Basics of Knee Replacemnet Surgery

Knee replacement surgery is the most common joint replacement procedure. It is medically known as Knee Arthroplasty. The procedure is done if patients are still feeling the pain symptoms during normal activities. The practice is done for patients who have knee diseases like osteoarthritis, rheumatoid arthritis and arthritis.

It can also be applied to patients who have knee injuries. There are two kinds of knee replacement. It can be partial or total replacement. The surgery depends on the severity of the patient's disease or injury. The replacement can also be either metal or plastic.

Normally, the replacement can last for ten to fifteen years. There are non operative treatments to avoid the procedure. Patients are given physiotherapy or physical therapy or they can also do special exercises like walking aids. Taking medicines are also medically advised by their respective physicians. However, if these non operatives can no longer cure the patients, surgery is done.

The traditional procedure of the surgery is when the doctor cuts the knee about ten to thirty centimeters long, until they will reach the knee joint. The worn or damaged parts are removed from the thigh to the shin bone of the patient. Physicians will then, shape the damaged surfaced with the metal or plastic replacement. Once they are done with the fitting process, they will put the knee replacement. The cut will be stitched and closed out.

Nowadays, they have discovered a new method of doing the surgery. The recent medical advances are discovered to lessen the tissue trauma or the surgery marks for the patients. They call it Minimally Invasive Surgery. It is done by just making a small incision and by going between the fibers and the muscles without cutting the tendons.

After the surgery, the patients are encouraged to walk with aids in sticks or walkers. They will also have physical therapists to assist them. It will take time for patients to fully recover. Perseverance and patience are advised for these patients.

Well, in some parts of the world where the surgeries are highly specialized and where everything is governed by robots, knee replacement surgery is not considered a major operation. They categorize it under repairs, whereas other types of surgeries require maximum hands-on operation. It is also important to know the extent of wellness the operation will do to you at the same time the things that you can or can't do.

It is recommended to have an overall examination in a timely manner to avoid misinterpretation and assumptions. It is highly recommended by doctors to immediately seek medical assistance if knee pain is present or felt. It can be just a simple pain but it may give a major medical problem to one's health that can lead to this so called knee replacement surgery.

It is a must that we have to be very vigilant in times of body pains. We do not know what is going on inside our body. What we refer to as a simple muscle or knee pain might already a fatal damage inside. If anything happens or you feel something different, have a check up with your doctor at once to avoid severe complications.

Total Knee Replacement - Why You Shouldn't Wait

Undergoing surgery is not something that anyone looks forward to. Sometimes people will learn to live with pain rather than going under the knife to repair any damage but when it comes to your mobility it's never a good idea to wait. Total knee replacement becomes necessary when the patient's mobility is hampered and typically more damaged is caused when arthritic conditions are ignored. This is especially true for female patients. It is thought that women can bear more pain than men so they wait longer to consider surgery.

What is a total knee replacement?

A total knee replacement is a surgical procedure that replaces the ends of the damaged femur (thigh bone) and the tibia (shin bone) and creates a smooth knee joint. The prosthetic components are made from metal or plastic and are secured to the bone with cement. Depending on the extent of the damage, a partial knee replacement or uni-compartmental replacement can be done in which only a portion of the joint is replaced. (The knee is comprised of three compartments).

What causes degeneration in the knee joint?

When bones become degenerative it is most commonly associated to osteoarthritis. Osteoarthritis, also referred to as "wear and tear" arthritis is common in older patients and is caused by aging joints, obesity and prior injuries. Symptoms associated with osteoarthritis are joint pain and stiffness and decreased mobility. Weight loss can improve osteoarthritis and has been shown to decrease symptoms.

What to expect after Surgery

After undergoing a total knee replacement, patients are instructed by their physician to under go physical therapy to strengthen the surrounding muscles and ligaments. Depending on the amount of trauma, rehabilitation time will vary in patients. Rehabilitation is extensive but is necessary in the process. It is very important to manage weight gain because one of the contributing factors to osteoarthritis is obesity. Throughout the recovery process it is vital to maintain constant communication with your doctor.

Exercise: Muscle Strengthening Aids New Knees

A new study suggests that a carefully focused program of muscle strengthening can make an important difference in how well patients recover after knee replacement.

Patients who underwent six weeks of progressive muscle strengthening aimed at the quadriceps did much better than patients given conventional treatment. The study appears in the February issue of Arthritis Care & Research.

