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Total Knee Replacement Surgery

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Learn about surgical options for a total knee replacement.

KNEE_PAINKnee pain is one of the most common types of pain that both men and women experience in their lifetime. According to the University of Alabama at Birmingham, as many as 2,000,000 patients will seek medical help for knee pain each year.

No matter your health, your fitness level, your race, or your gender, at some point or another, it is very likely that you will experience knee pain.

When you experience knee pain, when walking or running, the pain itself can be worrisome. Since your knees are always moving and experiencing pressure from your body weight, so when your knee pain appears to be making it more difficult to run or walk, it's easy to worry that something may be seriously wrong with your knees.

General Knee Pain and Physical Activity

Before you concern yourself too much with your knee pain, it's important to remember that knee joints need time to heal like all other tissues in your body.

If you are running – or even walking – regularly, your knee joints may simply need a break. It's important not to ignore this pain and continue to run, especially if you have yet to consult a doctor. Sometimes knee pain is nothing more than your body telling you that it needs a rest. Listen to your body if you've been exercising too often and give your joints time to heal.

General Causes of Knee Pain When Running

ARTHRITIS

While running is an integral part of maintaining a healthy lifestyle, it does put a great deal of pressure on your knee joints. Each step pushes your bodyweight into your knees at a considerable force, all while your knees move your legs with each step.

That pressure can create small tears or lead to irritation that causes swelling. Long-term runners may find that they suffer from overuse injuries as well, which include bursitis and tendonitis.

Because of the amount of force that is exerted on the knee, injury can also be a problem. One misstep and all of your body weight force the knee joints into a position it wasn't meant to twist. This can lead to some serious injuries, including a tear of the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), or the meniscus.

It's also possible to sprain the ligaments in your knee. Most sprains will heal on their own, but some sprains (Grade II sprains and Grade III sprains) may require surgery or physical therapy.

General Causes of Knee Pain When Walking

It's less common to experience significant knee pain when walking.

Previous injury, including sprains and tears, may cause knee pain while walking.

It's also possible to overwork the knee, either through repetitive motion or exercise. This can cause inflammation that may show up when you're walking and putting pressure on your knees.

Also, if you slept with your legs twisted in an uncomfortable position, you may also experience some knee pain while walking.

Chronic Conditions That Cause Knee Pain While Walking or Running

Mild knee pain can affect nearly anyone at any time. But when the knee pain is not caused by an injury and doesn't seem to go away on its own, it may be due to a long-term condition.

That condition is likely to be some form of arthritis –, particularly osteoarthritis. Arthritis affects as many as 50,000,000 Americans according to the National Health Interview Survey, and it's estimated that half of all Americans will experience some form of arthritis by their 80's.

Osteoarthritis is characterized by inflammation in specific joints – especially joints that are consistently mobile and may have received age-related damage over time. That inflammation leads to joint pain (in this case, knee pain) with swelling that may contribute to a lack of mobility.

GENETICSThis type of arthritis can be caused by a range of different factors, including:

  • Age
  • Gender
  • Wear and Tear
  • Muscle Strength
  • Genetics

Osteoarthritis generally starts mild but can become worse over time if not treated with the right supplements. Osteoarthritis is not deadly, and those that suffer from arthritis are generally safe to walk but may experience pain in the process.

Knee pain when running may be more pronounced, so it's a good idea to contact a doctor before taking up jogging to ensure you're clear to run.

Other Conditions That Cause Knee Pain

Other arthritic conditions are known to affect the knees. Rheumatoid arthritis is an autoimmune disorder that attacks your joints. It generally affects your hands, feet, and knees at first, and the symptoms can be fairly mild. The disease may progress without treatment, however, and many of your joints may be affected.

Other potential conditions that create knee pain when walking or running include:

  • Gout
  • Pseudogout
  • Polyarthritis
  • Joint Effusion
  • Osgood-Schlatter Disease
  • Septic Arthritis

Very rare conditions like osteosarcoma require a medical diagnosis and imaging scans.

What is 'Referred' Hip Pain?

