Arthroplasty, or total knee replacement surgery, is a major surgical procedure and to ensure proper healing it is important to follow the directions given by your orthopedic surgeon. The knee bears a great deal of weight and a well designed physical therapy plan should be followed after knee surgery to ensure restoration of movement and mobility to the knee joint.

Very basically, arthroplasty involves replacement of the knee joint cartilage with a prosthesis made up of special metals and plastics and involves a hospital stay of 3 to 7 days after the knee replacement surgery. Most hospitals will not discharge a patient who has had replacement knee surgery unless they can walk with the aid of crutches. Knee rehabilitation therapy commences almost immediately after the surgery and can continue for several months. This is a crucial key to good recovery.

Since it can take up to 3 weeks after surgery before the repaired knee joint can be expected to bear any weight, it may be necessary for patients to receive in-home assistance. If in-home care is not available then there are rehabilitation centers that can provide that service. This would mean staying at the center for 2 or 3 weeks after the operation. During this time the leg should be kept elevated as much as possible and use ice packs to help minimise swelling.

Since we are all different with different health, fitness and motivation levels and the complexity of knee surgery varies with each operation, the recovery procedure and recovery time can vary. The following are guidelines only and can vary from case to case.

For the first three to four weeks after the knee replacement, walking with aid of crutches or a walker is necessary.

After that period the use of a cane is recommended for two to three weeks.

Usually, after around 8 weeks, most people can walk unaided.

It generally takes from 6 to 12 months for the knee joint to heal completely. This time frame is dependent on the knee exercises and rehabilitation program being followed and on the knee not being damaged by trying to pursue some activities too soon.

The level of mobility of the knee following the surgery varies from person to person, however, most people should be able to bend the repaired knee joint to 90 degrees with two to three weeks after their knee replacement surgery. Eventually, many will get over 110 degrees of motion in the repaired knee.

It should be possible to return to jobs that are sedentary by 6 weeks after surgery. More physical jobs should be looked at on an individual basis in conjunction with your health care professional.

After about 12 weeks, most people are back to their normal activities and the pain experienced before the knee replacement has usually disappeared by this time.

It is important to remember that the components used in the knee joint prosthesis are not able to heal if the knee is damaged and so common sense must prevail when considering undertaking leisure, sporting and employment activities to lessen the risk of injury. Here is a list of recommended activities, activities that are allowed in moderation and ones that should be avoided altogether.

Recommended activities

* Swimming and water aerobics

* Cross-country skiing

* Golf

* Dancing

* Cycling

*Using training machines like cross trainers and exercise bikes

* Desk work

Permitted: Allowable in moderation:

* Hiking

* Sports like gentle tennis or gentle downhill skiing

* Jobs that do not require heavy lifting (driving, walking, standing etc).

These activities should be avoided at all costs:

* Jogging or running

* Impact exercises

* Contact sports and those sports that put a lot of stress son the knee through pivoting or twisting e.g. basketball, squash, football etc.

* Heavy labor and lifting.

With the advances made in total knee replacement surgery procedures and prosthetics, almost full use of the knee can be expected for many years.

Technorati Tags: arthroscopic knee surgery, arthroscopic surgery recovery, knee joint replacement surgery, orthopedic knee surgery, total knee replacement recovery, total knee replacement surgery

Total knee replacement surgery (also called arthroplasty) can be life changing for someone suffering from knee trauma but it is a major operation and so recovery can take quite a while. Recovery from this type of knee surgery could also mean suffering with quite a bit of pain and some loss of function of the knee joint. However, this knee operation can be a major player in helping restore quality of life.

Prior to knee surgery, the knee has usually suffered from some degenerative changes which, in turn, may have caused the muscles that help support the knee to lose some of their strength and to not function exactly as they should. After a knee replacement operation, exercise is a critical part of the healing process but because of the pain and loss of function of the knee as well as the weakened muscles, it can be difficult to stick with an exercise regimen.

Over the past few years a lot of progress has been made in developing knee prostheses that are extremely durable and long lasting. Even so, these synthetic knee joints are not as robust as the actual knee joint and are subject to being damaged by activities like running, jumping and twisting and other “high impact” physical movements.

Your orthopedic surgeon will guide you in the exercise routine that you should commence after knee replacement surgery. He will also advise when to start exercising. Major knee exercises generally should not commence until your knee can bear your full weight, swelling and pain at the front of the knee has subsided and you have good knee motion, usually being able to bend you knee through 90 degrees. This could be as long as three months after the surgery. As soon as possible after the knee surgery, patients are expected to do simple knee straightening and bending exercises, sometimes with the aid of a special machine. The exercises will progress from light exercises initially and slowly increase in intensity as time and the healing process progresses.

The aim of the knee exercises is not only to ensure the knee can be bent and straightened but also to build up the muscles around the knee that help support it and to develop balance.

Two of the best knee rehabilitation exercises are bike riding (on an exercise bike) and swimming. These not only provide excellent therapy to assist in the healing of the knee joint but also are excellent cardiovascular exercises that also help in weight control. Maintaining a healthy weight level will speed up recovery time as less pressure is applied to the knee joint.

