Orthopedics (alternatively spelled orthopaedic surgery and orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.
Spine surgery is an invasive pain management procedure in which a specially trained doctor (the surgeon) uses instruments to make incisions to repair damaged spinal tissues. Or in other words Spine surgery whether back or neck surgery, can be sum up as an advanced treatment option for pain and disability caused by an identifiable lesion in the patient’s anatomy that has not adequately improved with non-surgical treatments. Although spinal arthritis tends to be chronic, the symptoms are rarely progressive and rarely require surgery on the painful spinal joints.
There are different types of Spine surgeries, which include the following:
Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long standing osteoarthritis, the surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation and is not a reason to perform knee replacement.
Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly.
Total knee replacement (TKR), also referred to as total knee arthroplasty (TKA), is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces. Materials used for resurfacing of the joint are not only strong and durable but also optimal for joint function as they produce as little friction as possible.
The "artificial joint or prosthesis" generally has two components, one made of metal which is usually cobalt -chrome or titanium. The other component is a plastic material called polyethylene. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports).
The general goal of total knee replacement is designed to provide painless and unlimited standing, sitting, walking, and other normal activities of daily living.
It's really nice to know that with proper care individuals who have had a total knee replacement can expect many years of faithful function. Studies show that patients can expect a greater than 95 percent chance of success for at least 15 years.[jssorslider id=2]
Eligibility for the surgery
If you have been told you have a severely damaged knee joint and would benefit from a total knee replacement, the questions you need to ask yourself are:
If the answers to these questions are yes, you may be a candidate for a new knee.
Types of Knee Replacements
Broadly speaking, there are four basic categories of knee replacements depending on the degree of mechanical stability provided by the design of the artificial knee:
The highly successful non-constrained implant is the most common type of artificial knee. It is termed non-constrained because the artificial components inserted into the knee are not linked to each other and have no stability built into the system. It relies on the person's own ligaments and muscles for stability. This is the key feature of this group of artificial implants helping to maintain the stability of the knee.
The semi-constrained implant is a device that provides increasing stability for the knee. This type of artificial knee has some stability built into it. It is used if the surgeon needs to remove all of the inner knee ligaments(some surgeons prefer to do this), or if the surgeon feels the new knee will be more stable with this type of implant.
Constraint or hinged variety implants are rarely used as a first choice of surgical options. In this case, the two components of the knee joint are linked together with a hinged mechanism. This type of knee replacement is used when the knee is highly unstable and the person's ligaments will not be able to support the other type of knee replacements. It is useful in the treatment of severely damaged knees particularly in very elderly people undergoing a revision replacement procedure. The disadvantage of this type of knee joint is that it is not expected to last as long as the other types.
A Unicondylar knee replacement replaces only half of the knee joint. It is performed if the damage is limited to one side of the joint only with the remaining part of the knee joint being relatively spared. It is now possible for the surgeon to replace only that area of the knee joint which is severely damaged. However, even with only half of the joint destroyed, many surgeons prefer doing a total knee replacement believing this is a better procedure than the half-knee (unicondylar) replacement. But equally, there are surgeons who believe it is more appropriate to perform a unicondylar knee in the right circumstance.
Exercising following Knee Replacement
Exercising the knee and leg muscles following surgery is extremely important to the success of the total knee replacement.
Exercises aim to quickly regain increasing motion in the knee following surgery, prevent muscle loss, which is inevitable after surgery, rebuild the muscle strength and prevent stiffness of the new knee joint.
It is important therefore, to carefully follow the rehabilitation instructions given by the physical therapists and doctors.
This is a good beginning exercise as it not only initiates the needed muscle contraction but also is helpful in increasing extension of the knee. It is optimal for both legs as both legs will be in a weakened state postoperatively. Try to do this exercise several times every hour. However, the amount of discomfort will determine how many each individual can perform.
While lying in bed with legs straight and together and arms at the side.
Terminal Knee Extension
This exercise also helps promote muscle activity and increases knee extension. This exercise is to be repeated 10-20 times.
While lying in bed place a pillow or towel rolled up into a bolster under the operated knee to position the knee joint at approximately 40 degrees from full extension.
Heel Slides (Knee Flexion)
This exercise will promote muscle activity of the hamstrings as well as help increase the amount of knee flexion. The physical therapist will record the amount of flexion and extension for a daily report on the patient's progress to be reviewed by the physician.
While lying in bed on the back, keep legs straight and together and arms at the side.
Straight Leg Raising
This is another excellent exercise to promote strength to the quadriceps and the flexor muscles important in ambulating. Once the individual can perform 20 repetitions without any difficulty, gradual resistance at the ankle (such as the use of ankle weights) can be utilized to further strengthen the muscles. The amount of weight used should be increased in no more than one pound increments.
This is a good exercise to help strengthen the hip adductors or groin muscles.
Relax for a short period of time and repeat this exercise 10-20 times.