Revitalising Mobility: The Transformative Power of Total Knee Replacement (TKR)

 Introduction:

Total knee Replacement, also known as Total knee Arthroplasty, is a common orthopaedic surgery which was first performed in 1968. This is one of the most successful and effective procedure in all medicine. If your knee is severely injured or having arthritis, it may be difficult for you to perform basic activities like climbing stairs or walking. So if medications or non-surgical treatment didn’t helpful then you may want to consider Total knee Arthroplasty which is a safe procedure to alleviate pain, correct deformity and indulge in ADLs. So, whether you exploring the treatment or decided to go for TKR. This blog will help you exploring about the procedure.


I.Understanding Total Knee Replacement :

Anatomy of knee joint :

The knee joint is basically a modified hinge joint which is largest joint present in human body. It is made up of three bones i.e, lower end of femur bone, upper end of tibia bone and lastly patella. There are articular surfaces which is covered by a thin cartilage. In knee joint, the menisci adhere to lateral and medial surfaces of articular cartilage. These C-shaped wedges work as a shock absorber. This joint allows one degree of freedom. Large ligament present which stabilises the knee joint. Normally, all of the components work in hormone.



Indications of TKR:

    Osteoarthritis

    Rheumatoid arthritis 

 


    Severe Varus and Valgus deformity



     Flexion contracture



     Post traumatic arthritis caused by severe knee injury       




 Definition :

A surgical procedure in which an arthritic or damaged parts of the knee joint are replaced with artificial joint known as prosthesis.         

Types of TKR:

1.Unicompartmental: Either the medial or lateral compartment is replaced.

2.Bicompartmental: Here both the compartment is replaced.

3.Tricompartmental: Here along with both the compartments of knee, patellofemoral component is also replaced.         



Types of prosthesis:

Cemented(commonly used): The components of the implant fixed to the bone with poly methyl-methacrylate.

Uncemented : Components of the implants have roughened porous surface designed to allow bone to grow in it.  



II.Diagnostic measures :

A full thorough medical evaluation is performed before TKR surgery to evaluate the risk factors.

Imaging screening is done to determine worsening of the joint abnormality.

A knee radiograph is done before the closure of the incision to check the alignment of artificial joint.


III.Physiotherapy measures in TKR:

The following measures should be evaluated before TKR:

PainDeformity 

ROM

Gait analysis 

Muscle strength 

Status of other joint

The patient should be taught about postoperative exercise regimen for the muscle weakness and to counter the DVT.



IV.Post TKR surgery :

This surgery is not more than 1or 2 hours. Basically the physiotherapy regime should be started within 24 hours.Basically patient should be firstly concentrated on Range of motion, strengthening exercises and gait training then after that a home programme is prescribed before the discharge and ask to follow up the regimen.



V.Complication:

   Infection 

   Chronic pain

    Deep vein thrombosis 

    Bone fracture         


 Conclusion :

Total knee replacement is a safe and effective surgery to alleviate pain ,correct the deformity and alignment.It is mostly used in treating grade 4 osteoarthritis and is considered effective intervention.It provides reliable outcomes for the patient in severe degenerative knee joint.It is successful orthopaedic surgeries. It is a complex procedure which required precise measurements and skill fully removed the damaged part to shape remaining bone.

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