Almost 500,000 knee replacements are done in the United States each year, and patients often report that they still have problems doing things like walking and climbing.

For the study, more than 200 patients were divided into groups and given different treatments about four weeks after surgery.

One received conventional treatment. Another was also given quadriceps strengthening, while a third was given the strengthening and electrical stimulation to make the muscles contract.

While the electrical stimulation did not appear to make a difference, the muscle strengthening appeared to bring the patients back to a level of functioning almost normal for their age.

One of the authors, Lynn Snyder-Mackler of the University of Delaware, said in an e-mail message that knee replacement patients and their doctors should not underestimate the ability “to really improve their function.”

Cure Knee Pain With CFA Supplements

In our culture, fitness is the symbol of youth and vitality. However, for some people exercising comes with a price. Long-time runners often complain of knee pain. Some give into the pain and stop their workouts. Others say, "No pain. No gain." Wouldn't it be great if you could cure knee pain and continue the healthy lifestyle that you love? There is an answer: cetylated fatty acid (CFA) supplements.
Cetylated fatty acids lubricate cell membranes, allowing your joints to move freely again. For runners and people who are on their feet all day, it can cure knee pain so they can live active, healthy lives. CFA's have been medically and clinically proven to provide significant improvement in as little as 30 minutes.
The good news is that CFA's like Celadrin are available in topical and oral supplements. People who have taken CFA supplements report these benefits:
• Fast-acting relief. In a double-blind clinical study, subjects who took CFA supplements experienced relief in less than half an hour. Subjects who took placebos experienced no relief. • Available in over-the-counter oral and topical treatments. The great news is that you don't need a prescription to cure knee pain with CFA supplements. • 100% improvement in clinical trials. All patients who took CFA supplements experienced speedy relief from joint pain. Cetylated fatty acids lubricate the joints while combating inflammation. • No reported side effects. Cetylated fatty acids are safe and comply with FDA requirements. • Restored flexibility. CFA supplements help rebuild flexibility in knee joints and provide long-term relief for people who use it regularly.
Cetylated fatty acids enhance cell membranes and promote elasticity in the joints. As CFA's lubricate the joints, the joints are cushioned from the stress and strain of everyday impact. For runners, CFA's are the key to regaining the mobility and flexibility necessary for working out. Why miss out on life when you can live it to the fullest?
Here are some conditions that can benefit from CFA supplements:
• Sports injuries. CFA's can mend and repair a variety of sports injuries by reducing inflammation and relieving the pain. • Knee injuries. CFA's repair the wear and tear of knee impact and provide fast and long-term relief for common knee pain. They also prevent re-injury by lubricating joints. • Elbow pain. CFA's reduce swelling and provide relief to painful elbows. Used daily, you'll notice significant improvements in flexibility and movement. • Joint problems. CFA's lubricate the joints and provide a fluid cushion to prevent re-injury. • Lower back pain. CFA's relieve the pain and inflammation of back pain due to stress and injury. • Psoriasis. CFA's reduce inflammation both internally and externally, relieving pain and soreness associated with skin conditions.
CFA supplements are your key to an active life. Work out. Run a marathon. Take a hike. Don't let knee and joint pain keep you down. For people who want to cure knee pain, cetylated fatty acids are the answer. By reducing inflammation, providing lubrication, and healing tender joints, CFA supplements can help you live life to the fullest. Why let a little knee pain ruin your day? Try all-natural cetylated fatty acids, and your knee pain will be a thing of the past.

