Total knee replacement


What is a TKR?
A TKR denotes the removal of the end of the thigh bone, and the top of the tibia, and replacing them with prostheses (artificial knee implants).

The artificial knee is usually made of metal alloy and high density plastic that allows low friction between them.


Why do I need a TKR?
There are many diseases that require a knee replacement. The most common is osteoarthritis. This means that, the cartilage of the knee has worn out, resulting in the top of the tibia and the femur rubbing together. This is very painful and stops you from being able to move your knee as you once did.
 
Are there any alternatives to a TKR?
Before suggesting surgery your doctor may have offered several alternative treatments including medication, physiotherapy, weight loss, walking supplies or other operations. Only when these treatments no longer control your pain will your doctor suggest a TKR or, when your life perspective is not good any more


The artificial joint surfaces


Bone cement


(press fit technique) uncemented

How is it working?
After your operation, the damaged surfaces have been removed. In their position there is a new artificial joint that promotes you have no pain, which shouldimprove your ability to walk.
 
Are there any complications with a TKR operation?
There are some complications associated with this operation and although rare, itis important that you are completely informed about them. These are:
Deep Vein Thrombosis (DVT), Infection, Foot weakness, Loosening and Stiffness.

Deep Vein Thrombosis (DVT)
A DVT is a blood clot in the deep veins of the calf or the top of the inner thigh. To reduce the risk of developing a DVT, you will be given stockings to help with your circulation and medication that thins the blood. The physiotherapist and nursing staff will show you how to exercise your legs and ensure that you start to move about quickly after your operation. If a clot develops and part of it breaks off, it can travel to the lungs where it is termed a Pulmonary Embolus (PE). A PE is potentially life threatening so everything is done to prevent a DVT from developing infection.
There is a small chance of an infection and all possible precautions are taken to avoid infection during your operation. A superficial skin infection is treated with antibiotics, however, if the TKR becomes infected, it may need to be replaced at a later date.

Loosening over a period of time your artificial knee joint may become loose and further surgery may be required to correct this. An average TKR is expected to last between 10 and 20 years.

Stiffness
Stiffness and inability to move the joint satisfactorily are possible complications.
You will be shown exercises to improve the joint movement. If you are worried about any of these risks, please speak to the hospital doctor before your operation for further advice.

 
Advice on walking
You will usually start walking on the first or second day after your operation. The physiotherapist will advise you on what weight you are allowed to take on your operated leg. Initially you should have the supervision of either a physiotherapist or a nurse when walking and you will be advised when you are considered to be safe enough to walk by yourself. It is important that you practice and improve your walking pattern while on the ward. The physiotherapist will advise you on what walking aids to use and how long to use them for.

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