Knee orthopedic surgery is an invaluable form of medical intervention designed to address various knee-related ailments.
No matter the cause – sports injuries, arthritis or any other issue impacting knee function – understanding all aspects of knee orthopedic surgery is integral for making informed decisions regarding treatment and recovery.
This comprehensive guide addresses every facet of knee surgery – from its type and preparations, through surgery itself and postoperative recovery to care post-op care.
Table of Contents
Understanding the Knee Joint
Before jumping into knee orthopedic surgery, it’s essential to fully comprehend its anatomy and purpose.
The knee is a complex hinge joint connecting the femur with the tibia and fibula (small bone running alongside of it). Furthermore, the patella (kneecap) also plays an integral part in protecting and stabilizing this joint system.
Components of the Knee Joint
- Bones: The femur, tibia, fibula, and patella form the structural basis of the knee joint.
- Cartilage: The knee joint contains two types of cartilage – articular cartilage covers the ends of bones while meniscus cartilage acts as a cushion between the femur (thigh bone) and tibia (shin bone).
- Ligaments: Cruciate and collateral ligaments provide stability to the knee. ACL and PCL ligaments run parallel within the knee joint while collateral ligaments crisscross on its sides.
- Tendons: Tendons connect muscles and bones; for instance, in the knee area the quadriceps tendon connects directly with quadriceps muscles while the patellar tendon connects directly with tibia and the patellar tendon connects directly with the patella.
Understanding how these components interrelate is integral to understanding all the complexities associated with knee surgery.
Common Conditions Requiring Knee Orthopedic Surgery
Several conditions may necessitate knee orthopedic surgery. Each condition requires a tailored approach, and understanding the specific issue is crucial for determining the most appropriate surgical intervention.
1. Osteoarthritis
Osteoarthritis, a degenerative joint condition, is one of the main contributors to knee pain and stiffness, occurring when protective cartilage that cushions bones wear away over time.
Total knee replacement may be recommended in severe cases as an effective long-term solution to alleviate pain and increase mobility.
2. Anterior Cruciate Ligament (ACL) Tears
ACL tears are common sports injuries, often requiring surgical intervention for optimal recovery. Arthroscopic surgery, a minimally invasive procedure, is frequently employed to reconstruct the torn ligament.
3. Meniscal Tears
The meniscus, a wedge-shaped cartilage in the knee, can tear due to injury or wear and tear. Arthroscopic surgery is commonly used to trim or repair the torn meniscus, depending on the extent of the damage.
4. Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder that can affect the knees. In severe cases, joint replacement surgery may be recommended to alleviate pain and improve joint function.
5. Fractures and Trauma
Fractures or traumatic injuries to the knee may require surgery to realign and stabilize the bones. Internal fixation with screws or plates is often employed in these cases.
Preparing for Knee Orthopedic Surgery
1. Consultation and Evaluation
Before undergoing knee orthopedic surgery, a thorough consultation with an orthopedic surgeon is essential. The chirurgien orthopédiste genou will evaluate your medical history, perform a physical examination, and may order imaging tests such as X-rays or MRI to assess the extent of the knee damage.
2. Discussion of Treatment Options
After conducting an evaluation, a surgeon will discuss the most suitable treatment options based on your diagnosis. Before turning to surgery as the only solution, non-invasive approaches such as medication or physical therapy could also be considered as viable treatment methods.
If surgery is required, however, he or she will discuss its process, potential risks involved and expected outcomes with you before beginning their work.
3. Preoperative Tests and Optimization
Once your decision to undergo surgery has been made, preoperative tests such as blood tests and electrocardiography (ECG) will likely be administered in order to make sure you are healthy enough for surgery.
If you have preexisting medical conditions such as diabetes or high blood pressure, they will be carefully managed prior to surgery taking place.
4. Prehabilitation
Engaging in prehabilitation exercises before surgery can enhance strength and flexibility, promoting a smoother recovery process. Physical therapists may prescribe specific exercises to prepare the knee and surrounding muscles for the upcoming surgical intervention.
