What is Knee Replacement?

The knee is one of the most vulnerable parts of the body and plays an important role in your daily life. With a healthy knee, you can walk, run, sit, stand, and climb stairs. Although your knees can support your weight, a slight blow or illness can damage your knees and cause serious problems. Sometimes knee pain and injury due to various reasons, such as osteoarthritis, cannot be treated. Knee replacement is the most effective way to relieve pain in these conditions. What is knee replacement? Knee replacement is a surgical procedure in which a damaged knee joint is replaced with an artificial joint.

It is a complex and slightly complex procedure that requires surgical skill and experience, as well as specialized post-operative care. This article will cover the knee replacement procedure, as well as pre- and post-operative procedures, side effects, and costs.

Types of Knee Replacement Surgeries and How They Are Performed

Surgeons perform two types of knee replacement surgeries depending on the severity of the knee injury: total knee replacement and partial knee replacement.

Total knee arthroplasty, or arthroplasty, is suitable for people whose knee joint is completely worn out and/or damaged due to osteoarthritis, rheumatoid arthritis, or other conditions. In this surgery, both sides of the worn ends of the knee joints are replaced with prosthetics. Total knee replacement is the most common procedure performed on people between 60 and 80 years of age. During surgery, the doctor trims the worn ends of the femur and tibia and replaces them with a curved piece of metal and a flat metal plate, respectively. A plastic spacer is then inserted between the metal parts to prevent friction; in fact, this plastic plate serves as cartilage. Finally, the doctor stitches the wound and you must stay in the hospital for 3-5 days.

Partial knee replacement is the simplest method and is suitable for patients whose knee joints have been damaged on one side. Since the knee joint on one side has been replaced with a prosthesis, the wound will be minor and less bone will be cut in this situation. Doctors prescribe this method to 1 in 4 people with osteoarthritis, and it has a shorter hospital stay and recovery time than the previous method. Another benefit of a partial knee replacement is that you can bend your knee more naturally than a total knee replacement.

Some of the most popular questions patients ask about knee replacement surgery are: What are knee replacement materials? Which method is best for me? In answer to the first question, the artificial knee joint consists of metal and high-quality, wear-resistant plastic. Cobalt-chromium and titanium alloys are used as metals. Which method is right for you depends on your doctor's diagnosis and the extent of joint damage. However, keep in mind that knee replacement surgery is an important procedure that should only be considered as a last choice for patients whose pain is not relieved by physical therapy and steroid injections .

Who Are the Best Candidates for Knee Replacement Surgery?

Endoprosthesis replacement is the last option for people with limited mobility and pain even at rest. Over time, you may wonder what is causing the damage to your knee joints. Osteoarthritis is the main cause of damage to the bones of the knee over time, and symptoms appear as you age. In addition to this, other diseases such as hemophilia , knee injury , gout and rheumatoid arthritis can damage the knee.

In this case, after some time, people will experience severe knee pain, which will affect their daily and daily activities and reduce their quality of life. You can try various treatments to relieve pain during this period, but when your knee joint is completely worn out, your only choice is knee replacement. There are some signs that you are ready for a knee replacement, some of which include:

Swelling and stiffness in the knee joint
Moderate to severe knee pain, even at rest
Severe pain that disrupts your privacy and sleep
Everyday tasks such as shopping and getting out of the bath become impossible
Knee pain with knee deformity and deviation
Pain does not improve even with anti-inflammatory drugs
You are depressed due to pain and lack of mobility
You are unable to work or have a social life
Severe knee pain limits daily activities such as walking, climbing stairs, sitting and rising from a chair.

These options indicate that you need to have this surgery to get back to your normal life. The risks and recovery time may scare you, but don't worry; if you choose a professional surgeon, you will not have any post-operative problems. In addition, preoperative preparation is necessary to perform a simple operation with minimal side effects.

How is the Repicci endoprosthesis implanted?

To develop a joint-preserving method of treating knee arthrosis, American dentist and orthopedist Dr. Repicci used gentle technologies from the field of dentistry. Just like dental inlays, metal or plastic inserts replace the worn part of the knee joint. All ligaments and areas of the knee with intact articular cartilage are preserved. The progression of degenerative arthrosis is stopped with the help of a partial endoprosthesis. Compared to total arthroplasty, a unipolar endoprosthesis allows one to preserve more than 80% of the knee joint’s own biological structures.

