Hip and Knee Joint Replacement

We successfully perform partial and total joint prostheses in our Prosthetic Surgery Department. Total joint prosthesis aims to stabilize the joint by replacing the damaged joint surface with artificial materials and to eliminate existing pain. In recent years, total joint prosthesis practices having increasingly been performed in our country as in the whole world.

The joints where prosthetic surgery is mostly performed are knee and hip prostheses. It is also frequently used in the treatment of deformations in the cartilage surfaces of the joints due to arthritis, infections, rheumatic diseases, trauma, or congenital structural disorders.

We perform general anesthesia or local anesthesia (spinal and/or epidural) for our hip and knee replacement surgeries. We take the choices jointly with our patients. Generally, within the first 48 hours after prosthesis surgery, we get our patients to stand up and walk.

Hip and Knee Joint Replacement Surgery

Total joint replacement is a surgical procedure where parts of an arthritic or damaged joint are removed and replaced with a metal, plastic or ceramic device called a prosthesis or implant. The prosthesis is designed to reproduce the shape and motion of the normal joint.

A joint is an area in the body where two or more bones join together to allow motion. The surfaces of the bones are covered with cartilage to form a normal smooth gliding joint. Over time this cartilage can break down, leading to bone-on-bone friction which can cause inflammation and pain.

The most common conditions that lead to joint replacement surgery are osteoarthritis and rheumatoid arthritis. There are, however, other causes of joint pain that may also lead to joint replacement including hereditary disorders, developmental problems, and trauma. Joint replacement is performed only after other conservative treatments have failed such as medications, physical therapy, and injections.

What Happens During Joint Replacement Surgery

Hip and knee replacement are two of the most commonly performed operations in orthopedic surgery. Both procedures are very successful at eliminating pain, correcting deformity and improving patient mobility so patients can regain quality of life and get back to the activities they enjoy.

During hip replacement, the damaged ball of the hip ball and socket joint is removed and replaced with a metal or ceramic ball that attaches to a stem that fits into the femur. The prosthesis is usually coated with a special material into which the bone will grow over time. In some instances, however, the prosthesis is cemented into the bone. The socket portion of the ball and socket joint is also replaced with a metal cup that is placed into the pelvis. A plastic liner is then snapped into the metal cup and rotates with the new ball on the end of the femoral stem. The prostheses and implants come in a variety of shapes and sizes that can be tailored to the individual.

During total knee replacement surgery, a thin amount of bone along the surface of the joint is removed from the end of the femur or thigh bone, the top of the tibia or leg bone, as well as the underside of the kneecap. The surfaces of the bone are then shaped with tools and sized to allow an appropriate implant fit for each individual knee. The major ligaments and tendons of the knee are typically kept in place to provide stability and normal motion of the knee joint. Like hip replacements, knee replacements can either be cemented into place or are covered in a special material into which the bone will grow.

Total joint replacement surgery usually takes one to two hours and is typically performed in a hospital setting with a one- to two-day hospital stay. The procedure is usually performed under spinal anesthesia in combination with a nerve block. This prevents the need for general anesthesia and intubation during the surgery and can help patients avoid many of the side effects of general anesthesia such as post-operative nausea. This allows for better pain control and quicker recovery.

Following the surgery and a short stay in the recovery room, patients will begin walking on the day of their surgery. The majority of patients are then sent home with instructions for further therapy. Typically, patients can return to work and other normal activities within one to three months, depending on their overall health and progress during recovery.

Can I have a hip and knee replacement at the same time?

The short answer is no. If you have experienced injury or have arthritis in both your knee and hip, your doctor might recommend that you have both joints replaced but they are not usually done at the same time.

These joint replacements will be performed as 2 separate surgeries over 2 separate hospital admissions, usually at least a couple of months apart. Your doctor will advise what’s best for you based on your unique requirements and health, however, there are a few general guidelines for multiple joint replacements.

1. If you need a hip and knee replacement on the same leg, your doctor will often replace your hip joint first. There are three main reasons for this:

  • A painful hip is more likely to interfere with the successful rehabilitation of a knee joint;
  • The hip disease can sometimes cause knee pain, a process known as referred pain. Operating on your hip first allows you and your doctor to see how much of your knee pain is actually a result of arthritis in the knee rather than arthritis in your hip; and
  • Rehabilitation is less intense for a hip replacement. So after seeing how you go during your hip rehab, your doctor will be better informed as to how you might manage with the more intensive knee rehab.

2. On the occasion that one joint is causing more pain than the other, your doctor will usually replace the more painful joint first.

Hip and knee replacement surgery can help you to live completely free of pain, increase your joint mobility and get you moving again, so you can do more of the things you love.

As one of the top Orthopaedic Surgeons in Florence Nightingale Hospitals has helped many patients live pain-free and get moving again through robotic-assisted hip and knee replacement surgery.

Fractures of the knee area:

It can be caused by direct trauma such as falling on the knee, gunshot injury, or hitting the knee to the glove box in vehicle accidents.

How Are Patella Fractures Treated?

Patella fracture cases without separation (delineation) in the radiographs, and which are able to lift the leg straight without bending the knee, can be treated with a brace or plaster. Surgical treatment is performed with wire and thin nails, which we call stretching wire application, in patients with patella fractures who cannot lift the leg while keeping the knee straight.

Knee dislocations are important in terms of both side effects and accompanying vascular and nerve injuries. The primary accompanying pathology is peroneal nerve lesion. There is an anterior cruciate ligament rupture in all knee dislocations. Depending on the severity of the injury, posterior cruciate ligament rupture may develop. Deformity caused by dislocation of the knee is easily observed. When signs of dislocation are detected, the reduction should be performed urgently under anesthesia.

Knee Prosthesis

The most prominent reason in knee joint deterioration is wear and tear. Obesity, rheumatic diseases cause early wear of the knee. Genetic predisposition can have an effect on knee wear and tear. Physical trauma history or repetitive minor traumas are the reasons for wear on the knee. Joint damage is more common in those who regularly do heavy sports, and arthritis is more common in their joints. Women, especially those over the age of 55, experience knee problems more often compared to men. Knee problems are more common in people who have some blood diseases such as hemophilia and those who work by squatting heavily.

When is Knee Prosthesis Required?

If the patient does not benefit from drug therapy, feels intolerable pain, and has loss of joint movement, surgical intervention is considered. Pain intensity is the most important factor up to surgery. While radiological films are important, they are not determinative on the operation decision alone. Radiologically, advanced arthritis can be followed up in pain that can be resisted. The most important criterion in the decision of knee prosthesis is the clinical examination findings and the degree of functionality of the patient.

You can ask the expert team of Group Florence Nightingale Hospitals about the issues that you wonder about knee prosthesis surgeries and ask for suggestions regarding your question.

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    Group Florence Nightingale Hospitals Ltd UK 2020, all rights reserved.