Rapid Recovery Program is an innovative program for pain management that many Knee Specialists use on patients who undergo knee joint replacement surgery. The program has been developed following years of study and research by the surgeons and research. Researchers at Sydney Knee Specialists are using the latest methods from evidence-based scientific studies around the world. This has led to the development of a multimodal plan for management of pain following knee replacement surgery and revolutionized the way that people recover from a knee replacement. Traditionally, knee replacement surgery has been viewed as a very painful process and because of this, recovery has been slow. This new approach and research aims at reducing both pain and swelling within the joint so as to allow a faster recovery with least pain so that you can return to normal regular activities as early as possible. As you can imagine, however, pain is a much individualized problem and varies from patient to patient. Most patients however define the recovery following knee replacement at Sydney Knee Specialists with the Rapid Recovery Program as being comparatively free from pain or significant discomfort which allows you to get back onto your feet a lot sooner.
The surgeons strongly consider that developing muscles prior to your surgery not only accelerates the recovery, but also educates you on how to perform Pre-surgery Workup following the operation. Seeing a physiotherapist prior to your operation to work on strengthening weak muscle groups as well as improving the way you walk has significant benefits. It is strongly recommended that all patients who are considering a total knee replacement if possible ride an exercise bike on a regular basis for a minimum of 15-20 minutes a day. If you have problems with chronic lower back pain, often a recumbent exercise bike relieves the pressure on the lower lumbar spine and makes the muscles around the knee stronger. Several researches have been done to make a list of exercises which are recommended to the patients to perform before surgery.
Pain Management Plan:
You will be given a pain management plan that will help you to recover sooner and perform your knee rehabilitation. This new approach to pain management is called as pre-emptive multimodal analgesia. The concept of pain management is that pain is stopped by giving pain medicines before it actually occurs and hence pain can never develop to a point where it actually becomes uncontrollable. There are multiple tablets that you will be prescribed to take and this may be varied according to each patient’s individual needs and circumstances.
Knee replacement surgery, is also known total knee arthroplasty, which can relieve you from pain and restore function. The surgery comprises cutting away torn or diseased cartilage and bone from your knee cap and the adjoining area, including your thighbones and shinbones as well. You will be given a new artificial joint which is made up of metal alloys or high-grade plastics. Your artificial knee may feel little discomfort for few days in many ways, but it will take some time to get used to it. You may have various limitations with it. Usually, it takes three months for you to return to your regular activities. It can take six months to almost one year for you to make a full recovery and recover full strength. However, 8 out of 10 people who receive a total knee replacement report major improvements in the quality of their life.
Have Realistic Expectations
It’s significant to have realistic expectations about your knee. You shouldn’t expect your artificial knee, as extraordinary as it is, to function at the same level as your natural knee. It will not bend as much as your natural knee would have functioned. Activities such as the following will probably be little difficult:
Exercise and Stay Active
After operation, you will likely have to stay in the hospital for few days. Typically, your surgeon will have you walking with the assistance of an aid, such as with the help of a cane or walker. You should be walking without any assistance of an aid in two to three weeks. Once you’ve gone through knee rehabilitation and you’re back on your feet, you can return to most of your regular activities. You will be able to engage in many physical activities that were too painful to perform before surgery. During the first year, you should gradually regain strength and flexibility in your knee. As long as you observe an exercise program and stay active, your artificial knee will most probably show steady and ongoing development.
Manage Your Weight
Managing your weight is very important. Extra kilo negatively affects your knee by putting extra stress on your joint and can cause your prosthesis to break or wear out much sooner. Remember that you are at an increased risk of infection after you’re done with your knee replacement. Your orthopedic surgeon may prescribe antibiotics before dental work or any invasive medical process.
The success rate of knee replacement surgery is comparatively very high. The American Association of Hip and Knee Surgeons states that you have a 85 to 95 % chances that your joint will last for more than 10 years, and 80 to 90 % chances that it will last till 20 years. With growth and improvements in technology, these numbers may increase in the future. If you are older than 60 – 65 years at the time of your surgery, and you take proper care for your artificial knee, it will likely last for longer span of time, or may be for the rest of your life.