Another condition that can contribute to knee pain when running and walking is referred to as referred hip pain. According to the Liverpool Department of Orthopedic Surgery at the University of Hospital Aintree, hip pathology (diseases of the hip) can also lead to knee pain, especially in the elderly.

Osteoporosis, for example, is a type of bonus disorder that can cause degeneration in the hips. Some studies have shown that this type of hip pain may lead to knee pain. If no clear cause of pain in the knee can be found, it may be useful to have your doctor check your hip as well.

Treatment Options for Knee Pain When Walking or Running

Because there is such a wide variety of causes for aerobic knee pain, it's important to confirm an accurate diagnosis before you decide on a treatment.

Serious injury, cancer, bleeding disorders, or other rare knee problems will require a doctor's care. For more manageable diseases, care is as follows:

Care for Knee Pain

Overuse – Rest is priority number one. Overuse implies that your joints are weak, and maybe more prone to damage. Painkillers are also helpful to ensure that your painful knees don't disrupt your day. You should also consider strengthening your legs to prevent future recurrence.

Temporary Knee Pain – Always listen to your body. Temporary knee pain is rarely the sign of a larger problem, but it can be if you don't keep off of it. If you simply seem to have a bit of knee pain, take a break from running and let your knee joints rest. Ice packs and knee wraps can also be advantageous. 

Osteoarthritis – Knees that are suffering from osteoarthritis may need further treatment. Exercises can relieve some of the pressure, but supplements with glucosamine and chondroitin are important for staving off the disease. 


Interestingly, studies have shown that exercising once you feel you've recovered is an important part of preventing both temporary knee pain, overuse injuries, and potentially osteoarthritis, so make sure that you're taking the time to stay active. Consider athletic knee wraps as well, to keep your knee from experiencing further stress and injury when you exercise.

CALF_STRETCHWorkouts to Improve Knee Strength with Osteoarthritis

Supplementation is one of the better ways to treat osteoarthritis. Several nutrients are known to be effective at supplying the joints with minerals and nutrition that it needs to regain its strength and improve its regenerative powers.

But osteoarthritis is a degenerative disease, and when you have knee pain when running, you need to find a way to reduce the pressure you put on the joint each time you go out for a jog.

One of the best ways to do this is with osteoarthritis knee exercises – exercises that will reduce knee pain when walking or when running, and create an environment that puts less pressure on the joints. These include:

Calf Stretch

Calf stretches are designed to prevent injury. But they're also a good way to create additional strength around the knee.

Stand straight facing a wall. While you continue to face a wall, place one leg straight back and keep your foot flat against the ground. Place your other foot in front of you and bend at the knee slowly. With your back foot pressed against the ground, place weight on that leg so that your calf feels like its stretching. Hold for 20 seconds, then repeat with the other leg.

Leg Raise – Lying Down

Another useful leg exercise takes place while lying down. Lay back on something comfortable, like your bed or a couch. Bend one leg and bring it towards you, then take your other leg (keeping it straight) and raise it up to about 30 to 45 degrees above the bed. Hold for 5 to 10 seconds, then repeat with the other leg. Do roughly ten sets of each, depending on the strength level.

Aquatic Exercise

It's highly recommended that you consider aquatic exercise for the more advanced stages of osteoarthritis. When the pain of arthritis keeps you from exercise, the lighter weight in a pool reduces the pressure.

According to research at the Parker Institute by Drs. Else Marie Bartels and Hans Lund, aquatic exercise appears to be beneficial for short term improvements in osteoarthritis pain – an important step for reducing knee pain when walking.

One example looks like you're doing an underwater, "Can-Can." While standing in chest-deep water, lift one knee upwards. Once it's entirely raised, kick your leg out and upwards, using your leg muscles. Bring your leg back down and repeat with your other leg.

Managing Your Knee Pain When Walking and Running

Knee pain when running – and to a lesser extent, knee pain when walking – can be a normal occurrence. While there are some diseases that can cause these conditions, some degree of pain should be expected.

However, because of how important your knees are to movement and how fragile they can be, it's important to manage your pain and make smart decisions about how you handle your knee health.

