Risks Of Knee Replacement Surgery And Osteoarthritis
The One Stop Knee Shop
Positve and Negative Outcomes
In this article, I can provide first person experience with individuals I have known that suffered knee problems, along with some useful links to additional information.
I have known several people over the last twenty years that have experienced severe arthritis in their knees and/or hips. Several of them underwent knee replacement surgery. Some of these surgical patients had extremely good outcomes and some have suffered increased pain and difficulty walking after their surgeries. One lady with whom I worked was in her late seventies and kept the same set of knee replacements for over 25 years and reported no difficulty walking. Staying active and working until the age of 80 helped a lot.
One woman I know refuses to have any surgery at all despite severe hip and knee pain, while another woman I know gained enough relief through exercise, herbal medicine, and dietary changes that her condition improved very much. In fact, the physicians of this last women state that she no longer suffers from arthritis.
Certain types of arthritis can sometimes be reversed if not too far progessed, but not often at this juncture. It ould eb difficult to reverse the deterioration of osteoarthritis. However, research is under way to make this more of a possibiity and even a reality for a certain number of patients in the future.
Meanwhile, dramatic improvements are being made to knee replacement parts. In the late 1980s, The Ohio State University developed a ceramic based knee replacement that was reported to last a lifetime. This development, while not widely used to date, will be a boon to patients that have been instructed that they will need new knee replacements every 15 - 20 years. A number of people need their first replacement by age 50 and cannot face having it repeated twice in their lifetimes.
Another improvement is the development of different knee replacement for men and women,based in the difference between men and women in structure of the lower body and how the bones connect at the hips and knees. There has arisen some difficulties in using what is now seen as a "male" knee in female patients.
What Are the Complications Of Joint Surgery?
Cutting Edge Replacement
Knee Replacement Information
On top of arthritis, a knee can become infected, showing signs of severe pain, joint swelling with heat or warmth, fevers, and inability to walk, bend the knee, or hold one's weight. This can occur with or without arthritis, but can worsen the overall knee condition if arthritis is already present. Infections can be mistaken for arthritis.
One of the factors that can affect the success of knee replacement surgery is body weight. Morbid obesity works against the successful rebuilding of joints in the legs. One patient I have known was not able to lose much weight before surgery and had a bad experience with their knee replacements that were to treat osteoarthritis (deterioration).
Despite physical therapy and leg exercises in step-down care after surgery, followed later by twice-weekly physical therapy sessions on an outpatient basis, the knees would not fully bend. The actual body tissue around the knees was too much and the knees also swelled, as did the feet. Swollen joints cannot bend well, if at all. When insurance ran out, physical therapy stopped for this patient and the knees began to stiffen even further.
Today, several years later, the patient is left able to walk only about 100 yards before having to stop and elevate the legs, cannot drive, and can rarely walk up the steps of a bus.
Further, after the first surgery, this person developed a large amount of scar tissue in both knees and had to have additional surgery to remove it three years later. The knees worked better until insurance ran out and physical therapy stopped.
This patient states that they would not have had the surgery if they knew their pain would be worse than previous to the operation. However, they had been told that their arthritis was so badly progressed that both the knees were "bone on bone" with no cartilage padding left at all.
CONSISTENT REGULAR MOVEMENT AFTER SURGERY
It is possible that physical therapy needs to be administered at least 3 times a week in some cases, and prescribed exercises done daily without fail. I have worked with dozens of joint and back condition patients in my martial arts and fitness classes and found that once or twice a week sometimes produces no results. It's an individual matter, but I think the daily exercises are vital.
Wearing the wrong type of shoes can likely lead to joint problems before and after knee replacement surgery. Those folks that I have known that wore well-constructed shoes with a good arch support built in seemed to have had the best success. One of these women was able to put on 4-inch high heels for work 6 weeks after surgery.
WAITING TOO LONG
One of my my back-pain patients in the Health Psychology department in which I worked was to have knee replacement surgery to relieve osteoarthritis that was connected to military service and subsequent military-related injuries. He went into the hospital for one knee only the first time.
When he awoke, he was informed that the knee replacement could not be accomplished, because the knee was in too deteriorated a condition. The bones had to be fused to eliminate the knee joint entirely. This had a great impact upon him physically and psychologically and he did not have surgery on the other knee.
ADDITIONAL ARTHRITIS AFTER SURGERY
Another patient suffered additional arthritis after knee replacement surgery. Arthritis spread somewhat into the remaining bones of the legs and progressed into the back and even into some muscles (certain arthritis can attack muscles). This patient felt worse off than before surgery.
HOSPITALS AND DOCTORS
Second and third opinions about the advisability of knee replacement therapy should be obtained and then the decision should still be carefully considered.
One item to consider is the type of hospital to which you will go for your surgery. Sometimes teaching hospitals can produce superior results. Sometimes totally orthopedic hospitals that specialize in these surgeries produce the most positive outcomes.
The best course of action is likely to read everything you can about knee replacement surgery, learn about the hospitals and doctors that will treat you, get a second and third opinion, and weigh all of the information carefully in making your decision.
Other Risks of Knee Replacement
- Post-operative Infection.
- Fractures in the bones of the leg during surgery, especially near the knees - Surgical cement is being used instead of metal screws in many cases and this damage is thereby avoided.
- Blood Clots
- Vascular disease associated with the tourniquet required on the leg during surgery
- Tissue Death from over-long tourniquet use
- Neurological Involvement - 1) a type of palsy in the legs and/or 2) Restless Legs Syndrome
- Pain and Stiffness in some cases
- Psychological involvement - depression particularly
Alternative - Partial Knee Resurfacing
Making a Decision
If left untreated, arthritis in the knees can become crippling. Sometimes non-surgical treatment does not even work. However, sometimes knee replacement surgery is not as successful as it might be in certain cases. On the other hand, dramatic improvements in knee replacement parts and therapy techniques make for a better picture for the future of knee patients.
The keys are
- Patient education and
- A partnership between doctor and patient to work together for the best possible outcome in each unqiue case.
© 2008 Patty Inglish
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