• BIKE RIDING – Use an exercise bike. When sitting on the seat, the foot should just rest on the pedal and the leg should be straight. This will prevent over-bending the knee which could cause damage. Start on a low resistance setting and slowly increase the resistance and the time.

• SWIMMING – This is one of the favored exercises because it is not weight bearing and can provide a total body workout. Again, start slowly and, if necessary, use a float to support the legs. Avoid leg actions like in the breast stroke which can put excessive strain on the knee joint. Slowly work up to a normal kicking action.

As the strength of the muscles around the knee and the mobility of the knee joint increases, you should experience less pain and discomfort and be able to slowly get back to your normal daily routine.
Knee rehabilitation exercises post total knee replacement surgery are one of the best ways to reduce recovery time and ensure that the new knee will give you many years of pain-free use.

Knee Rehabilitation Exercises

Whether you are rehabilitating your knee form after surgery or after an injury, progression of exercises should be slow and pain free.

Knee Rehabilitation After Knee Surgery

A general rehabilitation program in a patient with total knee arthroplasty (TKA). Day of surgery

Technorati Tags: arthroscopic knee surgery, Arthroscopy, knee joint replacement surgery, knee rehabilitation exercises, knee strengthening exercises, orthopedic knee surgery, surgery, total knee replacement surgery

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

Total knee replacement recovery exercises play a major part in your recovery following knee surgery.  Remember that your knee replacement procedure was a major operation and full recovery will take time. 

It is imperative that a regular exercise regime is commenced as soon as possible to help restore the mobility and strength to your knee.  This will help speed up your recovery so that you can return to your normal activities as quickly as possible.

Your orthopedic surgeon will recommend the knee exercises that you should do.  These will generally start off fairly light and gradually increase in intensity.  It is important to follow your surgeon’s instructions on this physical therapy.
As you gain more strength and confidence your knee therapy can consist of more advanced exercises.  Here are some which can be useful.  Before starting on these exercises please run them past your orthopedic surgeon or physical therapist.  These advanced exercises should be started until at least 4 weeks after your knee surgery.

AdvancedKnee Exercises

Standing Knee Bends

Stand up and using a walker or crutches to steady yourself, lift your thigh while bending your knee as much as you can.  Hold this position for between 5 to 10 seconds and then straighten your knee making sure that your heel touches the floor first.  Repeat this a few times but do not over do it.

Advanced Knee Bends

Lie on your back and bend your knee to about 45 degrees.  Place a rolled up towel over your ankle and take hold of each end.  Gently pull back on the towel to increase the angle of bend.  Hold for around 5 – 10 seconds.  Repeat this exercise several times.

Resistance Knee Exercises

Using light weights, repeat the above exercises with the weights wrapped around your ankle.

These resistance exercises should not be started until at least 4 – 6 weeks after your knee replacement surgery. 

You will need some light weights that can be tied around your ankle.  These can be obtained from most sports stores.  Start with one or 2 pound weights and slowly increase the weight as you regain strength in the knee joint.

Exercise Bike

Using an exercise bike is great way to increase mobility in your knee and muscle strength.

Make sure you set the bike up properly.  Adjust the height of the seat so that with your knee almost straight the bottom of your foot touched the pedal.  Keep the tension of the exercise bike fairly low so it is easy to pedal.

First of all pedal backwards.  When you achieve a pedalling motion that does not give you any discomfort then start pedalling forwards.  Do this twice a day for about 15 minutes and slowly increase the time.  When you feel comfortable in doing so, increase the tension.

Precautions

It is not uncommon for you to feel knee pain or swelling after knee physical therapy like this.  This can be relieved by applying ice to your knee and elevating your leg.  If you feel the pain or swelling is extreme, cease the exercises and consult your health specialist.

These exercises should be an integral part of your total knee replacement recovery regimen 

Written by Kerry N  

Knee Rehab Exercises – Bill Starr

“There’s no doubt in my mind that a lot of major knee injuries have been prevented because the joint was extra strong. The controlled up -and-down movement of the squat is the best rehab exercise. 

Speeding Up Your Recovery After Knee Arthroscopy

… this is unusual with arthroscopic knee surgery. Usually, you will be able to walk without assistance. You will need to take care about bearing weight at first, but as time passes and you persist with your postoperative exercises

How to strengthen your Knees

Here’s a great video which includes a detailed analysis of knee function anatomy, common injuries, potentially dangerous exercises and causes of pain, useful rehab exercises and protocols. 

Knee (ACL) Exercises

Anterior Cruciate Ligament (ACL) Injury Rehabilitation Exercises. 

Physical Therapy Knee Exercises: Knee Rehabilitation Exercises

What knee exercises do you do/have you done to help strengthen your muscles? Have you worn a brace while running? If so, do you have an brands/types you can recommend over others? Is running on specific terrain easier on your knee?

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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 -

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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