Knowing About Knee Replacement Surgery

The knee is a one of the most common joints to suffer from wear and tear. While injuries are often the culprit, simple daily use of the knee joints can often lead to a need for surgery. Stiffness and pain that may be plaguing an individual are signs that should be taken to a specialist for prognosis. More basic treatments will usually be recommended at first, but if they do no help, surgery may be the best option.

How the Surgery Goes

In the case of a knee replacement surgery, anesthesia is used to put the patient under. An 8 to 12 inch incision is made in the knee and the damaged portion is removed. The surface needs to be shaped to fit an artificial joint and is held together by special cement. These replacement joints then rely on their surrounding ligaments and muscles to function correctly.

Minimally Invasive Surgery May Be an Option

MIS, or minimally invasive surgery, has helped shape a more efficient process for knee replacements. This procedure allows for surgeons to minimize large incisions, leaving the patient with less scarring. As described above, a cut can be as long as 12 inches, but with MIS the incision is typically between 3 to 5 inches.

With less tissue trauma, this method may lead to a decreased recovery time, less pain and even better motion. This method is relatively and only performed by a few orthopedic surgeons in North America. Research is still being conducted to measure the effectiveness of both procedures in comparison to one another.

Post Surgery

After surgery, the hospital stay is usually about three to five days. Most patients see a dramatic improvement in mobility about a month after the procedure. Pain caused by damaged joints is usually lessened by the smooth surface created during surgery.

Patients should be able to stand and move the joint the day following surgery. Rehabilitation may be needed, and often parallel bars or walking devices will be recommended. It is important not to put full body weight on the knee until the new joint is able to support it. Six weeks is the average time frame for walking with little assistance, and physical therapy will be required throughout rehabilitation.

Knee surgery can dramatically change the quality of life for many people suffering from chronic joint pain. There are, however, times when surgery should be delayed as long as possible. A physician or surgeon should always be consulted about all the options available to the patient before going ahead with surgery.

Running With Knee Pain? Let's Fix It!

It is well documented that one of the most common areas of injury in runners is the knee joint. One of the main reasons for this is the lack of balance in the muscles that stabilize the knee. For most runners they have strong/tight quadriceps and weak posterior chain muscles (hamstrings & glutes). These imbalances lead to knee problems. Using some simple exercises can help START you on the path correcting these imbalances.

1. Cook Hip Lift

The Cook Hip lift was created by physiotherapist Gray Cook hence the name. Prior to performing this exercise the hip flexors on both sides should be stretched.

• First start by lying on your back.


• Then pull your right knee to your chest and hold your leg with your hands.


• Contract your glutes then push your hips up.


• Pause at the top and lower yourself to the ground.


• Note: If your hamstrings are cramping that means your glutes are not firing properly. Therefore more activation exercises maybe required such as the double glute bridge or the clam.

2. Terminal Knee Extensions

This exercise helps strength the Vastus Medialis Oblique (VMO) which is a stabilizer of the knee.

• First start by looping an exercise band securely to an immovable object (post, squat rack etc.)


• Put one leg inside the band (start with non-dominant leg).


• Place band behind knee cap or just above.


• Find appropriate tension by moving towards or away from where the band is attached to.


• Starting position: both feet flat on the floor Start by lifting heel off the floor on side the band is on.


• Keep the other foot flat on the floor.


• Finish movement by moving your heel back to original starting position.

3. Nordic Hamstring Fall

Injuries to muscle occur during eccentric movements (when a tissue is being stretched too much) especially hamstrings in runners. Therefore is it essential to strengthen muscles during eccentric movements.

• Put a mat down or some type of cushion for your knees.


• Start in a kneeling position


• Have someone secure your feet by putting their hands on your ankles and then pressing down.


• Staying as straight as you can lower your body towards the floor as slow as possible by using your hamstrings.


• Catch yourself by using your hands right before contacting the floor


• Push use your arms and push yourself back into the starting position

4. Side Bridge and Front Bridge

In running or any other sport stabilize the upper the body is important to prevent low back pain. The "core" should be trained as stabilizers instead of movers. Crunches and sit-ups cause excess force on the low back. Dr. Stuart McGill from research has determined that one traditional sit-up can cause 780 lbs or 3300 N of compression on the spine (2006). Therefore sit-ups should pretty much always be avoided.