Recovery from Rotator cuff surgery can be a long, painful and stressful procedure. There is a very good reason why your surgeon restricts your activities for a long time after surgery. Once the surgery to repair a rotator cuff is completed, you need to ensure that you allow the rotator cuff to heal. A successful recovery after a rotator cuff repair often means paying close attention to the important instructions given to you. Becoming too active, too soon can lead to a recurring tear or injury. A full recovery from rotator cuff surgery can take 4-6 months to one year. Rotator cuff tears are a very common source of shoulder pain. Operation to repair the Rotator cuff becomes an option if shoulder pain does not respond to any non-surgical treatments. Operation is often the first treatment discussed for large tears due to a severe damage. Surgery on the shoulder to repair a rotator cuff tear usually gives pain and stiffness. Recovery from rotator cuff surgery is little slow. This is due to the time it takes for the repaired rotator cuff tendon to heal back to the bone. You are in a sling and told not to use your arm. A sling is required for up to 4-6 weeks to allow that healing procedure to begin. Not using the arm allows the repaired rotator cuff time to actually rebuild the bone. The stitches placed are not strong enough to let you use the arm for normal activities until healing takes place.
After the Procedure: Follow discharge and self-care instructions you are given.
Many people experience knee pain at some point in their lives. Sports, physical exercise and other activities can cause muscle strains, tendinitis, and more serious damages to ligaments and cartilage. For some, knee pain can be so extreme that it limits daily routine activities. For others, mild knee pain may be a chronic burden to the active lifestyle they are longing for. In both the cases, chances are that you’re dealing with a knee problem that shouldn’t be overlooked.
Important Knee pain facts:
Injuries to the structure of the knee can cause blood loss and swelling, and over time, if the damage is not treated correctly, it can create a chronic problem
The symptoms of chronic knee pain are not the same for each person, and the cause for the knee pain usually affects how the pain feels. Chronic knee pain may present as a:
People who are usually overweight or obese are at a greater risk for knee problems. For every pound or kilo that you are overweight, your knee must absorb an extra 4 pounds of pressure when you walk, run, or even climb stairs.
Other factors that raise your risk for chronic knee pain include:
Each underlying cause of chronic knee pain has a specific type of treatment. These treatments may include:
Rehabilitation following ACL reconstruction surgery has changed significantly over the last 30 years. We have advanced from casting the knee to allowing instantaneous motion and weight bearing in just a short period of time. As per our understanding of rehabilitation concepts continue to change, our attention has shifted towards functional workout and rehabilitation progressions, which is essential to maximize results following ACL reconstruction surgery. We are now seeing professional athletes completely dominate their postoperative rehabilitation. While everyone wants to talk about advanced training and return to sport, it is probably infinitely more significant to reassure that the early phases of rehabilitation go well to avoid problems and allow more advanced drills down the road. If the initial phases of ACL rehab go below par, you will surely be behind for the duration of your rehab.
Prevention to be taken post ACL Surgery
A Bankart tear is a particular injury to a part of the shoulder joint which is known as the labrum. The shoulder joint is a ball and socket joint, very similar to the hip; however, the socket of the shoulder joint is very narrow, and thus inherently unstable. To compensate for the narrow socket, the shoulder joint has a cuff of cartilage which is known as the labrum that forms a deeper socket for the ball of the top of the arm bone (humerus) to move within. This cuff of cartilage makes the shoulder joint much more firm, yet allows for a very wide range of movements (in fact, the range of movements of your shoulder far go beyond any other joint in the body).
Signs of a Bankart Tear
When the labrum of the shoulder joint is torn, the stability of the shoulder joint may be compromised. A Bankart tear happens when an individual has a shoulder dislocation. As the shoulder comes out of joint, it usually tears the labrum, particularly in younger patients.
Characteristic symptoms of a Bankart tear include:
Most young patients (under the age of 35) who withstand a shoulder dislocation will have a Bankart tear; hence, there is a high suspicion of this injury whenever a young patient dislocates their shoulder. On investigation, patients will frequently have a sense their shoulder is about to dislocate if their arm is placed behind their head.
X-rays are sometimes normal, but they may show damage to the bone called a Hill-Sachs lesion. This is a divot of bone that was damaged when the shoulder dislocation occurred. An MRI may also be attained in patients who have dislocated their shoulder. Bankart tears do not every time show up well on MRI scans. When a MRI is performed with an injection of contrast solution, a Bankart tear is much more likely to be seen.
Treatment of a Bankart Tear
There are two general options for the treatment of a Bankart tear. One option is to let the arm to rest, and the inflammation to lessen with the use of a sling. This is generally followed by physical therapy to recover motion of the extremity. The potential downside of this selection is that people who dislocate a shoulder once are much more expected to dislocate the shoulder again. The other option is to execute surgery to repair the torn labrum. When operation is performed, the torn ligament is reattached to the socket of the shoulder. The results of operation are generally very good, with over 95% of patients returning to their activities without any additional dislocations.
