PARTIAL AND TOTAL KNEE REPLACEMENT
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Partial knee replacement, called a unicompartmental knee arthroplasty,is a surgery that may be considered for treatment of osteoarthritis of the knee joint. Patients that have undergone total knee replacement with severe arthritis of the knee joint. In a total knee replacement, cartilage is removed from the knee joint, a metal and plastic implant is substituted.
Partial knee replacement surgery is a procedure that has generated significant interest because it means a smaller incision a faster recovery than total joint replacement surgery. A partial knee replacement, called a unicompartmental knee replacement' also 'minimally invasive knee surgery,' removing only the damaged areas of cartilage, and replacing the surfaces .
The Operation
A general or spinal anaesthetic is administered. Cutting is made about 8 inches long down the front of your knee. All damaged surfaces of the lower end of your thigh bone and the upper end of your shin bone are removed. Then replaced with an artificial joint. The artificial knee is made from metal and plastic. There are many different types of artificial knees. Some held with special bone cement, some not. The surgeon will consult with you as to witch he intends to use, and reasons for his choice. The incision is then closed up with stitches or clips. You will be hospitalized for 7 to 10 days following your operation. You will be able to go home when you can walk safely with crutches or sticks. The main aim of the operation is to stop the pain in your knee You should be able to bend your knee from straight to a right angle. The result is you will be able to walk further and climb stairs more easily. If you have become knock-kneed as a result of your arthritis, the surgeon will try to straighten your leg with the knee replacement. You will not be able to undergo knee replacement if you have angina (chest pains) or shortness of breath that limit your walking more than your knee pain. You should not have a knee replacement if you have a urinary infection. This could result in infection of your new knee. Your urine will be tested. If it is infected, you will be given antibiotics before your operation. The same applies for any other infection, it has to be cleared before you have your operation. You should not have a knee replacement if you are a man with prostate problems. If you have poor urinary flow, have this investigated and treated before your knee is replaced.
Any Alternatives
If you leave things as they are, the knee will slowly get worse. Steroid injections into your knee will not help the pain in the long term. If the pain in your knee interferes with your life and the X-rays show that the joint is severely damaged, then you should have your knee replaced.
Before the operation
Get your weight down if you are overweight. If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the doctors advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation.
Bring all your tablets and medicines with you to the hospital. On the ward, you may be checked for past illnesses and may have specific tests, to make sure that you are ready and that you can have the operation as safely as possible.. You will fill in an operation consent form.
After - In Hospital
Your knee for protection will be wrapped in a bulky bandage. You may have a fine plastic drainage tube running from the wound. To help drain any residual blood from the operation. You may have a knee support on your leg to keeping it still when you are not doing your exercises. The wound may be painful. You will be given injections maybe tablets to control this. . Your nurses will help you until you are able to do things for yourself.
Your physiotherapist will show you important exercises and you will walk using walking aids. Your occupational therapist will show you how to do your daily tasks, such as dressing and washing. The discomfort of the operation may make it difficult to pass urine or empty the bladder. It is important that your bladder does not seize up completely. If you are not able to urinate properly after six hours, tell the nurses or your doctor. The wound will drain be removed a day or two after your surgery it will not hurt. The stitches will be taken out 10 to 12 days after the operation. For the first 10 days wash around the wound. You can wash the wound area as soon as the dressing has been removed. Soap with warm tap water are entirely adequate. Salted water is not necessary. You can shower,take a bath once the wound has healed.
At Home
You will be able to move around the house,manage stairs. Most important continue the exercises shown to you. Avoid going shopping for the first few weeks after you go home. Make arrangements for a friend or family to shop for you. Your knee will continue to improve over the next six months. Do not drive for two months after you leave hospital. You will not be able to perform an emergency stop as quickly as before . How soon you can return to work is dependant on your job. If you can get to work without driving yourself or by using public transport you may be able to return to work six weeks after your operation. You should not do manual work after a total knee replacement.
Possible Complications
The tests that you have before the operation will make sure that your operation complication chances bring the risk for such complications very close to zero.
Artificial joints last for many years. However they tend to become loose and painful after years of use. A further operation may then be necessary.
General Advice
We hope these notes will help you through your operation. They are a general guide. They do not cover everything.
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