SIDE BRIDGE

Start by lining body up in a straight line on your side. Raise your hip off the ground by using your feet (stack on of one another) and your elbow as balance points Hold for 10-30 on each side. Keep chin retracted and eyes forward

FRONT BRIDGE

Start by balancing on your toes and forearms Hold your hips up so that if a stick was on your back it would touch the tail bone, upper back and head with a small arch in the low back (aka neutral spine) Hold for 10-30 seconds.

In conclusion, these exercises are a start to help correct a few of the imbalances caused by running. They are not the most glorious exercises ever invented but they do work and that is what I am after; results. These results are what keep my athletes and clients out on the road or on the court or field. Of course there many more exercises for injury prevention for runners.

ACL Surgery Recovery Time

How long the recovery time is from acl surgery until returning to activity depends on what you are wanting to return to. If you are looking to return to work and you sit at an office desk than as soon as you are able to walk you can begin returning for part time work. You will be able to walk before you are able to drive therefore you will need to get a ride into work.

If your job involves standing and moving around than most surgeons will recommend 4-6 weeks before you return.

Finally if your job involves physical activity such as lifting or climbing than depending on the intensity of the work it may take you 2-6 months to return. There are certain activities that in particular are very painful after acl reconstruction and will take extra long to recover from. One of the hardest things to do after surgery is kneel on your injured knee so if you are in home improvement and do a lot of work on your knees it will take closer to 6 months to recover.

How soon can you return to sported after acl surgery?
Most acl tears occur because of sports and therefore most people are interested in coming back from acl surgery and returning to sports. The typical time for return to spots after acl sugary is 6-9 months. There are cases where this time is much longer in particular if the initial injury was traumatic and caused significant cartilage and meniscus damage.

Psychological effect of acl injury and how it affects returning to sport or work
A not often discussed problem with acl injuries(all injuries for that matter) is that it has the potential to affect the patients confidence of performing the activity they were doing when they initially tore their acl. Sometimes the physical damage has been overcome, however the patient can still struggle with returning to the activity. This can cause several problems most significantly is that when someone is scared about being injured in an activity they are doing there chances of being injured in that activity don't decrease they actually become more likely to be injured.

Importance of effective ACL surgery rehabilitation
It is for all the reasons above that completing ACL recovery physiotherapy following a proper recovery timelines is important if you want a healthy pain free knee.

Knee Replacement Surgery - Risks and Rewards

Dorothy had both knees replaced almost two years ago. She struggled with this decision, discussing her options but she had already tried other treatments such as exercise and pain medication. The physical therapy and exercise did not work and the pain medication dulled her thinking and she did not want to live that way.

She was in her mid fifties, relatively healthy, active, and she knew herself well enough to realize that recovery would be painful whatever she decided and physical therapy would take time. She also knew myself well enough to realize that having gone through one painful recovery she would not want to live through that again for the other knee so she decided to do both at the same time. Dorothy is better but she has a problem with one knees and has returned to therapy twice. Some of her activities are limited and her story is still taking place.

The decision to have knee surgery depends on your age, health, activity level, and of course, how much pain and disability you have. Your doctor may also recommend knee replacement if you have lost a large amount of cartilage and if you do not have health problems that would make it dangerous for you to have surgery. Most of us have knee replacement when we can no longer control our arthritis pain with medicine and other treatments and when the pain interferes completely with our lives.

To make the decision about surgery make sure you get the facts, compare your options, know where you are in your life and where you want to go. Most people delay knee replacement surgery they believe the rehabilitation from the surgery is painful, takes a lot of time, their insurance probably covers only part of their therapy and office visits, and there is no guarantee of full recovery in the first place.

The problem is that delaying knee replacement surgery brings on its own sets of risks which usually involve more joint deterioration and increased pain and lack of mobility. Other risks include muscles and ligaments becoming weak and making the surgical procedure more complicated because more damage has taken place. In other words, if surgery is performed early it may be more successful and the patient is likely to recover faster.

Having said this there are still many risks of knee replacement surgery even when you have no other choice.

Blood Clots

Blood clots in the large veins of the leg and pelvis are common after join replacement surgery. Your doctor may want you to take blood thinning medications or wear a compression stocking to keep the blood in the legs circulating. The concern is that the clot does not travel to the lungs and cause a fatal pulmonary embolism.

Stiffness

Scar tissue is formed following surgery both on the kin and inside the joint. When a scars contract, a tightening of the soft tissues around the joint may occur which may make it difficult to bend the knee. That is way good physical therapy begins immediately keeping your knee in motion to prevent stiffness. If stiffness remains, your doctor can do a manipulation under anesthesia which will break the stiffness but require more physical therapy for you.

