leg. The large bone in the lower part of the leg is called the tibia on which the two condyles bear. Arthritic change and the inflammation it causes increases friction in the knee joint, wears away cartilage and is the primary cause of the symptoms leading to knee replacement.

Treatment – surgery

Before a patient is admitted to the Clinic for knee replacement they will be asked to make a visit for a pre-operative assessment. This is a thorough examination and education process during which routine tests are carried out. It is a very good opportunity for patients or their relatives to ask any questions to address their concerns about the upcoming operation and preparing for it.

The knee replacement operation itself at the most basic level involves removing the arthritic bone and tissue and covering the medial and lateral condyle and the top of the tibia with new bearing surfaces. The operation normally takes around two hours and is performed under anesthetic. It is possible to use either regional or general anesthetic, the latter being used in most instances.

During surgery a mid-line incision is made over the patella which is moved aside along with muscles and connective tissues. The operation is carried out with the knee in a bent position allowing all parts of the joint to be exposed. Arthritic bone is removed from both the tibia and femur, preserving as much healthy bone and tissue as possible. The tibia is hollowed out enough for the tibial implant to be inserted in a stable position and once the femoral and tibial compartments are smoothed over the surgeon will carefully measure both for the prostheses (implants).
Once measured a precise amount of bone will be removed from each part of the knee joint to ensure a good fit with the prostheses in place. Once the implants are inserted, which can be done with or without cement, the surgeon will bend and rotate the knee to confirm that it moves properly and the implants are aligned.

After surgery

A patient will normally stay in hospital for three to four days following a total knee replacement. With minimally invasive advances in surgical techniques it can be possible to start to walk short distances with the aid of crutches or a walker only hours after surgery. At the Clinic the nurses and physiotherapists will spend the most time with each patient and determine the most appropriate mobilization program tailored to each individual.

The exercises learned while in hospital will be a very important part of the long term success of the knee replacement replacement and should be continued as a part of a daily routine as prescribed by the physiotherapists while in hospital.

Normally a patient will be asked to attend a follow up appointment six to eight weeks after leaving hospital to see their consultant surgeon who will review progress and, if appropriate, make recommendations or adjustments to a patients activities at that time.

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 Knee arthroscopies are emerging as a popular option amongst orthopedic procedures especially for knee injuries. Following the recent advances in arthroscopy since late 1960′s, millions of people opt for it every year for quicker rehabilitation. Know the following facts of Arthroscopic Knee Surgery before undergoing one.

 A lot many musculoskeletal problems related to the knee can be diagnosed with history taking and joint examination. Laboratory investigations like knee aspiration, X-rays, MRI, CT scan can further help in better diagnosis. Arthroscopy would be the last rescue in difficult to diagnose conditions or for therapeutic purpose.

What is Arthroscopic Knee Surgery?
Arthroscopic surgery is a procedure wherein the inside of the knee joint is visualized with an endoscope for diagnosis and treatment. The word "Arthroscopy" in Greek means (skopein) looking within the joint (arthro).

What are the Indications of Arthroscopic Knee Surgery?

Arthroscopic knee surgery is helpful for diagnosing the following conditions

• Arthritis especially mono-arthritis
• Inflammation of synovial membrane
• Gouty arthritis
• Joint infections

Arthroscopy is of therapeutic importance in following impairments

• Repair of torn cartilage or other tissues
• Treating locked knee
• Correcting knee dislocations
• Loose bony fragments inside the knee interfering with mobility
• Patella-femoral syndrome
• Bakers’ cyst or popliteal cyst
• Knee Tendonitis
• Pain management in osteoarthritis

How is Knee Arthroscopy performed?
Arthroscopy is performed through two tiny incisions on the knee joint, one for the scope equipped with a tiny video camera and the other for injecting sterile fluid into the joint. The surgeon can clearly visualize the type of joint damage on a monitor and perform surgery with specialized instruments into the afflicted structures of the knee.

What are the Advantages of Arthroscopy?

• Surgery takes less than an hour
• Surgery can be performed through a considerably smaller incision
• Less pain, stiffness and low scarring
• Helps in accurate diagnosis besides being minimally invasive
• Quicker recovery than conventional surgeries
• Minimal hospitalization is necessary and the patient can be discharged within a day depending upon the complexity of disease

What is the Prognosis after an Arthroscopy?
Prognosis is usually faster than any open surgery. However complete recovery would vary for every individual depending upon the type of ailment. Rehabilitation post -surgery consists of incision care, exercise advised by physical therapist and some limitations in physical activities. Resuming back the complete range of activities would take around a month or 6 weeks and would differ for everyone.

Are there any Risks involved or Complications in Arthroscopy?
Arthroscopic treatment in osteoarthirtis and pain management is highly debatable; an orthopedic surgeon would best decide the ideal treatment whether arthroscopy or knee replacement suits one better. Anesthetic risks are unlikely, but rarely may occur. Possible complications are the same as in case of open surgery, though the possibility is very low on account of the smaller wound. Excess bleeding, infection, nerve damage, blood clotting, deepvein thrombosis are some of them.

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