Types of Knee Orthopedic Surgery
1. Total Knee Replacement (TKR)
TKR or Arthroplasty surgery involves replacing an affected knee joint that has been affected by osteoarthritis, rheumatoid or rheumatoid-related arthritis with an artificial one to reduce symptoms and enhance quality of living.
2. Arthroscopy
Arthroscopic surgery is a minimally invasive technique in which an arthroscope (small camera) is introduced into a joint through small incisions to access damaged tissues or repair any tears such as ACL or meniscal tears.
3. Partial Knee Replacement
Unlike total knee replacement, which replaces the entire joint, partial knee replacement involves replacing only the damaged part of the knee. This option is considered when arthritis affects only one compartment of the knee.
4. ACL Reconstruction
For individuals with a torn ACL, reconstructive surgery may be recommended. This procedure involves replacing the damaged ligament with a graft, typically from the patient’s own hamstring or a donor.
5. Osteotomy
Osteotomy involves cutting and repositioning the bones around the knee to relieve pressure on the damaged area. This procedure is often considered for younger patients with knee arthritis who may not be suitable candidates for joint replacement.
The Surgical Process
1. Anesthesia
Most knee orthopedic procedures are done under either general anesthesia (where patients remain asleep throughout), or regional anesthesia, where only part of their lower bodies are numbed. The choice of anesthesia depends on the type of surgery and the patient’s health.
2. Incision
The surgeon makes an incision to access the knee joint. The size and location of the incision depend on the type of surgery being performed.
3. Procedure Execution
The specific steps of the procedure vary based on the type of surgery. In total knee replacement, for example, the damaged joint surfaces are removed, and the prosthesis is securely implanted. In arthroscopy, the surgeon uses specialized instruments to address the specific issue, such as repairing a torn ligament or removing damaged cartilage.
4. Closure
Once surgical objectives have been fulfilled, the surgeon typically closes the incision using sutures or staples; with arthroscopic procedures however, small incisions may only need adhesive strips as closure.
Post-operative Care and Rehabilitation
1. Immediate Recovery
Once patients undergo knee orthopedic surgery, they are carefully observed in the recovery room before being transferred to their hospital room. At this initial phase, pain management with medications or other methods should take top priority.
2. Physical Therapy
Physical therapy plays an integral part of post-surgical recovery. Physical therapists guide their patients through exercises designed to increase mobility, strengthen muscles and gradually transition them back into regular activities.
3. Medication and Pain Management
Patients typically take painkillers after surgery in order to manage post-op discomfort and may also receive antimicrobial and blood clotting prevention medication, so it’s essential that patients adhere to any prescribed regimen.
4. Use of Assistive Devices
Crutches, walkers, or braces may be recommended initially to support mobility while the knee heals. Gradually, as strength and stability improve, these aids are phased out.
5. Follow-up Appointments
Regular follow-up appointments with an orthopedic surgeon are crucial in order to assess healing processes, identify any concerns, and adjust rehabilitation plans as necessary.
Potential Complications and Risks
While knee orthopedic surgery can generally be safe and effective, there may be certain inherent risks involved that should be fully understood in order to make an informed decision about surgery.
1. Infection
Infection is a risk with any surgical procedure. Antibiotics are often administered before and after surgery to minimize this risk.
2. Blood Clots
Surgery increases the risk of blood clot formation. Medications, compression stockings, and early mobilization help mitigate this risk.
3. Nerve and Blood Vessel Damage
In rare cases, nearby nerves or blood vessels may be damaged during surgery, potentially leading to complications.
4. Joint Stiffness
Some patients may experience joint stiffness after surgery, requiring additional physical therapy to address.
5. Implant Issues
Prosthetic joints can sometimes wear out or become loose over time, necessitating further surgery.
Conclusion
Knee orthopedic surgery can be an intricate and life-altering intervention for people suffering from debilitating knee conditions. This comprehensive guide offers an in-depth exploration of knee anatomy, conditions that warrant surgery, pre-op preparations for operations on this joint joint type and post-op recovery care after surgeries are conducted.