Knee Pain Relief - Jumper's Knee - The Benefits of Knee Braces

Patellar tendonitis, which is also known as "jumper's knee," happens quite frequently to athletes who play in sports were jumping is required. The patellar tendon runs along the top of the knee and connects the kneecap to the shin bone. As you can imagine, any inflammation or stretching of this ligament can cause some pain to the patient.
Jumper's knee happens when someone puts too much strain on the patellar ligament. Runners, basketball players, volleyball players and soccer players are prime targets when it comes to getting patellar tendonitis; although it can strike anyone if enough strain is put on the ligament. If you suspect you may have patellar tendonitis, you can usually feel pain when you press on the tendon that directly covers the knee. You may also experience swelling and stiffness. Sufferers of this form of tendonitis will usually feel pain when bending at the knee. This usually occurs when the patient kneels down or jumps.
Treatment for patellar tendonitis varies, depending on the severity of the case. In most cases, your doctor will take an X-ray of the knee, just to make sure there isn't any damage to the joint or bones of the knee. In some cases you may have to undergo an MRI. An MRI helps doctors assess whether the tendon, or determine whether it is aggravated. Once the doctor can make an accurate assessment, they will recommend a suitable treatment plan.
Applying ice to the tendon will help in most cases. Ice helps to control and minimize the swelling of the tendon. This will cut down on pain, and allow the tendon to relax and heal more quickly. Anti-inflammatory Motrin and Ibuprofen are prime examples of anti-inflammatory drugs. These drugs will help decrease swelling and control the pain. (Before you take any of these medications, you should consult with your doctor first.)
Rest is one of the best cures for tendonitis. Stay away from any activity that causes pain or that can irritate the tendon further. Allow your body to heal naturally by giving it proper rest.
A knee brace can help provide support to the knee. Many tendonitis sufferers use them not only when they have a problem, but also to prevent the problem from occurring in the first place. A well designed knee brace can be an invaluable tool to the patellar tendonitis sufferer.
Jumper's knee can often be painful, without a doubt. Avoiding having to suffer from it is a key element, especially if you rely on your knee for sporting activities. Make sure you stretch before you have to put your knee to use, and wear a knee brace when possible. This will help cut down on the chances that you will suffer from Jumper's knee in the future.

Knee Pain Relief - How to Survive Meniscus Tear Knee Pain - Knee Braces That Help Provide Support

Are you looking for a way to survive your knee pain after you have injured your meniscus?
If you would like free information on how to help reduce this kind of knee pain then read on...
Your meniscus is a shock-absorbing cartilage found in your knee. Tears occur most commonly when a person excessively twists or over-flexing their knee joint. Often times it is a sports related injury.
There is a meniscus located in two parts of each of your knees. One provides shock absorption on the outside aspect (also known as the lateral aspect), and the other is located on the medial aspect (inside portion of the knee). It also keeps your femur (thighbone) and tibia (shinbone) from grinding against each other. In other words, if a person was somehow unfortunate enough to be born without their menisci, their weight would fall squarely upon their bones and this would promote boney fractures and a ton of knee joint pain.
Even a very small tear to the mensicus can cause a lot of pain, which is the overall reason why the health of your meniscus is vitally important. If an individual is older and they have brittle cartilage, they can be more prone to a meniscus tear.
Symptoms include:
A popping feeling can occur at the time of injury
Knee joint pain When pressure is applied to the knee joint, knee pain can occur at the space between the bones.
A locking sensation can occur at the knee joint
Recurrent knee-catching
Diagnosis
When you see your physician after a knee injury and you are concerned about a meniscal tear, he/she will look at your history, and can perform a manual test like the Apley's compression test, or the McMurray's test. Your physician may also use an X-ray or MRI determine the severity of your knee injury. Surgery is not always required, unless the damage is extensive.
Treatment
Icing can help reduce knee swelling and reduce knee pain after a mensical tear. In addition, it is important to stay away from any activity that inflames your knee pain.
A well designed knee support can also help patients who have suffered a knee injury, such as a meniscal tear. Excessive side to side movements can be restricted and the support a knee brace can provide can reduce your knee pain.
If you are an active person, you can use knee braces for a prophylactic purpose. When you use a knee support when you are healthy you may help prevent a knee tear. A well designed knee brace can be a very useful adjunct to the health of your knee.
A good physician will tell you that they use surgery as a last resort; telling you that conservative measures should be considered first:
A meniscus repair can be used to help treat your meniscus, but more often a meniscectomy is performed, which removes the damaged part of the meniscus.
If you suffer a meniscal tear once, you are more likely to have further problems, such as arthritis. Prevention is the best method to avoid such an injury. Making lifestyle choices that can help prevent this injury are recommended, such as staying in shape. The extra weight can only be an increased burden upon your meniscii.

