Knee pain can be hard to bear and there is no way to tell when it will occur. Sometimes it will be during the day, meaning that you can’t do what you want and sometimes through the night making sleep difficult. Pain management is going to be vital, so you need to make sure that you get it right. Once you have the pain stabilized, you can look at a long term treatment and start to put this difficult period behind you. There are many different types of knee surgery and the majority of them are extremely effective. They can be the basic ones such as cleaning out the joint with keyhole surgery and can go to the extreme which will be a total replacement.
The trepidation felt before knee surgery is to be understood, but afterwards, recovery can be simple and speedy. There are around half a dozen regularly carried out procedures. Knee surgery is needed due to three major things that happen as we age. It can be general wear and tear where the structure starts to show damage, and this is usually through osteoarthritis. Overuse is another and when the same movements are made again and again, tendons can become swollen and inflamed. Often runners suffer from this condition. The third issue is the sports injury and knee problems are prevalent here.
When to consider knee surgery
There are other things to try first and knee surgery will normally only be considered when the pain and discomfort is stopping you living your life as you want to. If it is an impact knee injury, should be looked at right away and if there is warmth around the knee, it shows there has been damage done. If the knee is out of shape or makes a noise when it is moved, that is also a sign that treatment should take place. The same applies to a knee that does not move properly and if you struggle to put your weight on it. Once the consultant has had a chance to look at and examine the knee, they can decide what should be done next. Pain management should be in place, but often that is not a long term solution.
Common Procedures
One of the most common procedures is anterior cruciate ligament treatment. It is this ligament that is responsible for stability and there are two ways that it can be damaged:
- Direct contact – This will usually be as the result of contact in sport.
- Unusual movement – When turning quickly there can be an injury endured.
When either of these two issues occurs, there will normally be a ruptured tendon – sometimes complete, sometimes just partial. It is one of those injuries that can affect people in a variety of ways. Some can carry on almost as if nothing has happened, yet for others, the pain and instability can last for a long time. When there is a tear in the ACL, then it can be fixed, but when there has been a rupture, the only option is normally that a complete knee reconstruction has to take place.
Complete Knee Replacement
The main condition that is likely to cause the most requests for complete knee replacements will be arthritis. This is where the bones and cartilage are damaged as a result of wear and tear and it will only be done after all other options have been covered. It is a form of knee surgery that is becoming more common. Most of the time, you will be up and about testing out the new joint the same day that it is put in place.
Partial Knee Replacement
Sometimes arthritis does not inflict the entire knee, but just one half. When this happens, only that damaged part needs to be replaced. This is a much easier procedure than a full knee replacement as there is no need to take out the knee ligaments. There will be a much shorter and easier recovery time.
Lateral Release
When the problem is patella maltracking lateral release surgery will be required. Its presence is shown when the knee cap is pulled out of position and does not fit in the right place when moving. Tightness can occur and often when there is anterior knee pain, this is the cause.
Arthroscopy
When the cartilage is damaged, there is often debris left in the knee joint. It can be caused by arthritis or a meniscus tear. It is an easy procedure and does not take a lot of recover. Often there will not be the need to stay in hospital and the only issue could be that crutches may have to be used for a few days. In order to aid recovery, there should be plenty of exercise.
Osteotomy
Conditions like Osgood Schlatter’s Disease lead to the need to remove small pieces of bone from the area of the knee. Pain management will be in place but will not be the final solution. Recovery from surgery will vary depending upon the condition that has caused the damage. Some surgeries will not have been invasive so will have shorter recover times, while things such as a full replacement will take a lot longer. If there is likely to any swelling, pain or bleeding, you should be given advice as to how to best combat them. Three easy and regular aids will be: –
- Ice – This is going to be best to keep down swelling. If there has been any bleeding in the area of the joint, it can also help with that. It is not just a case of getting ice out of the freezer and applying it; there are set guidelines and they should be followed.
- Exercise – Even if it is the last thing that you feel like doing, you must keep the knee moving as soon and often as possible. Don’t just try to do what you want but ask for a specific program that will help the recovery from the procedure that you have been through. This is possibly the best one for pain management.
