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Total knee replacement

What are the parts of the knee?

The knee joint or as we all call it the knee is the biggest and most complicated joint in our bodies. Technically it’s made of two real (thighbone and tibia, thighbone and patella) and one false (the side of the patella and fibula which is closer to the knee) joint.

It is a strong but flexible hinge joint, playing an essential role in movement related to carrying the body weight in horizontal (running and walking) and vertical (jumping) directions.

Between the femur (upper leg bone) and tibia (lower leg bone) is the meniscus, a layer of tough fibrocartilage that acts as a shock absorber.

Anatomy of the Knee Joint
Anatomy of the Knee Joint

The knee joint is vulnerable to injuries, that most often occur during sports or recreational activities, work-related tasks, or home projects.

What are the common types of knee disorders?

The knee joint or as we all call it the knee is the biggest and most complicated joint in our bodies. Technically it’s made of two real (thighbone and tibia, thighbone and patella) and one false (the side of the patella and fibula which is closer to the knee) joint.

As we use our knees almost every minute of every day, they are at an increased risk for wear and tear, and even trauma. If a knee joint wears out that much, or you suffer a serious injury that repairing the existing knee joint is not possible anymore, total knee replacement may be the solution to the problems.

What factors contribute to the problems?

  • Overusing of the joint, degenerative defects especially due to old age
  • Joint inflammation, either as a part of a disease called rheumatoid arthritis or as an isolated joint inflammation
  • Axis deviation in the leg, frequent patellar dislocations
  • Injuries, falls, bone fractures

If all the conservative therapy fails to bring improvement, the everyday life causes pain and problems or/and you can’t sleep through the night orthopedic consultation is necessary to discover the root of your symptoms. On the consultation you and your doctor can decide about the future treatment plan whether it’s surgical or something else.

What kind of procedure is done in Medicover Hospital?

We at Medicover Hospital Hungary most often recommend the total knee replacement. During this procedure our orthopedic surgeons remove the inadequate knee joint and replace it with an artificial implant. This allows your knee to work just as well as it did when it was healthy, to move freely and stabile.

Total knee replacement - Medicover Hospital
Total knee replacement

How does the procedure go?

In our hospital the total knee replacement is done under local or general anesthesia based on your health, the results of the examinations, preferences and the doctor’s report.

During the surgery our specialists use a specific cuff which helps to minimalize bleeding.

After the appropriate anesthesia your doctor will cut an approximately 20 centimeter long wound just above the patella. Through this surgical site he can open up the knee joint and remove the worn-out articular cartilages to form the place for the implant. Next, he places a temporary implant into the area to check whether the implant fits and moves correctly. Then if necessary he can make changes to ensure the perfect fitting.

The implants, which are precisely defined in advance, will be fixated with a special antibiotic cement. Between the pieces a plastic component will be inserted which ensures the proper movement. If the patella requires more support, a button will be inserted, also made of plastic, to substitute the surface of your patella.

If every particle works the way they should, they’re stable and fix your doctor can let the blood flow through your leg again by releasing the cuff and take appropriate actions to stop the blood flow. After this your surgeon inserts a surgical drain and closes the wound. Finally a sterile bandage and an elastic swaddling band will be put onto the site.

Necessary preparations before surgery

In order to choose the perfect, fitting knee implant it’s necessary to undergo several examinations beforehand. An x-ray and in some cases CT is important to get a clear picture of your knee area.

As there is a risk of infection during knee replacement surgery, examinations are ordered to minimalize this risk:

  • You need to undergo a routine blood work, metal sensitivity testing, urine and throat discharge testing, abdominal ultrasound, dental check-up, urological and/or gynecological examinations.
  • The surgery may require your doctor to give you blood transfusion at some point during, or after the procedure. For this reason a blood type test is also necessary, so the hospital can prepare and provide the blood for the transfusion if required.

What do I need to do after surgery?

The most important part after surgery is the rehabilitation.

The sooner you start to rehabilitate your leg with the new implant, the better the odds are for a complete recovery. In order to do so, appropriate pain control is necessary. At Medicover Hospital Hungary we use a so-called EDA tube (Epidural anesthesia) to inject pain relievers in the area for a few days after your surgery.

Besides this, the day after surgery when the drain tube is removed from the wound the physiotherapy starts. This is done with the help of our trained physiotherapists manually and also with using a CPM machine (Continuous Passive Motion).

After 3 or 4 days you can leave our hospital and continue your recovery by continuing physiotherapy. You’ll be given every advice, medication and tips you’ll need to make a quick, complete healing. Learning and practicing the exercises is extremely important for you to avoid any problems with your movement later on.

What are the benefits of the total knee replacement?

Undergoing such a procedure has its risks however the benefits from it are often life-changing. Your pain and limited mobility can decrease and even stop completely.

With frequent and proper exercises and physiotherapy you can get back your normal movement. Thus, you can live a full life again, do sports, eliminate painkillers and other drugs and increase your quality of life.

What risks does the surgery hold?

As every surgical procedure, the total knee replacement comes with risk factors as well, some of them might be serious. Even with the most careful examinations side effects can occur.

This is why it’s important to undergo various exams to minimalize these risks. When the state of your health isn’t sufficient enough to do the surgery, we suggest to postpone it.

  • The most serious risk is an infection of the surgical side which can vary between a mild redness of the skin and a serious, deep bone tissue infection. Those with diabetes, excess weight or those under steroid medications have an elevated risk of getting infections post-surgery.
  • Thrombosis (abnormal clotting of the blood) can happen as well, however this is a risk every surgical intervention carries. If you have varicose veins, you’re overweight or you’ve suffered thrombosis in the past you have an increased risk. In order to prevent thrombosis from happening, you’ll be given anti-clotting injections for six weeks after surgery which minimalizes the risks.
  • During or even after surgery bone fracture can happen, however it’s very rare. If it does happen another surgery, or more extensive surgery is necessary to repair the broken bones with implants. The physical therapy in this case has to start later. If you suffer from bone loss, you’re more likely to be a victim of fractures.
  • In extreme rare cases nerve damage can occur on the surgical site.
  • After surgery some people might develop hematoma big enough to require it to be drained by another surgery.

Am I eligible for the total knee replacement?

In every case, your doctor will decide whether surgery is safe for you or not, based on your health and the results of the examinations you participated in. An anesthesiologist will also consult you about the preferred and safe pain management for the duration of the surgery.

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