Chondromalacia - Cause of Anterior Knee Pain in Middle Aged Women

According to the University of Virginia Health System:
Arthritis: Osteoarthritis is the most common type of arthritis that affects the knee. Osteoarthritis is a degenerative process where the cartilage in the joint gradually wears away, and often affects middle-age and older people. Osteoarthritis may be caused by excess stress on the joint such as repeated injury or being overweight.
Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. Rheumatoid arthritis often affects persons at an earlier age than osteoarthritis.
After walking for 6 hours a day, five or six days a week for twenty years, tearing my patellar tendon, having surgery for that and just seeing the years fly by like we all do, this is where I found myself. Knees that were bone on bone, my right kneecap 1/3 worn off, hurting all day and night if I wasn't taking some kind of pain killer every four or five hours.
What do you do? Just keep going and taking pills until the knees finally totally wear out and you either go sit in a chair or get knee replacement. At least that is what I thought and is what I planned to do.
Until. Until a friend shared something with me that I thought was nuts. "Sure Steve, that will work!" (sarcastically) But, what did I have to lose? Nothing but knee pain, so I tried it. He was right and I was wrong, did it ever work! To the tune of pain free with the same knees and feeling at sixty like I did in my twenties, NO PAIN! Amazing, yet true.
I would enjoy helping you achieve this same level of feeling good without prescription meds or pain killers of any kind. Get in touch and let's get you started too.
Doug Sandquist is a mail carrier in Omaha who has dealt with knee pain and surgery for many years. Having found a way to be PAIN FREE WITH MY REAL KNEES I want to help others reach that same level of healing. Isn't it time for you to start on the road to less pain?

Jumping - Daily Functioning of the Knee

Jumping
It’s hard not to feel a twinge of envy when you watch your favorite six-year-old leap off the furniture, knowing the only damage she’s likely to cause is to Mom’s favorite breakable. As we get older, the impact of jumping is likely to have far more painful consequences than paying for repairs out of our allowance money. The harsh impact combined with the potential for twisting and tearing, makes jumping a risky business indeed. Still, some of us can’t resist. We rise into the air on driveway basketball courts and in funk-music-driven aerobics classes. Sometimes we land easily, sometimes we don’t.

When you jump, even a good landing may compromise your knee joint. Those strong quadriceps muscles contract on landing and pull hard at the patellar tendon’s insertion on the tibial tuberosity (the little bump at the top of the tibia). This may cause jumper’s knee (inflammation of the patellar tendon). Of course, if you land off your intended, balanced course, you will strain all elements of your knee joint. The correct shoes and corrective knee bands can reduce knee injury when jumping.

Stair Climbing - Daily Functioning of the Knee

Stair Climbing
Once used primarily by athletes in training, stair climbing has become popular with exercisers who take step classes in gyms and with aerobic enthusiasts who use the outdoor stairs at beaches, hills, and high school or college stadiums. A lot of them end up limping into the doctor’s office with knees that just can’t take the strain. With stair climbing, the knee moves quite a bit and is under a great deal of pressure. The more the knee is flexed, the tighter the patellar tendon is stretched, pushing on the patella. When the tendon stretches out, the area where it attaches becomes inflamed, and tracking of the patella goes off course. It drifts, slips, and tilts, resulting in patellofemoral syndrome (runner’s knee) or, in more extreme cases, chondromalacia patellae (wearing out of the cartilage on the back of the patella). Extreme wear and tear on the cartilage and menisci (the cushioning discs between the femur and the tibia), over time, roughen the glassy cartilage surface and decrease the protection it and the menisci offer. Eventually, bone may meet bone, causing painful arthritis. Stair climbing may increase the force of the patella on the femur up to four times body weight. To help keep the exercise as safe for your knees as it is good for your metabolism and cardiac function, take care to give your knees a rest (don’t do the same exercise two days in a row), alternate stair climbing with other types of exercise, reduce your speed while climbing, and pay immediate heed when your knees start to ache or swell.

Squatting - Daily Functioning of the Knee

Squatting
In some cultures squatting is the preferred method of sitting and is practically an art form. People in those cultures can sustain the posture for lengthy periods of time—astonishing to the average American. Squatting is sometimes advocated for pregnant women as a way to ease the eventual difficulties of labor. When regular squatting is practiced from childhood, the knee suffers no ill effects. However, if you use this motion only occasionally—or incorporate it suddenly into your daily routine—it can cause problems. Certainly you may occasionally squat to pick up an errant sock or a sleeping child from the floor. Mostly, though, squatting in this country occurs during exercise. A well-executed squat is an excellent muscle-toner and muscle stabilizer, but a poorly executed one can create problems. Deep knee bends to a squatting position—once the cornerstone of military inspired exercise regimes—have now been determined to do more harm than good by jamming the patella into the femur, and subluxing (partially dislocating) the femur from the tibia—in this case, slipping the femur over the tibia, outside its normal anatomical placement. Squatting may increase the forces on the knee joint up to eight times body weight.

