Have you ever experienced these symptoms: knee ache, swollen knee, knee inflammation, crackling sound when walking, cannot extend your leg straight, including difficulties walking up and down the stairs? If so, these are warning signs for knee arthritis. Some risk factors are being middle-age or older, female, overweight, repeated trauma to the knees, previous knee injury, and genetics factors. If the knee surface suffered ample damage from inflammation or injuries, patients may feel pain when walking or using the stairs. If the damage is more severe, patients may feel aches and pains when they are sitting or sleeping.
Treatment begins simply by changing the way the patient uses their knees, taking anti-inflammatory medicines, or using a cane. If these pre-emptive measures are ineffective and the patient’s quality of life deteriorates, total knee replacement surgery may be an option. The damaged knee surface will be replaced with metal or plastic cap to gain usage of the joint. Current developments in surgical procedures and replacement materials allow of highly effective surgery. The patients can recover quickly and return to their normal routines.
The knee is the largest joint in the body and consists of three bones:
They are joined together by ligaments and muscles that allow movement. Each piece of bone is capped with articular cartilage, which is the white, smooth tissue that acts as cushion for their interaction. The smooth cartilage allows for better movement, while synovial membrane, a thin smooth lining tissue, produces lubricant for the joint.
The most common causes of knee pain are arthritis or chronic knee inflammation, such as rheumatoid arthritis, and knee injury.
Treatment begins simply by changing the patient’s physical activities to reduce tension and force on the knees by refraining from squatting, kneeling, using the stairs, jogging, and heavy lifting. Taking anti-inflammatory medication can also be helpful as well as knee muscle exercise to increase stability. If these options fail to improve the condition, direction injection with drugs, such as steroids or artificial synovial fluids, can be performed, to alleviate the pain and movement. Lastly, knee replacement surgery can be performed to get rid of the pain. Movement can improve and patients can begin walking after surgery with the aid of a walker.
Patients who receive total knee replacement surgery will feel less pain and can regain their quality of life. The patient will be admitted to morning of or the night before surgery. The anesthesiologist will assess and recommend the method of pain management suitable for individual patient. Methods include a systemic sedation or a spinal block. Total knee replacement surgery lasts approximately 1 – 2 hours. The damaged surface is surgically removed and prosthetic joint made of either metal or a composite is inserted to absorb the impact. After surgery, the patient will be observed in the recovery room for another 1 – 2 hours. Once the patient has gained consciousness, they will be moved to inpatient care ward. Most will stay in the hospital for 4 – 5 days. A physical therapist will begin rehabilitation immediately after surgery and subsequently help the patient to self-ambulate until they can be discharged and return to normal activities.
The Hip and Knee Center at Bangkok International Hospital is one of the pioneers of total knee replacement surgery using digital template program to plan the surgical position together with pain intervention technique, such as adductor canal block, and ultrasound waves (alternative supplement for pain management). Such combination minimizes pain and injury to surrounding tissues. Complications after surgery is also reduced, resulting in quicker recovery and patients can walk again within 24 hours as well as return to their daily routine quicker.