Implants fail

Overtime your knee implant will be worn out or it may loosen. Most implants last 15 to 20 years but every implant eventually wears out. A replacement surgery is usually the next step.

Infections

Infections sometimes occur following the surgery. They may happen a few weeks later or even in the next year. The goal is to remove the infection without removing the implant. Some patients develop urinary tract infections from their hospital stay.

The good news is that risks of serious complications are rare. Fewer than 2 percent of people undergoing knee replacement surgery experience serious complications. Keep in mind, however, that infection can occur even years after surgery so contact your doctor if you have a lasting fever, drainage from the surgical site and any redness, tenderness, or swelling and pain in the knee. If antibiotics fail to clear your infection you may need another surgery to remove the infected joint and to install a new one.

Anterior Cruciate Ligament (ACL) Injuries in Sports

Football is popular in the UAE, Oman, Saudi Arabia and Bahrain. Every town in the Middle east has a large stadium and the game is played in the streets and village playgrounds. with the world cup around the corner, many amateur footballers will try their skills at the game.

The game of football extracts a heavy toll of ligament and cartilage injuries of the knee joint. These are the commonest ligament injuries and the anterior cruciate ligament has been considered as the most valuable piece of connective tissue in the human body as professional football clubs hand over contracts to footballers worth several millions of Euros and dollars and withdraw them immediately if the player is injured. The MOH hospitals in Oman, Bahrain, and Saudi Arabia treat a large number of knee injuries. There have been a larger number of new concepts in the treatment of this injury.

ACL Injury(anterior cruciate ligament injury)

Anatomical background-

The ACL (anterior cruciate ligament) is one of four ligaments stabilising the knee joint. Ligaments are cord like tissues, which connect one bone to another. In the knee joint there are four ligaments, namely the medial collateral (inner), lateral collateral (outer), the anterior cruciate and the posterior cruciate. The anterior cruciate ligament runs from the back of the thigh-bone to the front of the inner side of the shin or leg bone. It prevents the leg bone from sliding off in front from the thigh bone. The ACL injury can be a partial sprain or a complete tear

Mechanism of injury-

The most common mechanism is a sports injury where there is a cutting or twisting injury to the knee.

Activities for risk

Injuries in sports like football when the player tries to tackle from the back, his knee twists and he falls to the ground. Involvements in other sports like basketball, cricket, skiing and hockey can also result in ACL injury. A blow to the knee from the front. Patients with cruciate ligament injuries are prone to develop tears of the menisci(semilunar cartilages) and this can lead to secondary osteoarthritis

Symptoms

The person falls to the ground and is unable to continue the sport or activity which he was pursuing. He can feel or hear a popping sound in the knee joint. A swelling develops rapidly. There is a feeling of instability in the knee joint. Pain in the knee immediately, which worsens with the onset of swelling. Repeated giving away of the knee can occur as the patient runs around curves or while coming downstairs

What is the future for a patient with an ACL injury?

Complete ACL injuries result in instability of the knee joint. Whenever the person runs or comes downstairs rapidly the tibia slides off the femur. This can lead to repeated falls. These can result in injuries to the semilunar cartilages or menisci. Meniscal tears can lead to mechanical symptoms like locking or unexpected falls.

A combination of persistent ligamentous laxity and meniscal tears can result in the development of secondary osteo-arthritis.

Treatment- RICE

(Rest, ice, compression, elevation). An ACL injury is a serious one which needs medical attention immediately. The surgeon may aspirate the blood inside the joint to provide comfort. He may order a MRI scan to confirm the diagnosis immediately. An ACL injury can be treated conservatively in those individuals who are willing to restrict their sporting activity. For those unwilling to do so, surgical treatment is advisable. Surgical treatment consists of an examination under anesthesia, arthroscopy and ACL reconstruction. The orthopedic surgeon may decide to take a graft from the patellar tendon or hamstrings. Bony tunnels are drilled through the tibia and femur and the graft is fixed.

ACL Knee Injury Is No Longer Career Threatening

Sports is definitely one of the best things you can do as a hobby or even a profession. Not only will you get lots of money and fame if you're good at it, but you will also be very likely to have a physically fit body. But whether you are a pro or an amateur athlete, an injury is something you would never want to have, but is also something you can never be safe from. And ACL knee injury, in particular, is one of the scariest types of injuries. In the past, an ACL tear was even considered a career ending injury. But with the better technology available to all of us nowadays, there is no reason that you will not be able to return to playing after such an injury.