Jogging and Running - Daily Functioning of the Knee

Jogging and Running
Jogging and running have benefits for both body and mind. Great calorie burners, they also clear your mind and renew your spirit, offering the much vaunted “runner’s high.” They can, however, take a real toll on the knees unless you take precautions. As discussed in the preceding section, good shoes are a must, and you should replace them regularly if you are a frequent or long-distance runner. Carefully consider your running surface—a dirt track is better than a concrete one, and flat or uphill running is preferable to downhill. Most runners do pay attention to these factors.

Another predictor of potential knee problems as a runner is your physical build. Q angle (quadriceps angle) is measured by drawing a line from your anterior iliac spine (the bump on your pelvis above and in front of your hip joint) to the center of your kneecap, and a second line from your kneecap to the tibial tuberosity (the little bump at the top of the tibia where the patellar tendon attaches to your tibia). A wide Q angle would be more than 15 degrees and might be found on extremely broad-hipped women. Such an angle may increase the likelihood of “runner’s knee” (patellofemoral syndrome), because it predisposes a person to run with the knees pushed inward (knock kneed). The resultant strain loosens the patellar tendon and its collagenous attachments and weakens their hold on the patella. The patella may then move off its track on the femur, resulting in pain and inflammation. A wide Q angle does not always cause pain and is not a reason to stop running, however; its effects can be adjusted by the use of orthotics or braces.

Shoes - Daily Functioning of the Knee

Shoes
The common shoe offender to knee health is, of course, high heels. Their negative impact is compound. First, they position the foot so that its usefulness as a shock absorber is greatly diminished. This problem is exacerbated by the fact that the shoes themselves are often thin-soled and unpadded, offering no cushion between the foot and the pavement. Second, they create stress for the knee by causing prolonged muscle contraction and fatigue. Third, over the long haul, constant wearing of high heels can create a permanent tightening and shortening of the Achilles tendons, so that any shoes other than high heels become difficult and painful to wear.

Another source of problems is worn-out or improperly fitted athletic shoes. Designed to compensate for the impact caused by running, jogging, or jumping, shoes that become worn down create problems in two ways. First, a reduction in the cushion increases the impact on the knees. Second, soles worn down on their sides, heel, or toe may magnify the slight imperfection in gait that caused uneven wear in the first place. A shoe that fits poorly may cause poor toe-off (the beginning of a step) or excess muscle strain.

Irregular Gait - Daily Functioning of the Knee

Irregular Gait
Gait is simply the way in which a person walks. In a perfect gait cycle, the pushing off and landing motions of the heel and toe are in balance, contributing to an even stride. Many people, however, unconsciously favor the heel or toe when they walk, contributing to an uneven and uncomfortable gait cycle. Plantar flexion, favoring the toe, occurs when the foot is angled down at the ankle from heel to toes (at its most extreme, walking on tiptoe). This causes the knee to hyperextend (literally straighten too far), putting extreme pressure on the joint itself as well as its individual anatomical parts. The tendons, ligaments, and joint capsule are stretched so that they move out of place, resulting in a sprain or strain. Dorsiflexion, favoring the heel, occurs when the foot is angled up from the ankle (at its most extreme, walking on the heels alone) so that the person falls forward, straining the quadriceps (thigh) muscles. Excess dorsiflexion keeps the quadriceps contracted in order to keep the individual from falling over and inhibits normal straightening of the knee. Both of these gait deviations are commonly seen in people who have had a stroke, brain injury, or spinal cord injury and in children with cerebral palsy

Walking - Daily Functioning of the Knee

Walking
No movement or exercise is easier on the knees than a well-paced, well-executed walk in good, comfortable shoes. Some factors, however, can make this most natural of motions hazardous to knee health, and I discuss those next.

Anatomy Of The Knee

The knee is made up of bones, ligaments, tendons, cartilage, and a joint capsule, all of which are composed of collagen. Ligaments connect bone to bone. Tendons attach muscle to bone. Cartilage is the smooth, fibrous connective tissue covering bones that allows easy, gliding movement.



Collagen is the fibrous protein constituent of connective tissue present throughout the body. As we age, the most obvious sign of collagen breakdown is in the face, where it leads to the sagging that keeps plastic surgeons in business. Less obviously, however, collagen breaks down throughout the body and contributes to a variety of age-related injuries and conditions. These keep orthopedic surgeons in business. However, treatments and methods other than surgery may do a better job of preserving and rejuvenating the knee.

