Artificial knee replacement guidance

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For the majority of patients with outpatient and online artificial knee replacement for many questions, and now do a unified answer, we want

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For the majority of patients with outpatient and online artificial knee replacement for many questions, and now do a unified answer, we want to help, welcome to discuss or ask questions

Artificial knee replacement surgery for what kind of patients? Department of joint surgery, Xijing Hospital, Han Yisheng

Total knee arthroplasty for severe osteoarthritis, ankylosing spondylitis, rheumatoid arthritis and other diseases caused by the destruction of the knee joint, knee varus deformity or flexion contracture of knee joint pain, instability and deformity, daily life and activities are severely limited, after conservative treatment is invalid or no significant effect of the patients. Knee joint with active infection, tuberculosis, accompanied by severe muscle and nerve dysfunction is not suitable for pedestrian knee replacement.

What age is suitable for artificial knee replacement?

The best age of knee arthroplasty should be 60-70 years, with the continuous development and operation technology of artificial joint technology improved, and the increase of the average life span, total knee arthroplasty has the tendency to expand the age range. Age is not the primary consideration of knee replacement, but is based on the patient's health status and symptoms, the degree of knee joint disease.

What is the effect of knee replacement?

Total knee arthroplasty is a very curative surgery, postoperative follow-up of 10-15 years, the excellent rate was 98%, can relieve the patient's symptoms such as pain, recovery of limb function and life self-care ability of patients, improve the quality of life.

How long is the life of the artificial joint?

Artificial joints can also wear. However, the strength and wear resistance of artificial knee joints are very strong, which can meet the needs of more than 15 years. The life span of the artificial joint is also related to many factors, such as the amount of motion, the choice of prosthesis, the technique and the condition of the doctor. In particular, the material and process of the prosthesis is also related to the use of imported or joint venture products.

How to choose artificial joint?

According to the age of the patient, the expected value of the operation, the economic situation, the amount of exercise, as well as the experience and technical level of the joint surgeon, can choose different types of prosthesis. Generally smaller hospitals more than the use of domestic prosthesis, large-scale hospitals using imported products or joint venture products more.

What are the risks and complications of total knee arthroplasty?

Complications can occur in any surgery. It is important to assess the risk of surgery and the incidence of complications, and to provide appropriate treatment and prevention. Knee joint replacement is an intermediate surgical procedure in the Department of orthopedics, and various complications may occur:

1, infection: including skin infection and deep wound infection. The prevention method for preoperative, intraoperative and postoperative use of antibiotics in aseptic operation, etc.. After the operation, there will be 1 - to 2 drainage of the wound will lead to bleeding, prevent wound infection, usually placed after the removal of 24 - 48 hours.

2, thrombosis: lower limb thrombosis more, most of them can be cured. The prevention method for application of anticoagulants, venous pump application, muscle contraction exercises etc.. The lower limb elevation on a cushion fixed to relieve pain and help lower limb blood reflux, prevent thrombosis and swelling.

3, neurovascular injury: seen in the anatomy of the structure is unclear or severe cases of deformity.

4, fracture: intraoperative fractures are more common in patients with severe osteoporosis, postoperative fractures caused by trauma;

5, prosthesis loosening: mostly occurred in the long-term after joint replacement. Loosening of the prosthesis after pain or poor joint function requires reoperation.

6, heart, lung, brain complications: relatively rare, but serious life-threatening.

Artificial knee replacement how to choose anesthesia?

General anesthesia can be used lumbar epidural anesthesia, spinal anesthesia: patients belonging to the awake state, fast recovery, but the operation of the same posture slightly tired; elderly patients, patients with lumbar hyperplasia of lumbar anesthesia difficulties and their own requirements of the patients by general anesthesia, intraoperative sleep, sleep after wake up.

Surgery is roughly how to do?

The operation of "replacement", the already damaged cartilage resection, cortical osteophyte, synovial membrane and small part of hardening of the metal prosthesis implantation package of femur and tibia, middle implant polyethylene pad; relieve pain, knee flexion and extension line, increase the scope of activities.

Is artificial knee joint replacement operation big? How long does it take?

Knee joint replacement is a major surgery in joint surgery. Simple operation requires more than 1 hours, plus anesthesia, disinfection time, generally about 2 hours.

Is the ache after artificial knee replacement serious?

After the first 1 days of pain will be more obvious, the doctor will use analgesic drugs or intravenous analgesic pump for pain relief. Can be basically painless after surgery, 24 hours after the pain will gradually reduce. There will be some pain in the beginning of functional exercise can be increased, can be oral analgesic drugs, but will soon be reduced.

Knee replacement costs?

The total hospitalization expenses (including artificial knee joint cost, cost of hospitalization, surgery and anesthesia fees) a total of about 10000-15000 yuan; different joint types at different prices ranging from 30000-60000 yuan; fees, medical insurance and new rural cooperative medical patients can be reimbursed according to the specific circumstances of the cost of 50-100%.

How long does the knee replacement need to be hospitalized?

After admission by necessary preoperative examinations and tests for 1-2 days, if there is no contraindication to surgery, postoperative 4-5 day activities, 1 weeks after operation and discharged, 14-21 days.

Can patients with high blood pressure, heart disease and diabetes do knee replacement?

