subject: Knee Replacement Before And After [print this page] Knee Replacement Before And After Knee Replacement Before And After
Your orthopedic surgeon has examined your painful, stiff and swollen knee. You have answered questions regarding the pain you feel? the exact location, when it started, how long it lasts, whether it comes and goes, what activity causes it to hurt most?and responded to inquiries regarding past injuries to your knee, pain in other joints, family history of joint pain and whether or not any physician has ever given you a diagnosis of arthritis. Your physician suspects osteoarthritis, but to be sure, he/she will order a number of tests to confirm the diagnosis and to rule out any other possible causes of your pain.
X-ray and MRI
The first test you can expect is an x-ray of your knee which is taken from various angles to provide an accurate visualization of the damage in your joint. If the physician suspects damage to ligaments or a meniscus, you may also undergo an MRI (Magnetic Resonance Imaging).
Blood Tests
Inasmuch as there are several diseases that can cause arthritis or arthritis-like symptoms, your physician will order particular blood tests to detect and identify the presence of any disease other than osteoarthritis that may be the source of your pain. For example, patients with rheumatoid arthritis, as opposed to osteoarthritis, will have elevated levels of what is referred to as rheumatoid factor (caused by specific antibodies in the synovium or cell lining of flexible joints). Another blood test, called an erythrocyte sedimentation rate (ESR or "sed rate") indicates an inflammatory arthritis or other related condition?such as rheumatoid arthritis or systemic lupus erythematosus?if the level is above a certain range. A test that measures the amount of uric acid in the blood may indicate or rule out gout as the cause of your joint pain. If your physician suspects a rheumatologic illness based on your health history, age and physical findings, there are a number of other blood tests that may be ordered to narrow the field.
Tests on Synovial Fluid
If the diagnosis is uncertain or your physician suspects an infection, a sample of synovial fluid may be withdrawn from your knee joint and sent for testing to confirm or rule out osteoarthritis. Examples of possible results are:
Cartilage cells in the fluid which are indicative of osteoarthritis.
A high white blood cell count which is a sign of an infection.
A high uric acid level which is an indication of gout.
There are a number of other factors in the synovial fluid that may be tested if the physician needs further elaboration.
Results
The results are in. Your orthopaedic surgeon informs you that your diagnosis is indeed osteoarthritis. If you think you are alone in your misery, here are a few facts you might like to know:
Osteoarthritis is the most prevalent form of arthritis, one of the most common diseases affecting humans and a common cause of disability. In 1998, it was estimated that more than 20 million Americans had symptomatic osteoarthritis (OA). As our population ages, the incidence of OA is expected to increase dramatically over the next 20 years.
OA is the second most common reason men over 50 claim work disability.
OA is a major cause of disability in persons over 65.
OA is often present, although asymptomatic, as early as the second or third decade of life.
By age 40, nearly everyone has some osteoarthritic changes in weight-bearing joints such as hip and knee.
At age 75, it is a truly amazing human that does not have arthritic changes in at least one joint.
According to radiologic studies (x-rays), OA of the knees is more common in women; OA of the hips is more common in men.
Options
Now that your diagnosis is confirmed, it is time to discuss your options. Your orthopaedic surgeon suggests a knee replacement and tells you about the several types of replacements that are currently considered state of the art. He/she explains the difference between a partial and a total knee replacement?including the new computer-guided minimally invasive approach used with total knee replacements?and the indications for each. In the end, your surgeon''s opinion is that you would benefit by having a total knee replacement.
Questions to Ask
Before you agree to consider your surgeon''s recommendation, make certain you ask the following questions:
What are the details of the procedure that you are recommending?
What is your experience with this procedure? How many have you done?
Are you board certified?
Why do you feel I need this operation now?
If I don''t have this surgery, what are the other options available to me?
How do you anticipate this surgery will improve my current situation?
Will the surgery be performed under local or general anesthesia?