The knee joint is a link between the thighbone—the femur—and the two bones of the lower leg—the tibia (large and on the inside) and the fibula (small and on the outside). The attaching ligaments on the outer surfaces of the knee are the medial collateral ligament (connecting the tibia to the femur) and the lateral collateral ligament (connecting the fibula to the femur). The patellar tendon attaches the quadriceps muscles of the thigh to the tibia, enabling extension of the knee. Inside the knee joint, two ligaments stretch between the femur and tibia—the anterior cruciate ligament and, behind it, the posterior cruciate ligament. Covering the ends of the bones is articular cartilage, which provides a smooth surface to facilitate motion. Articular cartilage is so named because when bones move against each other, they are said to articulate. In the knee, auricular cartilage covers the end of the femur, the top of the tibia, and the back of the patella (the kneecap). In the middle of the knee joint are the menisci, which are collagenous disc-shaped cushions that act as shock absorbers.

Unlike a ball joint, such as the hip, which sits in a deep pocket (the acetabulum of the pelvis), the knee doesn’t have much protection from trauma and stress. It is designed to move mostly in one plane like a hinge. Because of this inherent limitation of movement, strong knee ligaments are extremely important for knee health.

Side-to-side stresses are controlled by the medial and lateral collateral ligaments; front-to-back motion is handled by the anterior and posterior cruciate ligaments, which ensure that the tibia doesn’t slide backward or forward in relation to the femur. When these ligaments become lax, or are torn, bone movement may become excessive and damaging, and painful arthritis can begin.

HOW THE KNEE WORKS (AND DOESN’T)

The skeletal structure has two primary types of joints—the ball joint, exemplified by the shoulder, which allows free rotation (a freedom that comes with its own set of problems and injuries, by the way); and the hinge joint, illustrated by the knee, which operates primarily in a single plane (bent to straight) with only a slight rotational or pivoting motion. This restriction of movement is what makes the knee so vulnerable to traumatic injury. Additionally, the knee is regularly subjected to the stress of both supporting body weight and absorbing shock from intermittent impacts such as jumping, walking, and running. Over time these stresses cause a loosening of the connective ligaments, the tendons, and the joint capsule that holds the knee together. Along with a wearing away of cushioning cartilage and collagen, this loosening leads to the pain and dysfunction of bone meeting bone. At its worst, this condition manifests as arthritis.

Knee Replacement

Having a knee replacement takes not only certain physical preparation but mental preparation as well. Before having the surgery it is important to have your home laid out for simplicity and easy navigation.

Find a chair that you will be spending a majority of your time in when you arrive home. preferably, its a recliner as you do not want to have your leg in a dependent position where gravity affects the pooling of the blood. Once your chair is designated be sure its of proper height and does not rock. Building a platform prior to surgery to place under the chair is an idea that many have used in the past with great success to raise its height for easier transfers.

Hopefully you have been given an exercise handout prior to surgery to begin preparing your body for the surgery. Completing basic exercises to the affected limb or limbs will greatly assist you in the post-surgical recovery as its known that muscle has memory, and will return to normal function and strength much sooner if exercised in the same manner prior to surgery. The time varies, but 3-5 weeks out should have you prepared and ready following a written exercise program.

Please be sure to have a quality cold pack or other cooling system ready when you get home. Your knee will recover and respond much faster and pain relief will be kept to a minimum with an effective cold pack. Check your local drugstore or better yet a local medical supply will have a larger selection. I see many patients trying to ice down a knee with a small bag of peas and carrots this is something I do not recommend, your knee will need better coverage than that.

Have your meals prepared or have someone that will be staying with you for the first 10 days to 2 weeks home, as the last thing you want to do is stand on your surgical leg in the kitchen preparing meals, believe me it will only take one episode of meal preparation to understand the importance of having food prepared or someone assisting you with it.

Make sure you bring home your compression stockings that are issued at the hospital, many leave them and find they would have come in handy at home. The stockings are to curb edema and to prevent DVT. Take your pain medication as prescribed as well. Many try to get off the pain medication too soon only to be very uncomfortable you will need the pain medication anywhere from 4-6 weeks out from surgery.

And most of all, complete the exercises that have been prescribed by your therapist. your final outcome will be only as good as the time you put into the exercise program. You will see a big change in your overall condition within 6 weeks after surgery if not sooner remember, everyone is different and what your neighbor did and experienced down the street will be different from your experience.

