{"id":6179,"date":"2021-10-05T12:38:56","date_gmt":"2021-10-05T12:38:56","guid":{"rendered":"https:\/\/www.vannistrigelli.com\/en\/?p=2843"},"modified":"2023-11-21T15:52:34","modified_gmt":"2023-11-21T15:52:34","slug":"total-knee-replacement","status":"publish","type":"post","link":"https:\/\/www.vannistrigelli.com\/en\/blog\/2021\/10\/05\/total-knee-replacement\/","title":{"rendered":"Total Knee Replacement"},"content":{"rendered":"\n<p>The knee is the largest joint in the human body, formed by the femur, tibia, and patella, enabling the flexion and extension of the leg.<\/p>\n\n\n\n<p>Muscles and ligaments work together to provide stability to the joint and facilitate movement.<\/p>\n\n\n\n<p>The joint surfaces of the three bones are covered with cartilage, which cushions the contact between joint surfaces and reduces friction during movement.<\/p>\n\n\n\n<p>Irreversible damage to joint surfaces can be caused by certain diseases such as arthritis, osteonecrosis, rheumatoid arthritis, and post-traumatic arthritis.<\/p>\n\n\n\n<p>Only through Total Knee Replacement can these conditions be definitively resolved.<\/p>\n\n\n\n<p>In the initial stage, arthritis may improve with weight loss and rehabilitation. Cartilage supplements, pain management with ice and anti-inflammatories, and injections of medications into the joint can also be used.<\/p>\n\n\n\n<p>Surgery is advisable when severe arthritis with bone-on-bone contact is evident in X-rays, accompanied by the following symptoms:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Pain resistant to pain-relieving therapies<\/li>\n\n\n\n<li>Constant pain even at rest<\/li>\n\n\n\n<li>Difficulty standing for long periods<\/li>\n\n\n\n<li>Inability to perform daily activities such as walking or climbing stairs<\/li>\n\n\n\n<li>No benefit or limited benefit from physiotherapy and conservative treatments.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Knee Prosthesis<\/h2>\n\n\n\n<p>There are various types of knee prostheses: total covering prosthesis and partial or uni-compartmental prosthesis.<\/p>\n\n\n\n<p>The choice of implant type is personalized based on the patient&#8217;s needs, considering the type of arthritis, age, activity level, and bone quality.<\/p>\n\n\n\n<p>During the surgery, a small amount of bone is removed from the tibia, femur, and patella, eliminating damaged structures and creating high-quality bony surfaces for the prosthesis implant.<\/p>\n\n\n\n<p>Most ligaments and tendons are left in place, allowing natural knee movement.<\/p>\n\n\n\n<p>For patients with widespread arthritis or autoimmune diseases, total knee prosthesis is recommended, while patients with arthritis in a specific knee portion may benefit from a uni-compartmental prosthesis.<\/p>\n\n\n\n<p>Identifying a knee prosthetic surgery specialist ensures a good outcome and is the first step in evaluating the need.<\/p>\n\n\n\n<p>Not all patients require surgery, and not all pains can be cured by a prosthesis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Knee Prosthesis Surgery<\/h2>\n\n\n\n<p>The procedure begins with anesthesia administration. The safest method is spinal injection, which can be combined with a sedative if the patient wishes to sleep.<\/p>\n\n\n\n<p>Spinal injection is not painful and has many advantages: it reduces the risk of venous thrombosis, bleeding, and improves post-operative pain control.<\/p>\n\n\n\n<p>The damaged parts are replaced with prosthetic components, and the surgery concludes with suturing the incision and applying a dressing.<\/p>\n\n\n\n<p>The duration is about 1 hour, but from the time the patient enters the operating room to leaving the ward, approximately 2-3 hours pass. The duration of the waking phase varies.<\/p>\n\n\n\n<p>The patient returns from the operating room without a bladder catheter and surgical drainage.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">The Total Knee Replacement<\/h2>\n\n\n\n<p>In total knee prosthesis, the diseased bone and cartilage are removed and replaced with prosthetic components.<\/p>\n\n\n\n<p>The total knee prosthesis consists of 4 components:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>The femoral shield is made of metal, coated with alloys that reduce friction and wear during movement. Once positioned, it wraps around the joint part of the femur.<\/li>\n\n\n\n<li>The tibial component is made of titanium and usually has a small stem that enters a few centimeters into the tibia bone for increased stability.<\/li>\n\n\n\n<li>An insert in polyethylene is placed on the tibial component, a material of high resistance that generates minimal friction during prosthesis movement.<\/li>\n\n\n\n<li>The patellar component is a polyethylene button applied to the patella when this bone is damaged by arthritis or in cases of rheumatologic joint diseases.<\/li>\n<\/ol>\n\n\n\n<p>Each knee prosthesis procedure is tailored to the patient&#8217;s needs, and there may be variations case by case.<\/p>\n\n\n\n<p>The general steps of the procedure include:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Administration of anesthesia and, in agreement with the patient, sedation<\/li>\n\n\n\n<li>Surgical incision in front of the knee to access the joint<\/li>\n\n\n\n<li>Removal of damaged cartilage and bone to prepare the bone ends for implantation<\/li>\n\n\n\n<li>Ensuring that the prosthetic components are correctly positioned on the bone<\/li>\n\n\n\n<li>Testing the new joint<\/li>\n\n\n\n<li>Closure of the incision.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\">What is Uni-compartmental Knee Prosthesis?<\/h2>\n\n\n\n<p>Uni-compartmental knee prosthesis is the smallest implantable knee prosthesis: a device that respects anatomy and allows for quick healing.<\/p>\n\n\n\n<p>There are diseases that exclusively affect a part of the joint, for which a partial prosthesis can be used, smaller and allowing for the preservation of all healthy portions of the knee.<\/p>\n\n\n\n<p>The lower surgical trauma allows for rapid recovery. The patient walks with full weight on the operated limb just a few hours after the procedure, and the hospitalization duration is typically only about 3 days.<\/p>\n\n\n\n<p>Partial prostheses have significant advantages, such as a smaller surgical incision, shorter procedure duration, less bleeding, less pain and swelling, and better joint stability.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Materials Used in Total Knee Prosthesis<\/h2>\n\n\n\n<p>In recent years, designs and the number of available sizes allow for true customization of the prosthesis.<\/p>\n\n\n\n<p>The most commonly used metal is titanium, coated with a chrome-cobalt alloy that shows excellent durability over time. It contains nickel, to which certain patients may be allergic, but prostheses without nickel are also available.<\/p>\n\n\n\n<p>Cross-linked polyethylene, the latest generation, is highly resistant to wear.<\/p>\n\n\n\n<p>Typically, the knee prosthesis is fixed to the bone with cement: it ensures immediate and solid anchoring and has a very long lifespan.<\/p>\n\n\n\n<p>In young patients with good bone quality, non-cemented prostheses can be used, composed of a material that integrates with the bone.<\/p>\n\n\n\n<p>If you want to delve into the topic, I suggest visiting <a href=\"https:\/\/www.vannistrigelli.com\/en\/services\/knee-prosthesis\/\">this page<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Total knee replacement as a definitive solution for arthritis and certain pathologies.<\/p>\n","protected":false},"author":7,"featured_media":6064,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-6179","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-knee"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Total Knee Replacement - Vanni Strigelli<\/title>\n<meta name=\"description\" content=\"La protesi totale di ginocchio come trattamento per risolvere definitivamente l&#039;artrosi ed altre patologie. 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