The duration of this surgical intervention is about one and a half hours. The operation is minimally invasive and requires only small incisions. Thus, this gentle method prevents infectious diseases, as well as possible complications. After implantation of the Repicci endoprosthesis, minimal scars of 2-3 cm in size remain on the knee.

Artificial knee joints made from highly digestible materials help to significantly reduce the rehabilitation period. In addition, long-term studies have proven the strength of these structures. The key to the longevity of the endoprosthesis is the precision with which the doctor places the implant relative to the load line of the individual knee joint. Thus, the success of arthroplasty depends on the surgical experience and skills of the surgeon.

Before And After Knee Replacement Surgery

Before any operation, you must be mentally and physically prepared. Get more accurate and reliable information about endoprosthetics and familiarize yourself with the procedure. You can do this by reading informative articles on various websites or asking people who have had arthroplasty surgery to share their experiences with you. To have a short recovery period, strengthen the muscles around your knee by performing special strengthening exercises several weeks or months before the procedure. Doctors recommend light exercise, such as walking or swimming, before knee replacement surgery. To familiarize yourself with all the steps of the procedure, here are the steps to take before, during, and after surgery.

Before the Surgery

Before the procedure, you will sign a consent form, read it carefully, and ask your doctor any questions you may have.
Your doctor may order a number of tests, such as blood tests, to make sure you are in good health before you have surgery.
Be sure to talk to your doctor about all medications, chemicals, and herbal supplements you are taking.
Tell your doctor if you are allergic to any drugs, anesthesia, or metals; otherwise it may pose a serious risk to you.
If you have a history of bleeding problems or are taking anticoagulants such as aspirin, tell your doctor.
Avoid drinking alcohol and smoking for about two weeks before surgery; otherwise, the risk of dangerous bleeding will increase on the day of surgery.
You must fast for eight hours before the procedure.

These are some general tips that are almost the same for all patients, but the doctor may prescribe other specific medications depending on the physical condition and health of the patient.

Operation Day

Your anesthesiologist will put you to sleep using general anesthesia to make the operation easier for you.
A urinary catheter may be inserted after you are placed on the surgical table.
The surgeon will make small incisions at the knee surgery site.
The worn end of the knee joint is then replaced with an artificial joint made of plastic and metal.
Finally, sutures or surgical staples will be used to close the incision.
You will then be taken to the recovery room to have your vital signs checked.

You will not notice or feel any of the above steps. But don't worry; The anesthesiologist and all members of the surgical team will regularly monitor your general condition and vital signs. You will be transferred to the surgical department and post-operative treatment will begin as soon as your general condition has stabilized and you have regained consciousness.

After operation

You will be prescribed painkillers to reduce pain
A drain may be inserted to drain fluid from the incision site.
12 or 24 hours after surgery you should be up and walking with the assistance of staff
While you are in the hospital, your physical therapist will teach you specific exercises to strengthen your knee.
The day after surgery, you can slowly begin to exercise

Typically, you should stay in the hospital for 3-5 days, but this may be reduced to 1-3 days, depending on your general condition. The bulk of your recovery period will take place at home and you will need to be very careful with your new knee.

Conditions of accommodation at the Gelenk Clinic

Private ward at the Gelenk Clinic in Gundelfingen, Germany.
As a rule, during an inpatient stay at the clinic, you are in a separate room with a shower and toilet. In addition, we provide you with towels, a robe and slippers. You can also use the minibar and safe. Each room has a window. You only need to bring your own medications, comfortable clothes and nightwear. After knee replacement surgery, we provide 24-hour care from qualified nursing staff and experienced physical therapists. Generally, the length of hospital stay after surgery is 5 days. Your family members can stay at a hotel that is a few steps away from the clinic. We will be happy to take care of your hotel room reservation.

Steps to Take Care of Your New Knee

There are many steps you can take to care for your new knee joint, but strengthening exercises are an important part of your recovery plan. Perform these exercises regularly under the supervision of a physical therapist so that you can quickly resume your daily routine. The following steps will also help you take care of your knee replacement:

To reduce swelling, elevate your leg while seated and apply an ice pack to the operated area every three to four hours for 20 minutes.
For the first six weeks after surgery, do not sit cross-legged.
Avoid physical activities that strain your knee.
Do gentle exercises and light walking to reduce knee stiffness.
Never place a pillow under your knee while sitting or sleeping.
Do not drive for 6-8 weeks after surgery and be sure to consult with your doctor before you can resume driving.
For the first three months, do not do heavy work at all, such as vacuuming or moving furniture. You can only do simple things like dusting and doing laundry.
Do not have sex for 6-8 weeks after surgery.

