Operation of knee arthroplasty: reviews. Endoprosthetics of the knee joint: rehabilitation

In orthopedics, a procedure for replacing part of a damaged joint is often used. However, unlike hip arthroplasty , which passes without complications and is well tolerated, replacement of the knee joint is more difficult, and complications such as:

- infectious processes at the site of the endoprosthesis;

- displacement of the prosthesis;

- in the patellar tearing or tearing of the ligament is possible;

- thrombus formation in the lower leg;

- violation of the integrity of the femur (fracture).

Because of the presence of such complications, people leave such dissimilar responses. Endoprosthetics of the knee joint can take place without any difficulties.

It is worth noting that 10 years ago there were more patients with different complications after this joint replacement method. Over time, everything was improved - it's improving the quality of the prosthesis itself, as well as the process itself. An important function in the rehabilitation is the rehabilitation period and a set of necessary exercises for a speedy recovery. These factors greatly reduced the likelihood of problems occurring in the postoperative period.

In what cases is arthroplasty necessary?

The knee joint is a joint of the condylar type, the bone parts of which are covered with protective cartilage, consisting of fibers of collagen and chondrocytes, a germ layer and a basic substance. Thanks to the articular cartilage and the substance allocated to it, the necessary movements occur. The synovial membrane covers all articular surfaces, thanks to its assistance, a necessary liquid is developed, which prevents friction in the joint.

Due to various diseases degenerative processes of articular cartilage begin, hence the change in the shape and direction of the knee. In the presence of such diseases at the initial stage, it is necessary to conduct drug treatment, which will improve the state of cartilage and remove the inflammatory process.

In the later stages, when there is already destruction of cartilage and friction, in this case it is recommended to perform a knee joint surgery for prosthetics by installing a metal or plastic implant in place of the destroyed joint.

Indications for implantation

1. Deformation of the joint with age.
2. Deformity of the joint, accompanied by inflammation.
3. Injury.
4. Osteoarthritis is dysplastic.
5. The presence of dead skin in the joint.

Potential patients are people who have:

1. Restriction of movement with not passing strong pain.
2. Significant change in the shape of the joint.

Common Causes

- Sporadic cases of loss of the possibility of normal functioning of the knee joint are characteristic diseases. This is arthritis after trauma, fracture, rupture or sprain, and others.

- In rheumatoid arthritis the inflammation and compaction of the synovial membrane occurs, due to which the active development of the joint fluid begins, which leads to the destruction of the joint.

- The appearance of osteoarthritis in elderly people, which is characterized by deterioration of mobility and wear and tear of the joint.

What is the benefit of implanting an artificial joint?

Surgery for knee arthroplasty is carried out to facilitate or complete removal of pain for up to fifteen years. An artificial implant, similar and suitable anatomically, is inserted instead of the destroyed joint.

After the operation on the knee joint was successful, patients noted an increase in the volume of movements. The quality of life is drastically changing. Therefore, many people leave positive comments. Endoprosthetics of the knee joint in most cases is without complications, which leads to an early recovery of a person and a return to normal life.

Complications associated with endoprosthetics

Operation on the knee joint is also associated with the emergence of a number of risks, as in any other surgical intervention. Such risks include blood loss, in elderly people, possible exacerbation of chronic diseases, thrombosis in the lower extremities, infection processes at the implant site and in the urinary tract. Recently, this has become rare.

One of the worst options is the formation of an infectious process, the treatment of which is rather difficult and very expensive. Often, complications of this kind can only help remove from the body of an alien body, in this case an endoprosthesis. There is a percentage of people who are more prone to infection than others, including those with rheumatoid arthritis, overweight, patients who need to take hormone preparations.

Terms of operation

The fixed prosthesis can last up to fifteen years, in some cases and longer, but with wear and when the implant loosens, it is possible to re-operation on the knee joint, that is, replacement or re-prosthesis. In the case of pain before the expiration of a ten-year period or loosening, an operation is also necessary.

The process of endoprosthetics

The duration of the implantation operation can be 2-3 hours. Before surgical intervention, mandatory prevention of infection occurs. Before the operation, the patient undergoes spinal anesthesia.

To install the endoprosthesis, it is necessary to remove the fractured part of the joint and knee cap, the doctor also aligns the curved leg axis, if necessary, restores the ligaments.

Modern prostheses made from high-quality and non-corrosive materials, allow the leg to bend up to 150 degrees. Some after the operation left positive reviews. Endoprosthetics of the knee joint makes it possible to bend the knee 75 degrees before discharge. However, one should never forget about the rehabilitation period, without which the treatment will not be complete.

