Normally the joint surfaces are covered with a slippery and smooth cartilage texture. In this way, the movements are smooth and painless. The surface cartilage of the joint exceeding, increases friction during movements and joint movements are being limited and painful. This is called calcification (arthrosis). Replacing damaged surfaces of the joint with arthrosis is called prosthesis surgery.
Prosthetic surgery is necessary if there is a pain in a level which will effect your daily life, limitation of movement, leg posture deformity or non-stoping pains during resting.
Performing prosthesis surgery after 65 years of age in the calcification disorder reduces the number of prosthesis replacement. However, age is not a definite criterion for determining the operative time, but if the patient’s quality of life is reduced and the pain is in uncomfortable level (unresponsive to analgesic treatments and restricts your life), is the actual criteria.
Prosthesis consists of metal (cobalt chrome, metal ceramic (zirconium), titanium), plastic (polyethylene) or ceramic surfaces.
Although the material to be used varies according to the person and the process, the materials used generally do not cause allergic reactions in the body and are resistant to breakage and spoil.
During the pre-operative examination, by talking the anesthesiologisthich the method to apply is decided. We prefer spinal / epidural anesthesia method in knee prothesis surgeries. Due to the patient is not anesthetized during surgery, there are no lung problems, and the patients do not feel pain for 5-6 hours after surgery.
It takes 1.5-2 hours on average. The patient leaves from the operating room 3-4 hours in total, one hour is preparing to surgery and half hour is after recovery.
With the use of appropriate surgical techniques and modern prosthesis designs, the survival of hip prostheses has been extended to 15-20 years. It can prolong this period if patients keep their low weight muscles strong and avoid excessive compelling activities. At the end of this period, the loosen prosthesis or loosen parts of the prosthesis which split apart from the bone are replaced by surgery. This change is called revision surgery.
For many years, prosthesis surgeries have been successfully performed in specialist hands. However, despite all the precautions taken, some of the following undesirable complications can be seen:
One day after surgery, patients can walk with a hand support such as a walker or cane.
The average length of hospital stay is 2-4 days.
For safety reasons, driving should be started at least 6 weeks after surgery.
Although it is different for each patient, walking outside can be started within 4-8 weeks after surgery. Over time, sports might be done that do not require sudden movement such as swimming, exercise bikes which doesn’t have falling risk too; much.
Approximately 4-6 weeks, patients reach maximum bending degrees. The degree of bending is 110-120 degrees; depending on degree of bending of the knee before the operation, weight of the patien, success of the performed surgery and the patient’s full and regular exercising. The minimum bending angle is 90 degrees postoperatively, but the knee should be bent 110 degrees for sitting in low-lying places and getting up.
Learning and performing preoperative exercises will provide early recovery. Exercises are started a few weeks before the operation, the exercises are started 2-3 times a day and with 5 repetitions, the number is increased over time. Always warm up by walking or cycling before exercising.
– If spinal anesthesia is performed, the rotation of the leg movements may take 1-4 hours.
– If you have pain and nausea, medication will be given.
– Constipation and inability to urinate may occur due to anesthesia. Say it to your nurse.
– Patients shaking hands with visitors should wash their hands frequently and pay attention to hand hygiene.
– Be careful not to fall into the wet ground in the bathroom and after walking. Don’t get up without help.
– If there is no leaking after the 3rd day, bathing can be done with waterproof dressings.
– Swelling, bruising: Swelling may occur at different levels depending on patient in the surgical site. While these swelling decreases, bruising occurs. Over time, these bruises disappear by being yellow.
– Swelling of the leg: In the first month, prolonged sitting by hanging down the leg increases swelling in the leg and foot. Intermittent placement of a pillow under the leg and keeping it high will reduce swelling. Ice, cold shower application, wearing bandages or antiembolic socks reduces swelling. However, tight wrapping of the bandages and leaving the socks folded may cause swelling in lower level. Due to not occur of swelling, exercise is suggested. Resting the leg at high height, if the swelling does not decrease or does increase despite the application of ice, consult to your doctor.
– Wound Care: Keep the surgical site dry and clean, do not wet it. If using a waterproof medical dressing, shower after day 3. If there is redness and heat increase or leaking at the wound site, tell your doctor!
Walking starts with a walker or crutch on the second day depending on the functional capacity of the patient. Regular exercise by improving joint movement and muscle strength, allows early return to life. Each exercise is started 3-4 times a day and with 5 repetitions, the number is increased by the day. Reduce the number of exercises if pain, swelling, temperature increase and tenderness occur. If complaints still persist, consult your physician.
Knee joint; It consists of three compartments, the inner half, the outer half and the joint between the knee cap and the knee. When the inner or outer half of the joint wears off, covering this area with prothesis is called partial prosthesis surgery.
It is very important that other branch doctors and dentists who treat you to know that you have joint prostheses. In all dental interventions; including tooth extraction, root canal treatment, dental calculus cleaning; any intervention in the gastrointestinal tract or urinary tract; including; endoscopy, colonoscopy, urinary tract closed technique; upper respiratory tract diseases and interventions; in all serious infections; antibiotic protection is needed to prevent microbes from reaching the prosthesis through the blood. For this, 2 g cephalexin, amoxycillin should be taken orally or cefazolin by injection, also in the presence of allergy 600 mg clindamycin should be taken, 1 hour before the intervention.