One interesting fact that you may also not be aware of is that athletes are not the only ones who are prone to an ACL injury. It actually does not take you to be involved into sports to be unlucky enough to sustain this ligament tear. ACL is the ligament in the knee which is responsible for controlling the movements of the knee joints. This ligament is also supposed to make the knees stable and move only in the direction it is supposed to move. So if you come to think of it, an ACL injury can be caused by the improper movement and pressure applied on the knees, and we are all likely to do this.

A research actually revealed that most of the cases of ACL injuries are due to non contact sports. In other words, most of the people with this injury actually did not come into contact to anybody or anything. The main cause of the ligament tear is the wrong positioning of the body, which causes too much pressure put on the knees. The hips and the ankles are supposed to balance the knee joints, but when this does not happen, the ACL ligament will tear, and this is the typical way a person sustains an ACL knee injury.

As mentioned previously, there are several ways that a person with a torn ACL can still go back to playing sports. Basically, an athlete undergoes a period of rehabilitation. There will be activities that need to be done so that the ligament can heal. Part of this process is the usage of a special knee brace that will have the torn ACL heal by itself after some time. If the rehabilitation does not work, a surgery will be required.

If you are suffering from an ACL knee injury, you should not be scared that you may not be able to play again. With the proper surgery and rehab, you can surely be physically fit again in no time.

Cervical Disc Replacement - Risks and Benefits

Exactly what is a cervical disc replacement and what is it necessary? It is a device inserted between two cervical vertebrae to replace a surgically removed vertebral disc. What this basically means is that this disc will help to stabilize and maintain the motion of the neck after surgically removing a diseased disc in the neck. Disc replacement surgery is done to stop the symptoms of degenerative disc disease. Our discs wear out as a natural part of aging and from stress and strain on the neck. Eventually, the disc collapses and implanting this device is a last resort option when non surgical treatments means have failed to improve the health of the patient. The benefit of the surgery is obviously to help treat the worn out part of a patient's aging neck. It is usually a strong metal structure, thus eliminating most of the concern of whether or not the patient will require further replacements. The patient can recover quickly from the surgery and can be back to work within four to six week when following a strict recovery protocol. However, I believe that there are way too many risks and potential complications associated with this surgery.

When you stop and think about it for a moment, some things can go wrong with any implant. In the case of the disc replacement, sometimes the spine fuses itself, a process called spontaneous ankylosis. Loss of neck motion is the main side effect of this problem. Some patients are left with pain, numbness, and weakness. In addition, normal wear and tear over a prolonged period of time can cause debris to come off of the implant. The body may react to these tiny particles and cause pain, implant loosening, and implant failure. In rare cases, the artificial disc replacement can dislocate altogether and more complications will arise. Most surgical procedures require that some type of anesthesia be done before surgery. A very small number of patients have problems with anesthesia, however to avoid falling into that small percentage, consult your doctor. Thrombophlebitis is a fancy scientific term for blood clots, and they usually occur on the pelvis, hip or knee. When left untreated, they are life threatening. Infection following spine surgery is also rare but can be a very serious complication. Some infections may show up early and uninvited! Deep infections that spread into the bones and soft tissues of the spine are much harder to deal with and may require additional surgery. Cervical disc replacement surgery also carries the risks associated with injuring the blood vessels that travel near the front of the spine. Boy, these risks are piling up mighty fast.

Could you imagine if the surgeon makes a mistake? Injury can occur from bumping or cutting the nerve tissue with a surgical instrument, from swelling around the nerve, or from the formation of scar tissue. Any of these will result in muscle weakness and a loss of sensation to the areas supplied by the nerve. After doing some research, I believe that the potential for the voice box to be injured scares me the most. When doing this neck surgery, surgeons prefer to go through the left side of the neck, and coincidentally that's the closest path to the voice box. If the nerve gets injured in any way, shape or form, you can guarantee that you will have some hoarseness, voice fatigue, or difficulty making high tones. I love to talk; I couldn't imagine having that taken away from me "accidentally". While rare, spinal surgery can result in stroke, heart attack, spinal cord or spinal nerve injury, pneumonia, or possibly death. I don't like the sound of any of those possibilities! These are the more dangerous complications one can deal with after the surgery if performed. After realizing how dangerous this surgery can be, I definitely will be taking better care of myself and my health to prevent this from happening to me. If this surgery can be avoided altogether, I'd rather take that route instead of the latter.