Total Knee Replacement (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Total knee replacement facts
- What is a total knee replacement?
- What patients should consider a total knee replacement?
- What are the risks of undergoing a total knee replacement?
- What is involved with the preoperative evaluation for total knee replacement?
- What happens in the postoperative period? What is involved in the recovery from surgery?
- How does the patient continue to improve as an outpatient after discharge from the hospital? What are recommended exercises?
- Find a local Orthopedic Surgeon in your town
What is involved with the preoperative evaluation for total knee replacement?
Before surgery, the joints adjacent to the diseased knee (hip and ankle) are carefully evaluated. This is important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield significant improvement in function as the nearby joint may become more painful if it is abnormal. Furthermore, all medications that the patient is taking are reviewed. Blood-thinning medications such as warfarin (Coumadin) and anti-inflammatory medications such as aspirin may have to be adjusted or discontinued prior to surgery.
Routine blood tests of liver and kidney function and urine tests are evaluated for signs of anemia, infection, or abnormal metabolism. Chest X-ray and EKG are performed to exclude significant heart and lung disease that may preclude surgery or anesthesia. Finally, a knee replacement surgery is less likely to have good long-term outcome if the patient's weight is greater than 200 pounds. Excess body weight simply puts the replaced knee at an increased risk of loosening and/or dislocation and makes recovery more difficult.
Another risk is encountered in younger patients who may tend to be more active, thereby adding trauma to the replaced joint.
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