If it's simply some minor pain from running regularly or mild overuse, try to keep pressure off the knee while it heals. Ice packs and knee braces can be useful as well.

Osteoarthritis takes a bit more management. Osteoarthritis is also known as "degenerative joint disease" because the condition can worsen over time. Strengthening your leg muscles can be a big help. Also, make sure you're taking some type of osteoarthritis supplement to nourish your joints and keep them from degenerating further.

If the condition is more chronic and something more serious, like a tear to a ligament, contact your doctor and see what treatment they recommend. Surgery or physical therapy may be necessary to keep your knee from experiencing further damage. 

What Causes Knee Swelling?

"Swelling" is a blanket term to refer to an increase in the size of a part of your body. In the case of knee swelling, most visual swelling is caused by either inflammation (an immune system response that increases the size of your tissues and causes them to redden) or fluid buildup (the fluid that gathers in a joint without draining). When the cause of knee swelling is fluid, it's known as knee effusion or "water in the knee."

Water in the Knee/Knee Effusion

Contrary to popular belief, the fluid that builds up within the knee is not water. However, the type of fluid depends on the problem. For example, a common cause of water in the knee is gout. Gout is caused by high levels of uric acid.

Most knee effusion is caused by the development of a "bursa," or a fluid-filled sac. The sac fills with synovial fluid, which is a fluid designed to keep your joints lubricated.

Other types of knee effusion may be caused by blood buildup. Most often, blood buildup is the result of a specific injury.

For most patients, knee effusion tends to manifest itself in the same way regardless of the cause. That is why proper diagnosis is so important for treatment.

Common causes of knee effusion:

Arthritis – All forms of arthritis have the potential to cause knee effusion, with osteoarthritis being the most common and rheumatoid arthritis a close second.

Trauma – Knees can easily be damaged as a result of trauma. Trauma includes such conditions as ligament injury, meniscus injury, and patellar dislocation.
Gout – While gout is most common in the large toe, gout may also occur in the knee and can lead to both knee swelling and a burning sensation.
Infection – Many infections create knee effusion as well. Swelling in the knee may be caused by Lyme disease, Tuberculosis, and on rare occasions, gonorrhea.
General Stress – Overuse of the knee can also lead to knee swelling, particularly if a great deal of pressure was placed on the knee.

 

On rare occasions, knee swelling may be caused by a tumor. There are over a dozen different tumors that lead to swollen knees, including:

  • Fibrous cortical defect
  • Ewing's sarcoma
  • Chondroblastoma
  • Osteosarcoma
  • Synovial sarcoma
  • Osteochondroma

Knee tumors are fairly rare, and one of the least likely medical conditions to affect the knee. However, knee tumors do cause knee effusion, so they are likely to be tested by a doctor to ensure an accurate diagnosis.

How is Knee Effusion Diagnosed?

Generally, a doctor will go through your history and determine how or why the knee effusion occurred. Your personal history will help the physician rule out issues like trauma.

Also, the doctor will discuss your symptoms with you, along with what occurred before and during the knee swelling.

For example, if your knee appeared to simply "give out" on you, it may be an ACL tear. If you often use your knees repetitively while lifting, it may be the result of overuse.

Swollen knees will also be compared to the un-swollen knee to determine an accurate diagnosis. An ultrasound may also be used to diagnose knee effusion causes.

Are There Any Other Symptoms Associated With Knee Swelling?

Swelling in the knees rarely occurs on its own. Usually, it's accompanied by other symptoms that may disrupt your life. These include:

  • Knee Pain
  • Burning
  • Immobility/Stiffness
  • Redness
  • Popping Noises
  • Flexibility Issues
  • Trouble Standing

Each of these symptoms is important for both an accurate diagnosis and accurate treatment.