In general, patients with high blood pressure, heart disease and diabetes do knee replacement to be cautious. If patients with hypertension can control blood pressure in the normal range, no other complications caused by hypertension, can also be used for knee replacement. If there is a heart disease but the heart function is good, no serious arrhythmia and angina and other symptoms, can also be joint replacement. Patients with diabetes can control blood sugar in the normal range, no serious complications caused by diabetes, knee replacement surgery can be performed. The risk of postoperative infection in patients with diabetes is higher, so after surgery should be long-term medication to control blood sugar in the normal range. Patients suffering from these diseases need to improve preoperative examination, the relevant departments to make a comprehensive assessment of the treatment can be considered after surgery.

Do bilateral knee joint replacement do?

Sure。 Many patients with osteoarthritis of the two sides of the disease, double knee joint replacement should also be a hospital, surgery at the same time, can reduce the pain, but also to reduce costs, reduce the number of patients hospitalized again. Whether to perform a double knee surgery should be based on the evaluation of the doctor and the patient's own choice.

After the artificial knee joint wear or loose, can replace it?

Sure。 The incidence is very low, once the knee joint infection or loosening, the need for joint revision surgery". A specially designed knee prosthesis and surgical instruments. Revision surgery is relatively complex and may require bone graft, replacement of the prosthesis type, or the use of a prosthesis. After revision surgery, the majority of patients can obtain ideal surgical results.

How to prepare before the operation?

Psychological preparation: to understand the situation of operation, reduce the operation in patients with preoperative fear; 2 weeks of smoking and drinking; exercises on bed urination, prevent postoperative bed habits; to keep the body clean, focal infection treatment of colds, pneumonia; treatment combined with hypertension, heart disease, diabetes and other diseases; surgery Guide: first of all should strengthen the static contraction limb unit four quadriceps exercises and active ankle movement, for femoral head four muscle contraction for 10 seconds each time, 10 times per day for 1 groups, completed 5 ~ 10 group. The patient sits on the bed, carries on the leg straight leg raise movement and the ankle joint resistance to stretch the movement, according to the patient's own situation, the number can be repeated 2 to 3 times a day.

What are the precautions after the operation?

After about 6 hours after eating, by liquid and semi liquid gradually changed into normal diet; diabetic patients adhere to diabetic diet, hypertension, hyperlipidemia patients with low salt diet; 2 weeks before operation to give up smoking and drinking; the increase of protein, vitamins and other nutrients in the diet; eat easy to digest food, vegetables, fruits (e.g. banana) increase cellulose, prevent constipation (and sit up, lie; reduce time) change "misleading surgery cannot eat seafood fishy, eat more fish can effectively increase the protein.

How to exercise after the operation?

1 for the first time after the operation, the isometric contraction of the muscles and the dorsiflexion of the foot were performed on the 1-2 day after. After 2 days after the removal of the drainage tube began to practice straight leg elevation, the foot can be placed under the affected limb, to help the affected limb elevation. Limb do unit four biceps static contraction, hold for 10 seconds, every 10 times into 1 groups, 10 groups of patients every day; sit on the bed, limbs do straight leg raising exercise, do not require the lift height, but there should be about 10 seconds of time; do the ipsilateral ankle dorsiflexion the joint exercise, maintain 90 degrees, and the joint movement around repeated 15 times, completed 2 to 3 times a day; the application of knee joint exercise apparatus (CPM) for the passive movement of the affected limb in painless condition, 2 times a day, in 1 weeks to reach or exceed the knee flexion 90 degrees.

Second weeks after operation in 2: the knee in painless range, by the end of the initial joint activities, small range of rhythmic back and forth to further strengthen the loose joint; limb straight leg raising exercise; encourage patients to get out of bed, crutches, walkers, standing in the first practice, the focus of the contralateral, ipsilateral bearing after touchdown, focus gradually to the ipsilateral transition.

3 after surgery for third weeks: continue to take the initiative to raise the leg straight exercise to consolidate the results of the previous training, to restore the weight-bearing capacity of the affected limb, to strengthen the walking gait training, training the patient's balance, to further improve the range of joint motion. In addition to bend the knee function training, but also must pay attention to training of knee extension, such as seat leg etc..

The amount of training from small to large, step by step, so as not to cause knee discomfort.

How to continue rehabilitation training after discharge?

After discharge, the active straight leg raise resistance exercise, increase muscle strength; knee extension, knee exercise, increase the range of motion; gradually reduce the use of crutches and walkers, generally 2-3 months after walking independently.

Daily attention after knee replacement?

1, the appropriate rest and exercise gradually increase your activity, avoid too tired, after exercise to have the right amount of rest, let the joints in the normal position as far as possible to relax,

2, to maintain the ideal weight to reduce the burden on the knee.

3, daily activities should avoid excessive burden on the knee, in order to reduce the chance of joint wear and tear, such as heavy things to cart instead of portable, up and down stairs, handrails, etc..

4, after knee surgery, please try to avoid the following actions: squat; climbing; run; lifting; a long way to go.

5, comply with the doctor to give you the activity limitations, until your next visit.

6, six months after the operation can swim, ride a bike, return to normal life.

7, if the situation immediately return: wound inflammation, secretion; pain; knee injuries and cause difficulty walking.

8, after the normal film once every 1-2 years, were compared using retention data.

 

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