- Attitude – While this should not be used instead of other procedures, having the right attitude when it comes to recovery from knee surgery, can give you a step in the right direction.
Seeing a Doctor
You will need to see a specialist when you are considering knee surgery and want to make sure you see the best. Choose one with experience of pain management such as Dr. Michael Nguyen. Dr. Nguyen is an orthopaedic surgeon who is currently working at the Vein Institute along with the Pain Centers of America. He focuses on pain medicine and deals with venous disease of all degrees. He has a great deal of experience and is a vital part of Medtronic’s advisory panel. His role is to help them bring in strategy and develop state of the art equipment that will help when it comes to dealing with venous disease.
Dr. Nguyen completed his residency at Harvard and while there he was named “Fellow of the Year.” After finishing training Dr Nguyen became a member of the Harvard faculty and was again honored. He was named “Outstanding Teacher of the Year” as well as “Mentor of the Year.” The Doctor is a published author having written medical literature explaining vein treatments that are minimally invasive. He is well respected and has appeared on television as part of his role. His main areas of work cover: –
- Venous medicine
- Intervening with pain management
- Minimally Invasive Cosmetics.
Dr. Nguyen’s training was varied and includes time at Harvard, Brigham and Women’s Hospital and the University of Miami. He is considered an expert when it comes to pain management.
Alternatives
Before knee surgery is recommended, there are a lot of other procedures that the doctor will consider. Physical therapy is an option as is medication, and there are even conditions that are improved by the use of a walking stick. Some people will have brought the problems on themselves, especially when it comes to osteoarthritis. If you are overweight, you are putting increased pressure on the joint and while it may take some time to happen, the joint will eventually buckle under the pressure. With a lack of exercise, the muscles in the area will become weak and they will no longer offer the joint the protection that it needs. If exercise is not an option, then a course of physiotherapy may help. Before the surgery takes place, pain management will be arranged and this can delay the need for the full operation right away.
Understanding how knee surgery can help
The obvious immediate reaction is that there is going to be less pain after knee surgery. It may be a case that there is more pain at first as the surgery will require some cutting and removing. Over time and with the correct help and pain management program, the pain will start to subside, and normal activity can be resumed. Many people who have undergone knee surgery say that the pain of recovery is preferable to the pain that was felt beforehand. Before long the patient should be able to live as normal and if this stage is not reached, it will be best to go back to the doctor who will work out what the problem is and a course of pain management until a final solution can be found. It could well be that a small follow up knee joint treatment is all that is needed.
Are there any risks?
As you are bound to be told, there will be the same level of risk that there is with any type of surgery. Partly the risk will be around the operation itself, part of it will be around your own conditions and overall state of health. You need to understand what the risks of knee surgery are so that you can do all you can to limit them, and the knee doctor needs to know your full medical history so that they can take the required precautions from their side. It’s only once you have the full picture that you have to decide if you want to go ahead and have the surgery or look for an alternative solution.
Realistically this is going to be pain management and acceptance as every other option will have been considered before you get to this stage. It has been suggested that there could be a problem in about 5% of cases of surgery and sometimes this will be while you are under the knife, and with others it will be while recovery is taking place. The main risks are DVT – deep vein thrombosis – infection in the wound, bleeding that cannot be stopped and issues that arise from being under anesthetic. As mentioned, these are very rare and once identified will be dealt with right away.
Preparation for surgery
The better condition your body and especially the joint are in, the better the outcome will be. Do any exercises that you can to keep the muscles strong. You will need help getting home, so arrange for someone to be there for you and if possible have some level of help for the first couple of weeks. The stronger the knee is the less likely it will be that a lot of pain management will be needed. Before you go to hospital you can arrange the house so that it is easy to get around and reach what you need. Try to have a table with things you will need next to where you sit. Once you are in the chair you don’t want to have to keep getting up to find the TV control and get a drink to take your pain management medication.
Even having some meals ready will save you time standing in the kitchen, or money ordering them. All in all, there is no need to fear having an operation as modern knee treatment procedures are safe, and the recovery time will be monitored. Before you know it, you will be back at work or playing sport.