The knee is one of the most complex joints in the body, and for good reason—it is one of the primary load-bearing components, being heavily responsible for both horizontal and vertical motion of the body. Unfortunately, the knee is prone to arthritis and other conditions that reduce its ability to move smoothly and painlessly. If a knee replacement is necessary, Dr. Nitin Goyal has over a decade of experience in partial and total knee replacement in Washington, DC and North Virginia. With a record of excellence and glowing patient reports, he is sure to deliver the best relief available to his patients.
How the knee works
As one of the strongest and most comprehensive joints in the body, the knee consists of three primary parts:
- Lower part of the thighbone (femur)
- Upper end of the shinbone (tibia)
- Kneecap (patella)
These three bones form a junction. The end of each bone is covered with a substance called articular cartilage. This articular cartilage is smooth, providing a surface along which the bones can easily move against each other. The thighbone and shinbone are held together with a series of ligaments, and the kneecap is placed in front of this junction for protection.
When all components are working in harmony, the knee is a remarkable feat of engineering. When disease or injury disrupts its operation, the resultant pain and muscle weakness can be debilitating.
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Symptoms and causes for a knee replacement
In most cases, knee replacement surgery is necessitated by damage to the articular cartilage between the bones. This can come about from a number of orthopaedic conditions, including:
Generally seen in patients age 50 or older, osteoarthritis is the result of excessive wear upon the articular cartilage. When this cartilage is damaged, the bones rub against each other causing pain and reduced mobility.
This is an inflammatory condition, in which the tissue surrounding the knee becomes thicker than normal. This inflammation causes damage to the knee cartilage and results in joint pain and stiffness.
After a serious knee injury, tears in the ligaments or fractures of the bones can damage the articular cartilage, resulting in pain and reduced function in the knee.
Each of the above conditions can produce a number of symptoms. For patients experiencing any of these, it is wise to receive a full examination to find out the exact cause. These symptoms include:
- Daily knee pain
- Knee stiffness
- Deformity, such as knock-knees or bow-legs that restrict normal knee function
- Pain that is severe enough to inhibit one’s ordinary activities
- Significant instability in the knee
- Damage from known arthritic conditions, such as osteoarthritis or rheumatoid arthritis
While the above symptoms may be indicative of a separate condition, they may represent a condition that will eventually require a knee replacement. Patients are encouraged to make an appointment if they are experiencing any of the above symptoms. The office of Dr. Goyal will be happy to advise on any subsequent steps following the examination for possible knee replacement surgery at our Washington, DC practice. We are here to help, so please give us a call.
Knee replacement procedure
While knee surgery is a complex procedure that must be delivered by a fully qualified professional, the surgery itself consists of four basic steps to replace, or resurface, the various components in the knee.
- Dr. Goyal first prepares the bone by removing damaged cartilage at the end of the thighbone and shinbone. He will also remove a small amount of underlying healthy bone to make room for the prosthetic.
- He then places the metal implants on the new surfaces. These implants will recreate the surface of the joint, and are either cemented or screwed into the bones.
- Dr. Goyal then resurfaces the underside of the kneecap. This is done by removing the undersurface and replacing it with a plastic component. In some cases, the kneecap will not need to be resurfaced.
- The final step is inserting a spacer. This plastic spacer will go between the prosthetic components on the shinbone and tibia, allowing them to slide easily as the knee bends. Dr. Goyal puts extreme care and perfectionism into every surgery he performs, striving to provide the best total knee replacement Washington, DC and North Virginia have available.
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Knee replacement recovery
Knee replacement surgery generally takes 1½ to 3 hours in the operating room. Directly following the surgery, the patient is brought to a recovery room where vital signs are monitored. Once the patient has been stabilized, he or she can move out of the recovery room.
There are several components to the rehabilitation and recovery process. Each one is integral to the entire course of healing. These components include:
- Physical therapy, which is crucial to a full recovery. During the first several days of physical therapy, some degree of discomfort and stiffness is expected. As the therapy continues, your body will adjust to the new prosthetic, allowing it to operate as part of your leg.
- Incision care. As the exposed portion of your healing knee, the incision requires total care. While the suture will be removed two or three weeks after surgery, it must be properly dressed during that time. Dr. Goyal will give precise instructions on proper incision care during the interim.
- Physical activity. Even after physical therapy is concluded, the knee needs to continue being active. Walking or other mild activities are perfect to increase mobility over time.
- Follow-up. For the first year following surgery, follow-up appointments with Dr. Goyal will ensure that recovery is going as planned. He will likely ask to see you at three weeks, six weeks, three months, six months and one year after your surgery. After that, annual visits may be expected to keep your knee in peak condition.
As a veteran of complex joint replacement surgery, Dr. Goyal continues to deliver among the most effective knee replacement surgery North Virginia and DC offer. When it comes to load-bearing joints, it is not enough to find a surgeon who has a general understanding of human anatomy—you need a specialist. Dr. Goyal has spent his career focusing solely on hip and knee replacement, giving him the qualifications to correct any issue in his constant endeavors to provide the most excellent total knee replacement Washington, DC and North Virginia have available. Please call us with any questions or to set an appointment.
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