Treating Knee Swelling

The proper treatment for knee swelling depends on the disorder. When the knee is badly injured, or a tumor is present, the knee may require surgery. However, most swollen knees will be treated with one or more of the following:

Swollen Knee Treatments
Bracing – Knees that cause trouble standing or are at risk of re-injury may receive brace or orthotic support. This support will prevent further injury/overuse of the knee and reduce the likelihood of future swelling.
Removing Fluid – Because knee swelling tends to cause pain, doctors may decide to remove some of the fluid from within the knee to reduce the pressure on the nerves and potentially improve mobility. However, if the underlying cause of the swollen knee isn't treated, the fluid will likely come back.
Injections – Some doctors prefer to inject swollen knees with drugs that provide temporary relief. Both corticosteroids and hyaluronic acid provide some relief from knee joint pain and swelling.
Herbal Medicine – Several herbal medicines provide relief from knee pain. The two most common are chondroitin and glucosamine – both of which help nourish and lubricate joints and may be beneficial for those with osteoarthritis. Some herbal medicine enthusiasts also take linden flower and arnica.

Knee swelling prevention is also possible. Consuming nutrients that improve knee health can be incredibly beneficial for warding off issues like osteoarthritis. Weight loss can help as well, since obesity may lead to pressure on the knees.

It's also important to avoid repetitive motion and respond to your body quickly – if you feel any light pain while don't ignore the pain and reduce pressure on your knee. Responding quickly to your body can help you avoid future injuries.

How to Reduce Swelling in the Knee At Home

In addition to natural treatments, there are a few strategies you can try to reduce knee swelling in your home. These include:

Home Remedies for Knee Swelling
Icing – Icing the knee will not treat any knee swelling issues, but it can reduce inflammation, which should provide some temporary relief from knee pain.
Compression – Compression involves putting pressure on the knee with a knee brace. Knee braces may prevent further damage and pressure around the knee, and also warm the knee to reduce inflammation.
Elevation – Keeping your knee elevated also has the potential to reduce inflammation. It takes much of the pressure off your knee that occurs when you sit, stand, or lay down.
Rest – Simply keeping off of your knee can reduce knee pain when the cause of your knee pain is due to injury or overuse. The severe injury still requires treatment, but rest will prevent further damage.
Anti-inflammatory Medicine – Any anti-inflammatory agents can reduce knee swelling and pain. Ginger is one of the most common, as is Boswellia.

Should your symptoms appear to get worse while on these home remedies, or if you are concerned that your knee pain/knee swelling is not subsiding, it's a good idea to contact a doctor and have them check for a more serious problem. 

Cartilage

As the cartilage becomes damaged due to regular wear and tear or brutal injuries, the bone ends start rubbing against each other, causing severe pain.

This leads to restricted mobility of the limbs. Such friction may also affect the synovial fluid acting as a lubricant for the joints to work properly and allowing zero friction.

Time

A total knee replacement (TKR) surgery usually takes less than 3 hours. The orthopedic surgeon examines your knee and replaces the injured cartilage or bone with a pair of plastic-and-metal implants.

With the help of TKR, the normal function of your knee and limbs can be restored. The surgeon even sees to it that the alignment of your knee is properly sustained. After being released, you would be asked to exercise regularly and do rehabilitation to get a full range of motion back in your leg.

The degeneration of the knee is an obvious reason why people resort to total knee replacement procedures. The deterioration of the knee's functionality can be quickly corrected with the help of TKR. An estimated 85% of the people who have undergone TKR have found their implants to last for around 20 years. However, the durability of the implants widely varies between 10-20 years approximately.

Author's bio: The author, John Stuard, is glad to inform her reader base about the importance of total knee replacement and how it helps retain normal activities of an individual.

References

https://www.mayoclinic.com/health/knee-bursitis/DS00954/DSECTION=symptoms

https://www.aafp.org/afp/2000/0415/p2391.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263744/

https://www.mayoclinic.com/health/knee-pain/ds00555/dsection=symptoms

The knee is a major structure supporting our lower limbs and allowing us mobility. 

It is the meeting point for the femur and the shin bone as the two move smoothly together without triggering any friction. The articular cartilage is responsible for triggering a smooth effect as the limbs move. The entire joint holds the ligaments in place and is being covered by the kneecap.

Next Article: How to Stop Arthritis