How can a foreign patient make an appointment and the operation itself?

In order to assess the condition of the knee joint, it is necessary to provide the results of MRI diagnostics, as well as x-rays. After viewing the sent images, within 1-2 business days you will receive all the necessary information, a treatment proposal, as well as an estimate of the costs of surgical treatment.

Foreign patients can make an appointment with a Gelenk Clinic specialist in a short time frame that suits their plans. If you need to postpone your trip, we will refund your advance payment in full.

For foreign patients, we try to reduce the time between preliminary examination and surgical intervention to a minimum. This way you will not need to come to the clinic several times. During your outpatient and inpatient stay at the Gelenk Clinic in Freiburg, our multilingual patient management staff (English, Russian, Spanish, Portuguese) will answer all your questions. In addition, we provide a translator (for example, into Arabic), which is paid for by the patient himself. Also, we will be happy to help you organize a transfer, find a hotel and tell you how to spend your free time in Germany for you and your relatives.

Send request

What Can You Expect After Knee Replacement Surgery?

Before you have a knee replacement, you should consider how much it will affect your return to normal life. Most people expect this surgery to completely solve their problem, but this is an unrealistic expectation. Endoprosthesis replacement significantly reduces pain, improves mobility and improves quality of life. About 8 weeks after surgery, you can engage in activities such as walking, swimming, cycling, driving, and climbing stairs. However, keep in mind that an artificial joint will never act like a healthy knee for you and you must take great care of it. Activities such as running, jumping, hiking, skiing, tennis, and lifting heavy objects can pose a serious threat to the survival of a knee replacement. However, this surgery will significantly reduce the pain caused by a knee abrasion, and for people who experience pain even at rest, this may be the only thing they look forward to from the surgery. However, to have a comfortable life after surgery, you will need to take care of your artificial knee for many years.

How Long Does a Knee Replacement Last?

The complete recovery process after surgery takes about two years; During this time, you can speed up the recovery of the muscles around the knee with strengthening exercises. A common misconception among people who have a knee replacement is that they think the prosthesis will last forever. However, this is not true; wear and tear from daily use eventually causes damage to the plastic part of the artificial joint. According to the National Joint Registry (NJR), one in 20 people who have surgery will need repeat surgery after 12 years, depending on the type of knee replacement surgery. This shows that these dentures are not permanent and the period may be shorter if you do not take proper care of them.

Indications

For diseases of the knee joint, doctors try to carry out conservative treatment. If there is no result from it, the question of performing an operation is raised. Endoprosthesis replacement is performed for the following diseases:

severe knee injuries;
arthritis;
arthrosis;
aseptic necrosis;
congenital malformations;
Bekhterev's disease;
rheumatoid lesions;
dysplastic changes.

The decision on the advisability of installing an endoprosthesis is made individually.

Side Effects of Knee Replacement Surgery

All surgeries have side effects, which can be mild or severe, depending on the patient's condition. In addition to the patient's condition, it may depend on the skill and experience of the surgeon. Statistics show that patients who choose professional and experienced knee replacement surgeons experience few post-operative complications. Endoprosthetics can also cause moderate to severe side effects, which doctors report occur in 1 in 20 cases. Fortunately, most of these side effects are minor and go away after some time. Here are some common side effects of knee replacement surgery:

Side effects associated with anesthesia include sore throat, aches and pains, drowsiness, vomiting, shaking and difficulty breathing. Anesthesia-related side effects are rare but common in people who are allergic to anesthetic drugs.
Deep vein thrombosis (DVT) refers to the formation of a blood clot in a vein deep inside the body, which is one of the most dangerous and common side effects of orthopedic surgery. This blood clot can travel to the heart and lungs through the bloodstream and can be life-threatening if left untreated.
Unexpected bleeding inside a joint usually occurs due to the use of anticoagulants given to patients after surgery.
Infection is one of the most serious and rare side effects of knee replacement surgery. According to statistics, about 1.5% of patients experience joint and wound infections within three months after surgery.

