CNY Orthopedic Sports Medicine, PC: InjuryDetail: Total Knee Replacement
 
Injuries and Conditions: Knee: Total Knee Replacement: Medical Details
 
Overview
As the bones of the knee come in contact with each other, an insulating layer of cartilage helps distribute weight and reduce friction across the joint. Osteoarthritis, or other degeneration of this cartilage over time, reduces the smooth surfaces of the knee and causes pain as bone and bone come in contact and rub against each other. For patients that have exhausted other treatments and continue to suffer pain, a knee replacement may be recommended to alleviate many of the problems caused by a degenerating joint.



Causes of Injury
  • Many conditions can result in degeneration of the knee joint; the most common is osteoarthritis.
  • Some individuals are more prone to develop osteoarthritis than others. Causes for the condition are not yet known, although it is likely similar to other degenerative conditions that are the result of a combination of factors including heredity, type and intensity of athletic activity and the extent of previous injury to the joint.
  • Repetitive pounding or impact producing actions to the knee can cause damage to the cartilage over time.
  • Cartilage can also be damaged from a traumatic event, such as a sudden twist or blow to the knee.
  • Any injury to the cartilage of the knee may accelerate any degenerative arthritis already occurring in the joint.



  • Diagnosis
    Both the patient's previous treatment history and their ability to tolerate the pain associated with a degenerative knee are of primary importance when considering a knee replacement. A painful knee can greatly reduce the patient's ability to lead an active life. After progressive treatments have been undertaken to treat the knee and are no longer providing effective pain control, a knee replacement may be considered.

    The orthopaedic surgeon will review previous treatments which may have included steroid injections, anti-inflammatories, activity modification, correction of any bio-mechanical deficiencies and weight loss. A physical examination and x-rays will be used to determine the extent of the degeneration and to determine if a total knee arthroplasty or knee replacement is the best treatment option to treat the condition.

    Symptoms
  • Patients that suffer from severe osteoarthritis, degenerative joint disease or continual discomfort and pain throughout the entire knee.
  • Pain while using the leg in normal activities, particularly intense pain while climbing or descending stairs or during movements that place additional stress on the knee.
  • Discomfort or pain after sitting or keeping the knee motionless for an extended period of time.
  • Stiffness, which increases after the knee has remained motionless.
  • Pain at rest.
  • Anatomy
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     Product Considerations
    Reachers
    Reachers were designed to help persons who have suffered an injury, undergone surgery or have a disability which results in difficulty bending over, stooping, or "reaching" common household items. This inability to perform activities of daily living may be temporary and a Reacher can help until you regain the ability to care for yourself without assistance. Reachers are available with many different features. A few are listed below and each person should determine his or her particular needs before choosing a Reacher.

  • Sideways opening jaws work well when picking up boxes from shelves or items with an open top, and allows the user to see the object while grasping it without twisting the wrist.
  • A palm-activated full hand trigger allows the full strength of the user's entire hand to close the jaw, unlike a conventional trigger that uses only a couple of fingers.
  • A comfortable pistol grip and rubber suction cups that can pick up anything from a coin to a 5 pound brick.
  • A design which features a magnet on the front tip for picking up small metal objects.
  • A patented SAF-T-LOK can maintain a secure grasp onto items with out constant tension on the trigger, or even holding the pistol grip.


  • NSAIDs
    NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) are a group of drugs used to control pain. This category of medications includes both prescription and common over-the-counter painkillers such as ibuprofen. NSAIDs are effective for many types of pain that can occur because of inflammation of muscles, joints and bones. The drugs work quickly and people often notice some benefit within a few hours of taking the tablet. However, the complete effectiveness of the drug may not be realized for up to four weeks. For each individual, some varieties of NSAIDs are more effective than others. Often, patients will find that one or two varieties are helpful whereas others may not be as effective in controlling symptoms. It is usually necessary to try several brands and continue with the one that is most suitable. NSAIDs can be used to treat:
  • Pain resulting from inflammation or swelling.
  • Pain after injury.
  • Joint pain and arthritis.


  • Knee: Cold Therapy
    Cold therapy is used to reduce pain and swelling and is a convenient method to apply cold to an injured or rehabilitating extremity, such as a knee or shoulder. A cuff fits like a sleeve around the extremity and utilizes cold water supplied by a connected thermos or canister to chill the extremity. Water flow into the cuff can be controlled by different mechanisms. The simplest way is gravity; elevating the canister fills the cuff and controls the amount of pressure against the extremity. Water flow may also be controlled by a pump which will automatically circulate the cold water to and from the cuff. After surgery or immediately following an injury, the canister should be refilled with cold water every one to two hours to maintain a proper temperature. The cold therapy may also be used during rehabilitation, especially after physical activity, reducing the inflammatory heat from exercise.

    Cold therapy can be used to treat: Knee, Shoulder, Elbow, Wrist and Hand, Back, Hip, and Foot & Ankle Injuries.

    Knee Examples include:

  • Pre-operative ACL/PCL injuries.
  • Non-surgical ACL/PCL injuries.
  • General knee pain or swelling.
  • Soft tissue injuries.


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