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Total Knee Replacement

 
Why you might need a Total Knee Replacement?

 

The main reason for knee replacement is the pain suffered by the patient. A painful, non functioning knee can significantly decrease the ability to run a full, active life. Advancements in this type of surgery in the past 25 years made knee replacement surgery a very common and reasonable solution for damaged knees.

 

What is a Total Knee Replacement Surgery?


Knee replacement surgery is a very common form of treatment. It is considered a reconstructive operation, involving the removal of the infected areas of the knee, and wrapping the bones with a prosthetic, made out of metal and hard plastic. The procedure is performed through an incision in the front of the knee, while optimally maintaining and balancing the ligaments surrounding the knee.

The prosthetic is composed of 3 parts: 1) the femoral part, 2) the tibial part, 3) the knee cap part.

The femoral part is made of very firm, smooth metal, which is capable of withstanding heavy loads.

The tibial part is made both of plastic and metal, which maintains the height of the knee joint.

The knee cap part is made of polyethilen plastic.

These parts are attached to the femur and tibia (thigh and shin) using biological cement. Some prosthetics are made with no cement, and those encourage the bone to grow onto the prosthetic, however, experience shows that the latter type of prosthetics disattach more frequently, which is why Dr. Suzanna Horovitz does not recommend them.

 

What are the reasons for Knee Pain?


Arthritis (degenerative changes to the joint) is the most common reason for knee replacement. Typically, patients choose knee replacement when pain becomes intolerable and/or when knee problems prevent patients from leading an active, normal life.

 

What are the most common types of knee Arthritis?


Degenerative / erosion-inflicted changes result in the gradual destruction of the joint. With time, the knee cartilage is damaged, broken, and the bone under the cartilage is eroded as well. Degenerative / erosive changes appear without being set off by trauma or as response to inflammation.

Degenerative changes caused by trauma such as a broken bone, torn ligaments or torn meniscus. Due to trauma, the mechanical mechanism of the knee is ruined, and as a result, with time, so does the cartilage.

A rheumatic / inflammatory disease in the joint. In this instance, an inflammatory disease occurs, and the human immune system causes damage to the body itself, including damage to the cartilage and to the tissue which encases the knee. The result is the destruction of the knee joint.

AVN/ Avascular Necrosis of femur or tibia. As a result of a disease, blood flow to the bone is diminished. The result is necrosis and collapse in the bone close to the surface, which then damages the stabilizing surface of the cartilage in the knee joint. This condition causes intense pain for months, and may be fWollowed by erosive changes, caused by the collapsing bone.

What are the signs of Knee Arthritis?


Knee pain, during activity and even during rest.
Swelling caused by fluid accumulation, which worsens the pain while bending the knee.
“Screeching” during knee movements, caused by friction between the eroded surfaces of the knee.
Stiffness and movement limitation.
Limping.
Deformation, visible as X or O legs. This phenomenon is caused by erosion of the cartilage, in either the medial or lateral sections of the knee.
Treatment options for Knee Arthritis
Conservative treatment
Medicating with pain relievers and anti-inflammatory pills.

Steroid injection to the knee joint in order to reduce the inflammation in the knee.

Hyaluronic acid (viscosupplement) injection, to help balance the knee’s fluids and temporarily relieve inflammation.

Using walking aids, such as a walking cane or crutches, using knee braces.

General changes, such as weight reduction, and exercising to strengthen the quads.


In cases, where arthritis is centered only in one side of the knee joint, and is accompanied by changes or deformations of the knee axis, some younger patients may benefit from an osteotomy of the bone in the vicinity of the knee, and a change to the angle of the bone along with affixation of the osteotomy. After the fixation the bone heals itself back to its correct angle, which will shift back most of the load onto the healthier parts of the knee during walking or standing. It is important to notice that the recovery time from this type of procedure is long, and often the patient will require, in approximately ten years average, knee replacement surgery.

 

For consultation


If you suffer from an Orthopedic problem in your knee, Dr. Suzanna Horovitz may be able to assist you to return to an active life. For consultation and diagnosis, please contact us.

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