تعريف

Knee replacement, also called arthroplasty, is a surgical procedure to replace a knee damaged by disease or injury.

Recovery may take several weeks to months depending on your overall health.

استبدال الركبة

أسباب هذا الإجراء

This is done if you have chronic pain and stiffness in the knee joint that limits activities.

Knee replacement surgery is most often done to:

  • Ease knee pain and disability due to arthritis or previous severe knee injury
  • Correct a knee deformity

المضاعفات المحتملة

المشاكل من هذا الإجراء نادرة ، لكن جميع الإجراءات تنطوي على بعض المخاطر. سيراجع طبيبك المشاكل المحتملة ، مثل:

  • العدوى
  • Excess bleeding
  • تورم
  • Blood clots
  • Chronic weakness in مفصل الركبة
  • Worsening or unchanged pain

تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:

  • التدخين
  • سوء التغذية
  • History of blood clots
  • Long-term illness
  • Use of certain medications

ما يمكن توقعه

قبل الإجراء

طبيبك سوف المرجح أن تفعل ما يلي:

  • اختبار بدني
  • تحاليل الدم
  • الأشعة السينية
  • MRI to get images of the internal structure of the knee

Before surgery, you will need to:

  • رتب لتوصيلة إلى المنزل.
  • Arrange for help at home while you recover.
  • Talk to your doctor about any allergies you have.
  • Ask your doctor about assisted devices you will need.
  • If you are overweight, lose weight. This will help to decrease the amount of stress on your new joint.
  • Install safety equipment in the bathroom, shower, and on the stairs.
  • Prepare a bedroom on the first floor if possible. Climbing stairs will be difficult at first.

Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure, like:

  • Aspirin and other anti-inflammatory drugs
  • Blood-thinning drugs, such as warfarin
  • Anti-platelet drugs, such as clopidogrel

لا تأكل أو تشرب أي شيء بعد منتصف الليل في اليوم السابق للجراحة ، ما لم يخبرك طبيبك بخلاف ذلك.

التخدير

Anesthesia will keep you pain-free and comfortable during the procedure. Anesthesia methods include:

  • General anesthesia—you will be asleep
  • Spinal or epidural anesthesia—your lower body will be numbed from an injection into the back

وصف الإجراء

The doctor will make a cut in the skin. The damaged cartilage and bone will be removed. The remaining bone will be prepared to receive the new joint made from material such as plastic and metal. The doctor will then place the artificial joint in the proper position. It may be cemented within the bone. The doctor will close the incision with staples. A drain will be left in to allow extra fluid to flow out.

كم من الوقت سيستغرق ؟

About 2 hours.

كم هو مؤلم ؟

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

متوسط ​​الإقامة في المستشفى

This procedure is done in a hospital setting. The usual length of stay is 3-4 days. Your doctor may choose to keep you longer if complications arise.

رعاية ما بعد العملية

في المستشفى

Right after the procedure, you will be taken to recovery and monitored closely. The staff may give you:

  • A splint or brace to hold the knee in the right position
  • Pain medication
  • المضادات الحيوية لمنع العدوى
  • Medication that prevents blood clots

While you are recovering at the hospital, you may need to use a continuous passive motion machine, which is designed to:

  • Slowly move your knee
  • Restore function
  • Decrease swelling
  • Improve circulation

During your recovery, you will need to:

  • Move your foot and ankle to increase blood flow back to your heart.
  • Wear support stockings. These may help prevent blood clots from forming in your legs.
  • Work with a physical therapist. You may start the day after surgery. You will learn safe ways to move your knee and support your weight.
  • Wear a brace or splint. You will learn how to use a walker, crutches, or other support devices.

في البيت

To help ensure a smooth recovery at home, take these steps:

  • Keep the incision area clean and dry. Place a clean dressing over it.
  • اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
  • Start working with a physical therapist once you are instructed to. The therapist will focus on balance, range-of-motion, and strength training.
  • Maintain a healthy weight after surgery.
  • Follow your doctor’s instructions.

Within six weeks, you should be able to go back to light activities and driving. You may feel a soft clicking in the joint when walking or bending. Continue to work with the physical therapist. Water-based exercises may help to improve joint pain, swelling around the knee, and range of motion.

After your knee replacement, you must take preventive antibiotics before dental or surgical procedures to prevent infection. Talk to your doctor before your dental appointments or any other surgery.

استدعاء الطبيب

Call your doctor if any of the following occurs:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
  • Swelling, redness, or pain in your legs, calves, or feet
  • Pain that you cannot control with the medications you have been given
  • استفراغ و غثيان
  • سعال أو ضيق في التنفس أو ألم في الصدر
  • Your leg, foot, or toes appear chalky white, blue, or black
  • Numbness or tingling in your leg, foot, or toes
  • ألم أو حرقة أو إلحاح أو كثرة التبول أو نزيف مستمر في البول

إذا كنت تعتقد أن لديك حالة طارئة ، فاتصل بالمساعدة الطبية على الفور.

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