Knee Osteoarthritis

Osteoarthritis, or degenerative joint disease, affects the elderly in parts of the body where it hurts the most. A person suffering from knee osteoarthritis will most likely equate it with cardiovascular disease because the breakdown of articular cartilage of knee joints restricts movement and the patient has to follow a set regimen affecting his lifestyle.

Knee Osteoarthritis is due to injury, congenital disorder, or obesity. The deterioration of articular cartilage, a smooth and fibrous connective tissue that acts as a protective cushion, narrows the joint space between bones. In time, the cartilage becomes grooved and fragmented and surrounding bones thicken or sprout into spurs. Sometimes, there is additional swelling in the knees caused when synovium, a membrane producing a thick fluid to nourish the cartilage, becomes inflamed and produces additional fluid known as ‘water of the knee’. Changes occur due to constant rubbing of joint bones leading to deformity of joints that is equally painful.

Knee osteoarthritis is diagnosed through physical and pathological examinations of joints on either side of knee including hip joints, checking on posture, and gait. Once knee Osteoarthritis is confirmed, a treatment is suggested depending on nature and extent of damage and on the personal physical history of patient. Women over 60 years of age are high risk factors for knee osteoarthritis as they spend major portion of their lives doing physically demanding work that has direct relationship with knee Osteoarthritis. Wearing high heeled shoes also aggravates the pain. In youngsters, knee osteoarthritis is hereditary or due to some injury.

Precautions such as weight reduction, changing work routine, postures, diet, avoiding injuries, participating in physiotherapy, and exercise are advised. Other methods of relief such as acupuncture, ointments, prescription drugs, magnetic pulse therapy, vitamin regimes, and topical pain relievers are temporary. Using prescription drugs and surgery should be a mutual decision between patient and doctor.

What Is Anterior Knee Pain?

Knee pain has can be dressed up in many different guises. Whatever someone decides to call it, all we need to know is that it usually occurs on the front of the knee and it hurts!

The pain is normally associated with running, walking down hills/stairs, or sitting with a bent knee for long periods of time. This is due to an alteration in the biomechanics of the knee which is usually caused by an imbalance in the soft tissue structures.

The pain within the knee joint usually increases when the quadriceps muscles work eccentrically (meaning the muscles working as they get lengthened). This exerts a large force through the patella (knee cap) when the muscles are used this way. The large force presses the patella against the femoral groove, which if not located correctly causes pain.

Mal-tracking of the patella within the femoral groove is the most common cause of anterior knee pain. This is like a train being driven off its rails which will lead to a bumpy and uncomfortable ride! An imbalance in the pull of the quadriceps muscles (vastus medialis, vastus lateralis, vastus intermedius and rectus femoris) which attach to the patella can alter its position.

The angle of pull of the quadriceps muscle through the patella is known as the Q-angle. The Q-angle is determined by drawing a line from the ASIS (bony point on the front of the pelvis) to the midpoint of the patella with a second line being drawn from the centre of the tibial tubercle (flat piece of bone below the knee cap) to the middle of the patella. The point where these two lines cross is known as the Q-angle which should be 13Ú in males and 18Ú in females. Anything outside these ranges could be the cause behind knee pain. Note when performing these tests the leg should be relaxed.

One of the main culprits behind the altered positioning of the patella is a weakness in vastus medialis obliqus (VMO). This muscle attaches medially (to the inside) on the patella with weakness here allowing the patella to drift laterally (outwards). This muscle is the first of the muscles to waste following injury and lack of use of the quadriceps muscles. The quadriceps muscles can start wasting within 24 hours of non-use! Treatment may therefore consist of strengthening of the VMO muscle to alter the pull of the quadriceps on the patella thus correcting its position.

Likewise shortening of vastus lateralis which attached to the lateral aspect of the patella may also result in an outward pull on the patella again affecting the Q-angle. Treatment here would consist of heat, stretching and massage to normalise the length of the muscle. In extreme cases surgery may be required to ’release’ the muscle to allow the patella to re-position itself correctly.

Other causes of anterior knee pain from the patella-femoral joint include

" Tightness in certain structures (e.g. calf and hamstring muscles).

" Altered hip, knee or foot posture.

" Anatomic variations such as a shallow patella-femoral groove.

If knee pain is left untreated the articular surfaces of the patella-femoral joint may, in some cases, become affected and worn, exacerbating the problem.