What is a Posterior Cruciate Ligament Injury?
The posterior cruciate ligament (PCL) is the sturdiest ligament in the knee joint. Ligaments are thick, tough bands of tissue that join bone to bone. The PCL runs along the back of the knee joint from the end of the thighbone (femur) to the top of the lower leg bone (tibia). The PCL helps keep the knee joint to stable, particularly the back of the joint. An injury to the PCL could include injuring, straining, or tearing any part of that ligament. The PCL is the least regularly injured ligament in the knee. A PCL injury is sometimes denoted to as an “overextended knee.”
Causes of PCL Injuries
PCL injuries are often due to a shock to the knee while it's twisted. Common causes comprise of:
Symptoms of PCL Injury
Most people don't feel the sensation or hear a "popping" feeling in the knee after PCL damage. This is more common with an injury to the ACL. After PCL damage, people frequently think they only have a negligible knee problem. They may try to go on with their regular activities. However, symptoms that can develop which includes:
Diagnosing PCL Problems
To diagnose a PCL injury, a surgeon may take these steps:
Your surgeon will ask what you were doing when the damage occurred, such as traveling in a car or playing a game. He or she will also ask:
Home Treatment of a Posterior Cruciate Ligament Injury
With each step, forces equivalent to three to seven times your body weight travel between your thigh bone (femur) and shin bone (tibia) in your knee. These forces are diminished by a meniscus on the inward and outward portion of the knee, and the ends of the bones are secured by articular cartilage. Patients with a condition called as osteoarthritis, or also known as degenerative arthritis, experience a consecutive wearing on the menisci and articular cartilage. These degenerative processes limit the capability of the knee to glide effortlessly and can result in popping, locking, clicking and aching.
In a condition called malalignment, unbalanced forces cause extreme pressure on either in the internal (medial) or external (lateral) portion of the knee. Degenerative arthritis and malalignment can cause the knee’s defensive tissues to wear on one side more than the other in a dreary cycle of injury. A partial or total knee replacement can exact this condition when joint injury is beyond repair. In certain cases, however, a method known as osteotomy can realign the knee, taking pressure off the injured side. A procedure known as high Tibial osteotomy wedges, open the upper shin bone (tibia) to reconfigure the knee joint. The weight-bearing part of the knee is shifted from degenerative or damaged tissue onto improved tissue.
A high tibial osteotomy is usually considered a method of extending the time before a knee replacement is essential because the benefits usually fade after seven to ten years. This procedure is usually reserved for younger patients with pain resulting from shakiness and malalignment. An osteotomy may also be executed in conjunction with other joint protection procedures in order to permit for cartilage repair tissue to grow without being exposed to excessive pressure.
Purpose of procedure:
There are two main reasons to execute high tibial osteotomy. For patients with medial section arthritis and a varus knee, its resolution is to provide years of relief former to knee replacement. This is particularly vital in patients too young to be ideal candidates for knee replacement. The other reason it is done to spot-on malalignment in patients undergoing another process such as Cartilage implantation. In these patients the HTO is performed to guard the cartilage replacement from catastrophe due to too many compressive forces on the graft.
Valgus knee and distal femoral osteotomy (DFO)
Several patients instead of being bowlegged (varus deformity), are knock-kneed or have a valgus knee malformation. To spot-on this problem, distal femoral osteotomy can be achieved. This is similar to the HTO, but instead of cutting and adjusting the tibia, the femur, or bone in the upper leg is cut in its place. This process is infrequent than HTO, but the surgical process, post-operative course, threats and benefits, and outcome is alike.
The technique is performed in a hospital with the patient going home the morning after operation. The tibia or shinbone is cut and straighten out. In many process they insert pins above and below the bone cut. Then a device called an external fixator is used to join these pins. The patient turns a small crank at home to moderately, painlessly and gradually straighten the tibia. X-rays are taken in the clinic during the initial one to three weeks that the patient wears the fixator. These X-rays are used to make sure that the knee is accurately aligned to the desired outline. Once suitable alignment is achieved, the fixator is protected and the bone is allowed to rebuild. During the healing age, patients can normally progress their actions as tolerated. At about three to four months, healing is usually complete enough to eliminate the fixator and the metal pins. This is done under a brief general anesthetic in the operating room.