And other complications such as:

Wound complication
Continued pain or stiffness
Loosening and fracture of the implant
Allergy to Artificial Joint Metals
Loss of Movement
Complications of the popliteal artery
Nerve damage
Death

Possible complications

Despite the fact that at the preparatory stage doctors try to minimize all risks, in rare cases complications arise after surgery:

Inflammation of the joint (infectious etiology).
Insufficient stabilization of the knee implant, its loosening and wear.
Dysfunction of the prosthesis.

The professional intervention of a surgeon will help solve the problem.

Knee replacement surgeries are performed by specialists from the Central Clinical Hospital of the Russian Academy of Sciences in Moscow. You can find out how much the operation costs, study patient reviews and step-by-step photos of the procedure on the clinic’s website. Call to schedule a consultation with specialists or receive any other information regarding the cost, preparation or implementation of knee replacement.

Alternatives to Knee Replacement Surgery

Fear of surgery, especially knee replacement, is one of the main reasons why patients always seek alternative treatments. They are usually concerned about side effects, recovery, and most importantly, they don't want to lose their knees. Nowadays, doctors usually offer other alternative treatments to patients. These methods include:

Mini-Incision Method

Mini-incision surgery is one of the most popular methods that surgeons often use for partial knee replacement. In this method, the surgical team makes a smaller incision than the standard incision method and uses a special tool to maneuver around the tissue. Shorter recovery time and no additional incision are advantages of mini-incision surgery.

Patellofemoral replacement

Another name for patellofemoral surgery is kneecap replacement surgery, which is the best option for those who have a damaged kneecap. Thus, thanks to this simple operation, there is no longer any need to perform a total or partial knee replacement surgery when the kneecap is damaged.

Image-Based Surgery

This is a modern method of endoprosthetics that does not have incisions and postoperative complications. The surgeon uses computerized images obtained by attaching infrared pointers to parts of your leg and surgical instruments to perform image-guided surgery.

Patient-Specific Endoprosthetics

As the name suggests, this arthroplasty method is a patient-specific procedure. In this method, each prosthesis is custom-made for each patient to ultimately fit them. Patient-specific knee replacement is an advanced type of knee replacement, and doctors believe it can last longer than a standard knee replacement.

Preparing for surgery

The decision on the need for surgery is made only after a face-to-face consultation with a specialist in the appropriate field. There are a number of tests and examinations to determine the degree of wear of the joint, as well as to find out what functional load it can bear. Based on these data, as well as in the absence of contraindications, surgery is prescribed. For each patient, the type of endoprosthesis is individually selected, taking into account the anatomy and current condition of the bones.

Preoperative examination is required to prepare for surgery. It is customary to undergo it in the same clinic where the operation is planned to be performed. In addition to this examination, a consultation with an anesthesiologist is required.

There are several types of anesthesia - your doctor will help you choose the right one. Either general anesthesia or spinal anesthesia is used. In any case, the operation itself is painless for the patient, and discomfort can only arise at the rehabilitation stage and is considered a normal stage in the body’s recovery process.

How Much Does a Knee Replacement Cost?

Artificial knee joints tend to be expensive because they are made from special high-quality metal and plastic. Knee replacement surgery is typically a complex and complex procedure that requires great precision. Reports state that the average cost of total knee replacement in the United States is $50,000, and the average cost of partial knee replacement is 10-20% less than total knee replacement.

And the Last Word...

If medication, changes in daily activities, and physical therapy do not help relieve the patient's problems, knee replacement is the last choice. Before surgery, try to learn more about the procedure, side effects, and recovery period. You can do this by consulting your doctor and asking him to show you knee replacement before and after photos or by reading scientific articles on reputable websites. If you are one of those who have done this, please write down your experience for other users.

What type of anesthesia is used during surgery?

Typically, knee replacement surgery is performed under general anesthesia. However, in order to prevent certain risks, doctors sometimes use the option of injecting spinal anesthesia. To do this, the anesthesiologist injects an anesthetic directly into the spinal canal of the lumbosacral spine. During such an operation, the patient is fully conscious. What type of anesthesia is suitable for the patient is determined individually, during a conversation with the anesthesiologist. At the same time, our specialists take into account all available indicators, as well as the physical condition of the patient. The practicing anesthesiologists of the Gelenk Clinic in Freiburg are professionals in both of the above-mentioned methods.