These are just a couple of examples of causes of anterior knee pain. To have your specific condition diagnosed correctly it is advised that you seek medical advice from a professionally qualified practitioner.

Understand Knee Rehabilitation

James had injured his knee on a rambling trip in France. After consulting his family doctor he was advised to work out on an exercise bike. This just made the knee worse so he consulted a second doctor who sent him for physiotherapy. The physiotherapist referred him to a gym, where the fitness manager put him through a rigorous programme of exercise with a rowing machine, treadmill and cross-trainer. Imagine his misery when instead of the knee getting better it swelled up, became much more painful and he found himself wondering if he should buy a walking cane and move to a downstairs apartment. What was going on?

Well, knee rehabilitation after injury or surgery is not just a case of going to the gym and pushing through the pain. In this case, none of the medical people had made a proper diagnosis, but even without a diagnosis the knee itself was making it clear that the exercise regime was inappropriate.

You see, the body follows a natural progression of healing. Each step of the rehabilitation programme needs to be in sympathy with this healing process. If not, one can do a lot of harm.

After any insult to the knee the inflamed joint lining produces increased fluid and a cascade of chemicals that appear one after the other in a specific sequence. The early part of this cascade encourages blood vessels to dilate and become leaky. Blood plasma containing immune cells leak out of the blood to enter the damaged area and try to clean it up and prevent infection. This whole process contributes to the knee feeling swollen, hot, red and painful. This is called inflammation. Different chemicals emerge later in the cascade to promote closing up of the injury and enhance healing through formation of scar tissue to replace damaged or missing tissues caused by the original injury.

If the knee keeps getting stressed, then the choreography breaks down and the inflammation cascade occurs at the same time as the scarring cascade. This can sometimes prove disastrous, with a hot swollen painful knee stiffening up with sticky adhesions within the knee cavity and the lubricating pouches around the knee, tying previously mobile tissues together and reducing movement within the joint. Without the right attention these adhesions can turn into scar tissue.

To give your knee the best chance of benefiting from a rehabilitation programme you must clearly identify what phase of rehabilitation your knee is in. You need to know what the phases are and the dos and don’ts of each phase. You need to be able to recognise when you have pushed things too far for that phase and what to do about it if you do.

In the early stages of rehabilitation after injury or surgery be sensitive to the fact that the knee lining is likely to be inflamed. The swelling and pain that are normal in this phase may cause the muscles, especially the quads muscles, to become inhibited and unable to contract properly. Gentle sustained stretches ensure that the tendons of the inhibited muscles do not shorten and limit movement in the future. Gentle progressive movement is necessary and really important to lubricate the joint properly and to break down any adhesions. Simple ’balance’ exercises improve balance and position sense in the knee, both of which can easily be lost at this stage leading to re-injury. Rest, ice, compression dressings and elevation are needed after each session to try and minimise swelling. While the inflammation settles you may have to limit some activities and then build these activities up again gradually during the later healing stage.

Only when you have close to full range of movement should you start to concentrate on rebuilding strength. Keep in mind when starting strength training that muscles act in complementary sets. For example, you need to exercise the muscles that bend the knee as well as those that straighten it. Too much emphasis on one set of mucles may lead the complementary set to weaken which destabilises the knee. The quality and timing of the muscle contraction is also important in re-building muscle strength efficiently.

Under ideal conditions, rehabilitation would progress smoothly from strength training to endurance training and then back to full activities. But moving to endurance training too early can again trigger an inflammatory response and set rehabilitation right back with more swelling, pain, muscle inhibition and loss of the range of motion you may already have regained. This is what happened in James’s case. He had already lost time off work, and had now wasted all his efforts in going to the gym.

In this scenario, pushing through the pain is not going to fix the knee. It will only make things worse. With knees, repeating cycles of healing and then renewed inflammation signify that you are pushing too hard and are not being careful enough in your rehabilitation programme. Back off right down again to the first stage of rehabilitation. Return your focus to dealing with the inflammation not the strengthening or endurance. While that might seem like a step backwards, it is really a step forwards towards your ultimate goal of getting better.

Start again with rest, ice, elevation, compression, and possibly anti-inflammatory medication. Stretches and gentle flexibility exercises should be continued, but only when the inflammation settles should you return to strength and endurance training. If you cannot manage this on your own, a good physiotherapist with experience in knee rehabilitation should be able to resolve the problem before things deteriorate too far.