Joint Replacement

Joint Replacement Needs

Introduction:

Joints:

Joint is a structure that separates two or more adjacent elements of the skeletal system. Depending on the type of joint, such separated elements may or may not move on one another. This section discusses the joints of the human body.

Major weight bearing joints are Knee joints and Hip joints.

Arthritis:

An individual faces normal wear and tear of the joints throughout their life. However, when this wear and tear is chronic it leads to joint damage which gives inconvenience to an individual while performing their routine activities. The joint damage depending upon the type and severity can be categorized as Arthritis.

Arthritis can further be classified as Osteoarthritis, Rheumatoid arthritis or polyarthritis.

Causes

Arthritis is most commonly caused due to aging, “wear and tear,” injury, disease, and developmental abnormalities in the joint's structure. There are over 100 different types of arthritis.

Types of Arthritis

Osteoarthritis, Post-Traumatic Arthritis, and Rheumatoid Arthritis are types of arthritis that frequently develop in the knee.

  • Osteoarthritis is the most common type of arthritis. It tends to develop as people grow older. Osteoarthritis can result from overuse of the main joints during sports or work. Osteoarthritis causes the articular cartilage covering the end of the bones to gradually wear away, resulting in painful bone on bone rubbing and disrupted movement.
  • Rheumatoid Arthritis is one of the most serious and disabling types of arthritis. Rheumatoid Arthritis can affect people of all ages, but most frequently occurs in women and those over the age of 30. It is a long-lasting autoimmune disease that causes the layer of connective tissue to become inflamed, which then attacks the cartilage. This damages the smooth, white tissue covering the bone ends and leads to pain and stiffness.
  • Post-Traumatic Arthritis can develop in individuals of all ages after a serious joint injury. A joint fracture or severely torn ligaments can damage the cartilage over time. This can cause joint pain and limit function.

Symptoms

  • You may feel moderate to severe pain while moving or resting.
  • Your affected joint may feel swollen, stiff, or become unstable.
  • Your legs may look like angulated inward or outward, instead of being straight.
  • You may feel difficulty to move or bend your joints. Your joint pain may eventually limit everyday activities, including walking, stair climbing, and getting in and out of chairs.
  • Your medications, rest, and physical therapy may provide little relief from the pain of severe arthritis.

Diagnosis

  • Physical examination: Medical history, symptoms, and level of pain, muscle strength, joint motion, and knee alignment. Blood tests and other laboratory tests
  • Radiographic Evaluation: X-rays, Magnetic Resonance Imaging (MRI)

Treatment

  • Medication
  • Rest
  • Physiotherapy
  • Joint Arthroplasty or replacement is recommended when non-surgical treatments do not provide relief of symptoms.

Surgery

Knee & Hip Arthroplasty involves removing damaged joint and replacing it with an artificial one. This is an inpatient procedure. You will most likely be admitted to the hospital on the day of arthroplasty and stay there for several days.

Post-operative Instructions for Patients Undergoing Total Knee Replacement (TKR) or Total Hip Replacement (THR):

Home Safety Preparation: : Listed below are suggestions for preparing your home for a safe recovery.

  • Bathroom:

    • Elevated commode seat
    • Toilet seat riser
    • Shower chair
    • Grab bar for shower / tub
    • Hand-held shower head
    • Long-handled bath sponge
  • Traffic pattern:

    • Be more careful from floor wires, carpet and mat while walking.
    • Create a wide, clear path from your bedroom to your bathroom and kitchen so you can easily move about with a walker or crutches.
  • Sitting:

    • Sit in chairs that keep your knees lower than your hips. Choose a firm, straight-back chair with armrests.
    • A dining room chair may work if you don’t have other chairs.
    • Add a foam cushion or folded blanket if you need to raise yourself up, but avoid sitting on a soft pillow and sitting in rolling chairs or recliners.
  • Children and Pets:

    • Small children and pets can pose a safety hazard.
    • Small children may need to be taught how to interact with you in ways that keep you safe.
    • If you have pets, make arrangements to keep pets in another area of the house when you arrive home.
  • Stair climbing:

    • It’s okay to climb stairs without assistance, if you are able.
    • However, you may need help with climbing stairs when you first get home.
    • Consider installing handrails or make sure existing handrails are secure.
  • Laundry and cleaning:

    • Get help with cleaning and laundry. Have a few weeks’ of clean clothes available
  • Meals:

    • Arrange for help with your meals and perishable foods (milk, salad, and fruits and vegetables).
    • Freeze pre-made dinners before your surgery.
    • Stock up on non-perishable foods (boxed, canned, and frozen) to make it easier to prepare meals after surgery.
  • Driving:

    • Arrange for someone to drive you to your  home after surgery appointments.
    • Do not drive until your surgeon tells you it’s okay to do so.
    • Do not drive after taking medicine as some medicine can lead to sleep. Do not drive until you have regained the range of motion, strength, and reaction time needed to drive safely