Important will be a reminder that the operation in most cases is under local anesthesia, that is, in a state of wakefulness. However, you can express your wish to an anesthesiologist or surgeon about making general anesthesia, if possible. One must be very brave and patient in order to calmly listen to the sounds that accompany the procedures of enoprosthesis.

Postoperative period

After the operation, the lack of sensitivity and functioning of the lower extremities is considered the norm. During the intervention, the patient loses a large amount of blood, transfusion of blood substitutes, the introduction of necessary medications for anesthesia and antibiotics.

Further, for several days, the patient's vital signs are monitored (heart rate, pressure, ECG, change in blood counts).

In the absence of worsening and normalization of the condition, the patient is transferred 24 hours from the intensive care unit to a simple ward.

Rehabilitation after knee arthroplasty

After the endoprosthesis is installed, the rehabilitation period lasts on average about 3 months, but it also lasts longer, depending on the patient's condition.

A mandatory recommendation is daily exercise and exercises after knee replacement to restore its functioning.

Most often, the rehabilitation period of the patient is spent in a specialized clinic (about one month).

Stages of the rehabilitation period

After the operation, the patient should stay for about two months in the clinic and perform the specified set of exercises by the doctor. With an increase in the rate there will be an improvement in the motor activity of the joint, which will lead to an early return to the habitual course of life. An extract from the clinic is also possible.

After staying in the rehabilitation center (in 2-3 months), the patient is recommended to continue physical activities in the form of swimming, walking and yoga sessions. It is worth remembering that excessive physical activity is contraindicated.

Exercises for restoration

Rehabilitation after knee arthroplasty involves a set of exercises that help overcome stiffness of movements, increase the strength of muscle mass in the joint, and reduce painful sensations.

They begin with small rates and loads, gradually shifting to more complex ones, as adjusted by the physiotherapist. It is recommended to avoid too active sports so that it is not traumatic for a new joint.

Complex of necessary exercises for daily execution (4-5 times a day):

1. Ankle joint - flexion-extension with a gradual increase in tempo, starting from 5 and reaching 12.
2. Contraction of anterior femoral muscles for 5 seconds.
3. Reduction of the hind femoral muscles for 5 seconds.
4. Raising the leg in an erect state.
5. Cut the muscles of the buttocks for 5 seconds.
6. Extension-flexion of the lower limb in the knee joint.
7. Hip to take away to the side.
8. Straighten the raised leg to a level of 45 degrees and hold it in a submerged position for up to 5 seconds.
9. Vzmahi foot in the straightened state to a level of 45 degrees and delay in this state to 5 seconds.
10. Application of the apparatus "Dikul".

Contraindications to the procedure of prosthetics

Absolute contraindications:

• Independent movement is not possible.
• Diseases of the heart and CCC.
• Thrombosis with inflammatory process.
• Pathological impairment of respiratory function, respiratory failure of a chronic type.
• Infectious processes.
• Sepsis.
• Allergy.
• Neuromuscular pathology.
• Mental disorders.

Types of endoprostheses

Modern prostheses have a protective function and are subdivided as follows:

• total;
• Prosthesis directly to the surface of the joint;
• Bipolar;
• Single-pole.

The prosthesis is fixed in several ways:

• Cement;
• Hybrid;
• Cementless.

In order for the implanted prosthesis to last a long time, the production uses high-quality anti-corrosion and wear-resistant, and most importantly, biocompatible materials:

• ceramics;
• polyethylene;
• Alloys of metals;
• Bone cement.

Many people need to analyze various reviews in order to decide on an operation. Endoprosthetics of the knee joint is performed by a physician taking into account the individual characteristics of the physiology of the patient.

Price policy

Endoprosthetics of the knee joint in Moscow, Israel, Turkey, Lithuania, Germany are carried out by qualified specialists who know their business.

There are quite a few clinics that specialize directly in performing an operation to replace the joint or its parts, including those performing knee replacement The joint. The cost of endoprostheses corresponds to the quality of the materials of which it consists, and the firm that produces it. Reviews about foreign clinics are often much better (especially with regard to the rehabilitation period). However, in Russia this intervention is carried out at a high level.

Thanks to many years of experience and high qualification, the doctor will choose the most suitable biocompatible prosthesis and will perform knee replacement without complications. The price of this procedure depends on the complexity of the operation and the cost of the prosthesis.