Although research shows that both women and men use knee replacement, nearly two thirds of the annual knee replacement patients in the US are women according to the National Center for Health Statistics. As such, women seem to experience wear and tear in the joints of the knees more than men.
Knee replacement surgery
Knee replacement surgery or knee arthroplasty is a common surgery for those with severe damaged knee to relieve the pain and disability from degenerative arthritis known as osteoarthritis. It is especially for those who do not respond to medicine and other alternative treatments.
In a total knee replacement surgery, the surgeon removes the damaged cartilage and bone from the surface of the knee joint and replaces them with metal or plastic man-made surface shaped to restore the knee movements and function. The new artificial knee is termed 'prosthesis'. The prosthesis which composes of two metal pieces is fitted to the ends of the tabia and the femur with a plastic piece inserted between them to act as a bearing. Usually a durable and wear resistant polyethylene is used for bearing.
Partial knee replacement surgery is a minimally invasive procedure and the surgeon replaces only one part of the knee joint. Here, only the diseased portion is removed and replaced with metal implant.
Knee replacement surgery cost
The Joint Replacement Center of NYC offers a guide on the costs involved in a knee replacement surgery:
For patients without health insurance, a total knee replacement surgery could cost about $35000 or even more. Of course, there are health centers that offer uninsured discounts as well which would be a special tariff with a highly discounted price. A partial knee replacement costs about half the amount of a total knee replacement.
Knee replacement surgery as such is covered by health insurance if required by a doctor. Even if patients possess health insurance, there could be out-of-pocket expenses to the tune of $ 4000 to 5000.
For optimal recovery from knee replacement surgery, some preparations to living space are necessary. These include a stable shower bench, a toilet seat raiser with arms, bars in the shower and bath which also involve some expenditure.
Knee replacement surgery recovery
After surgery the patient is usually taken to the recovery room and monitored. Necessary pain medication is administered on the patient to enable participate in the rehabilitation exercises. Recovery varies from person to person depending on their level of pain and activity before their surgery. Factors such as strength before the surgery, body weight, ability to manage painful symptoms all matter.
Although there could be possible side effects such as scarring, blood clots and infection, orthopedic surgeons advice patients to keep moving those knees. Exercise can make the knee more mobile and certainly stronger. Patients begin with simple activities such as ankle pumps, leg lifts and heel slides. Some surgeons use a motion machine called CPM for continuous passive motion although the benefit of such machines has not been proved.
Most of the patients take their first few steps after surgery with the help of a walker. Some opt for crutches. The physical therapist works on mobility, strengthening and walking even during the hospitalization of the patient. The patient starts preparing for such tasks such as washing, dressing and other daily activities. Patients are trained by the therapists to go up and down the steps using crutches/walker.
Return of the patient to driving depends on the side of the operation and also the type of the vehicle driven. Return to work depends on the kind of job; patients who work in a seated position with limited walking can go back about four to six weeks from the time of surgery. The patient's new knee will perform just like the old one; of course participation in high sporting activities is ruled out.
Knee replacement exercises
Exercise after surgery is pertinent to the success of the total knee replacement. Exercise aids to regain the increasing motion in the knee following surgery. It prevents muscle loss and helps rebuild the muscle strength and prevents stiffness of the new knee joint.
Orthopedic surgeons and physical therapists recommend exercise for approximately twenty minutes to half an hour at least twice daily coupled with a thirty minute walk twice or thrice daily during early recovery. Exercises that are non-weight bearing are the most beneficial. Water exercises, bicycling, stretching programs and yoga help preserve musculature and reduce symptoms.
It is advised to undertake the following post operative exercise regimen under supervision of a therapist.
Knee flexion exercise: Lie in bed on the back and keep legs straight and arms at the side. Slide the foot of the surgical limb toward the back to a point where a mild stretch is felt. This position should be held to a count of ten and then slowly return to the starting position. This exercise promotes muscle activity of the hamstrings and also helps to increase knee flexion.
Straight leg raise: Bend the other leg that has not undergone surgery by raising the knee and keeping the foot flat on the bed. Keep the leg that has undergone surgery straight and about six to ten inches off the bed. Hold this position for about ten seconds and then lower the leg slowly to the bed and repeat twenty times. This exercise promotes strength of the quadriceps and flexor muscles.
Terminal knee extension: Tighten the quadriceps muscle and straighten the knee by lifting the heel off the bed. Hold the muscle contraction for about ten seconds and then slowly lower the heel to the bed. This exercise promotes muscle activity and increases knee extension.
Pillow squeeze: Place a pillow between the knees and squeeze the pillow and hold for a count of ten. Relax for a short period of time and repeat the exercise twenty times. This exercise strengthens the hip and groin muscles.
All types of sports and stressful activities should be avoided. Weight lifting, jumping from heights, falls and exercises with machines are dangerous and should be avoided. As such it is recommended not to lift more than forty pounds. It is advised to start the exercises as soon as the patient is able. Although the patient may feel uncomfortable at first, these exercises will certainly speed the recovery process and help diminish the post operative pain.
Knee replacement alternatives
A knee replacement surgery can be construed as the last resort of defense for arthritis of the knee. There are several other treatment options and alternatives as not every patient is suitable to undergo knee replacement surgery due to age or declining health and other related factors.
In the past during a knee replacement surgery the orthopedic surgeon would make adjustments in order to make a traditional knee implant fit a woman. Whereas recently there knee implants are so designed to fit that lady patient perfectly working on the distinct anatomical difference between women and men.