Foreword By The Author
Doctors may suggest a knee replacement operation when knee suffering and loss of function is severe and drugs and other remedies no longer alleviate the pain. The doctor will usually request x-rays in order to inspect the knee bones and cartilages and check the extent of injury to evaluate whether the pain might in fact be coming from a different source. Even though knee replacement surgery is widely carried out on people who are overweight (due to the fact that they are much more predisposed to knee problems) this type of surgery is not recommended for those who are severely overweight because replacement joints are so much more prone to failure.
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The Need For Surgery
People of both sexes who are overweight have an increased likelihood of needing knee replacement surgery and the more overweight they are, the more likely it is. Males who are overweight are five times more disposed to a knee replacement than those of normal weight, and females are four times more likely to need it.
Overweight patients in all age groups represent the highest proportion of recipients for knee replacement surgeries. However, although overweight people are credited with most knee replacements, the more overweight they are, the more prolonged the process usually is before they can have the surgery. The difference in waiting period is not an issue of discrimination against those who are overweight but rather, according to the specialists, that fast track procedures for knee replacements tend to cater to patients who pose less chance of complications.
The usual result of doing a total knee replacement on a severely overweight person is a longer hospital confinement, the necessity of using rehabilitation services instead of normal recuperation at home, and an increased risk of complications. These effects become more pronounced as the body mass index (BMI) increases. The morbidly obese, in particular, can suffer from increased wound problems, infections and medial collateral ligament avulsion.
The Effects Of Surgery
Knee replacement involves attention to the ends of bones in a damaged joint. The surgery creates new joint surfaces and the edges of the injured bones of the thigh and lower leg, and commonly the knee cap, are covered with synthetic planes coated with metal and plastic. Typically, orthopaedic surgeons change the whole frontage at the edges of the bones of the thigh and lower leg. However, it is more common to change the inner knee planes or the outer knee planes, depending on the site of the injury. This is called unicompartmental replacement. People who are good candidates for unicompartmental surgery have better results with this procedure than with total joint replacement. Orthopaedic surgeons commonly cement knee joint parts to the bones.
Joint variations as result of osteoarthritis may well extend and injure the ligaments that attach the thigh bone to the bone of the lower leg. After the operation, the man-made joint itself, and ligaments all over the joint which were left behind, typically give sufficient strength for the injured ligaments not to be an issue.
Regional anaesthesia is normally used for knee replacement surgery, although, the exact choice of anaesthesia is dependent on the surgeon, the general health of the patient, and to some degree, on the patient’s own preference.