The knee, which is the largest joint in the body, connects the upper leg to the lower leg. It is an important component of the skeletal system. It consists of cartilage, muscles, ligaments, and nerves, all of which play an important part in supporting the body’s weight, allowing for the movement and bending of the legs during activities such as walking, running, and jumping. The mobility of the legs is one of its primary roles, as is the provision of stability when standing and moving and maintaining balance.
Knees are susceptible to a variety of common diseases that result from damage to bone and connective tissue, such as arthritis, osteoarthritis, bursitis, tendinitis, and osteoporosis. These conditions can all cause pain and discomfort in the knees. ACL and MCL tears, meniscus tears, hyperextended knees, sprains, bone fractures, dislocations, and diseases like patellofemoral pain syndrome (PFPS) are only some of the sports-related injuries that are common.
Even when you are at rest, severe arthritis or a knee injury can make it difficult to do day-to-day activities and create pain in the joint. Total knee replacement surgery is a realistic alternative to alleviate pain and restore regular functionality when traditional treatments fail to do so. The most common reason for knee deterioration is osteoarthritis, which is also the primary reason why knee replacement surgery is performed. Injuries to the knee and rheumatoid arthritis are two other factors that contribute. Knee replacement is an option when the patient experiences severe pain, stiffness, and limited mobility. Typically, this option is explored only after non-surgical treatments such as physiotherapy or injections have been tried and found to be ineffective. When knee discomfort significantly impacts quality of life, sleep, and the ability to conduct routine duties, work, or engage in social activities, a surgeon may prescribe surgical intervention.
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Knee replacement surgery, just like any other surgery, comes with its own set of inherent risks and benefits. Although they are uncommon, problems can include knee stiffness, wound infection, deep joint infection that requires additional surgery, unexpected bleeding into the knee joint, and potential injury to ligaments, arteries, or nerves in the area around the knee. Post-operative knee discomfort that does not subside is one of the potential hazards, coupled with the formation of blood clots or deep vein thrombosis (DVT). There is a possibility that the new knee joint will not reach total stability in all patients, which may result in the need for additional corrective surgery.
In order prepare for knee replacement surgery, you will need to follow the instructions given to you by your orthopaedic surgeon. In most cases, this will involve going through a physical examination, having blood tests done, and getting additional diagnostic procedure. Imaging studies like knee X-rays, and maybe MRI or CT scans, could be required. If you take any medicine, it is imperative that you discuss these various medication and supplements with your doctor, since you may be required to temporarily stop taking these medications. In addition, your surgeon will inform you of other pre-operative rules such as specific eating habits and other lifestyle changes.
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On the day of the procedure, anaesthesia will be administered to ensure that the you does not experience severe discomfort. This may involve general anaesthesia, which induces unconsciousness, or regional anaesthesia, which numbs the lower body. During the knee replacement process, the surgeon will cut away any damaged cartilage and bone, implant the artificial knee joint, insert a plastic spacer to simulate the function of the cartilage cushion that was removed, and modify the kneecap so that it fits over the new joint. Knee replacement surgery usually takes hours to complete, since it is a complex treatment. Your new replacement knee will have prosthetic pieces that are designed to look very much like your original knee. The artificial joint is comprised of metal and plastic rather of bone and cartilage like a natural joint would be. It is developed to mimic the size, form, and function of a natural knee joint as closely as possible.
Opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, and local anaesthetics are some of the medications that orthpaedic surgeons prescribe to help patients manage their pain after surgery. Pain management is an essential component of the healing process. It is recommended that patients undergo physical therapy, which consists of exercises designed by a therapist to restore knee movement, strengthen the leg, and make it easier for patients to return to their regular activities as quickly as possible. In addition, knee support devices such as crutches may be utilised by surgeons for the purpose of movement restoration. This rehabilitation plan will depend on the patient and the diagnosis of the orthopaedic surgeon.
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In the event of complications after surgery, it’s important to promptly contact your surgeon. These symptoms include chest pain, shortness of breath, a fever, bleeding, indications of infection at the surgery site like leakage, swelling, discoloration, odor, or warmth, new or escalating pain in your calf, ankle, or foot, as well as severe pain that remains unrelieved even after taking pain medication. Immediate communication with your orthopaedic surgeon is advised if any of these symptoms arise.
Patients can experience the an optimal range of motion and mobility. It is normal to experience numbness and stiffness around incisions, as well as clicking sounds when bending or walking due to metal or plastic components. These symptoms, coupled with clicking sounds, normally resolve over time. Keeping one’s strength and mobility up through exercise, avoiding falls and injuries, and regularly following up with one’s orthopaedic surgeon are all factors that contribute to the long-term success of the knee implant, which in the majority of cases continues to be functional for years after the surgery.
After having knee replacement surgery, you should stay away from high-impact activities like jogging and cycling. Your orthopaedic surgeon will provide you will a complete guide for your recovery.
During the course of your recovery, your orthopaedic surgeon may instruct you to take certain medications and make specific lifestyle changes.
Following knee replacement surgery, there is a possibility of developing an infection; however, precautions can be done to reduce the likelihood of this happening.
It is possible to improve the outcome by keeping a healthy weight, remaining active within the suggested limits, and following the advice provided by your orthopaedic surgeon.
Knee replacement surgery can be performed on patients of any age, although in most cases, it is reserved for above the age of 60 who have tried other treatments without success.
After a joint replacement, physiotherapy and exercises are recommended for minimising the risk of complications and restoring function and mobility.
During the postoperative recovery period, mobility aids such as crutches, walkers, and canes can be of great assistance.
After having knee replacement surgery, precautions should be taken to eliminate “trip and fall” hazards, such as installing grab bars and clearing up all walkways in the house.
Dr Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon in Khoo Teck Puat hospital before embarking on sub-specialty training in Switzerland at the famed Inselspital in Bern.
He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as Visiting Consultant to Khoo Teck Puat Hospital.
Well versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Prior to his entry into the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.
Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well as spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.
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