Total Knee Replacement (cont.)
What patients should consider a total knee
replacement?
Total knee replacement surgery is considered for patients whose
knee joints have been damaged by either progressive arthritis,
trauma, or other rare destructive diseases of the joint. The most
common reason for knee replacement in the United States is severe
osteoarthritis of the knees.
Regardless of the cause of
the damage to the joint, the resulting progressively increasing
pain and stiffness and decreasing daily function lead the patient
to consider total knee replacement. Decisions regarding whether
or when to undergo knee replacement surgery are not easy. Patients
should understand the risks as well as the benefits before making
these decisions.
What are the risks of undergoing a total
knee replacement?
Risks of total knee replacement include
blood clots in the legs that can travel to the lungs (pulmonary
embolism). Pulmonary embolism can cause shortness of breath, chest
pain, and even shock. Other risks include urinary tract infection,
nausea and vomiting (usually related to pain medication), chronic
knee pain and stiffness, bleeding into the knee joint, nerve damage,
blood vessel injury, and infection of the knee which can require
re-operation. Furthermore, the risks of anesthesia include potential
heart, lung, kidney, and liver damage.
What is involved with the preoperative evaluation for total
knee replacement?
Before surgery, joints adjacent to the diseased knee are carefully
evaluated. This is important to ensure optimal outcome from the
surgery. Replacing a knee joint which is adjacent to a severely
damaged joint may not yield significant improvement in function.
Furthermore, all medications which the patient is taking are
reviewed. Blood-thinning medications such as warfarin (Coumadin) and
antiinflammatory medications such as aspirin may have to be
adjusted or discontinued prior to surgery.
Routine blood tests of liver and kidney function and urine tests
are evaluated for signs of anemia, infection, or abnormal metabolism.
Chest X-ray and EKG are performed to exclude significant heart
and lung disease which may preclude surgery or anesthesia. Finally,
it is less likely to have good long-term outcome if the patient's
weight is greater than 200 pounds. Excess body weight simply puts
the replaced knee at an increased risk of loosening and/or
dislocation.
A similar risk is encountered in younger patients who may tend
to be more active, thereby adding trauma to the replaced joint.
Next: What happens in the postoperative period? »
- ardeparin- injection, Normiflo - Consumer information about the medication ARDEPARIN- INJECTION (Normiflo), includes side effects, drug interactions, recommended dosages, and storage information. Read more about the prescription drug ARDEPARIN- INJECTION.
- MRI (Magnetic Resonance Imaging Scan) - Medical information on magnetic resonance imaging (MRI) used in detecting structural abnormalities of the body. Learn uses, risks, and how to prepare for an MRI scan
- Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission).
Latest Medical News
Arthritis RSS