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KNEE REPLACEMENT
Joint replacement procedures also called arthroplasties, involve
replacing a painful joint with an artificial implant known as
a prosthesis. Each year there are more than half a million joint
replacement procedures performed nationally. At Joint Implant
Surgeons, Dr.'s Mallory, Lombardi, and Berend specialize exclusively
in total joint replacement of the hip and knee and each year
perform over 1500 of these procedures. |
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The
reasons for knee replacements varies. Tthe most common reason is to
relieve severe pain from conditions such as osteoarthritis, rheumatoid
arthritis or pain from an injury.
Total knee replacement
is often called Total Knee Arthroplasty or TKA. TKA comes in two
forms primary and revision.
- Primary
TKA occurs when the patient is having a total knee replacement
for the first time.
- Revision
TKA occurs when there is a problem with the current knee replacement
and needs to be replaced by a new knee replacement.
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| Healthy
Knee |
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In
a healthy knee, the bones are smooth and glide together
easily in the kene joint, allowing you to walk effortlessly.
The cartilage between the knee joint serves as a cushion,
permitting the bones to rotate, glide, and roll upon each
other while you walk. |
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| Problem
Knee |
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With
certain condition such as osteoarthritis, rheumatoid arthritis
or injury , the knee's cartilage slowly wears away. The
bones rub against each other, causing pain and difficulty
walking. The knee cap may move and allow the knee to feel
unstable. |
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| Knee
Prosthesis |
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A
knee prosthesis is comprised of three smooth surfaces,
much like a healthy knee. The femoral component caps the
end of the thigh bone; the tibial component covers the
surface of shin bone. The patellar component covers the
underside of the knee cap. Together these components replace
the worn knee joint surfaces and allow movement and walking
without pain. |
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New patients are sent a packet of information to be completed and
brought with them at the time of their appointment. Patients will
need to bring any insurance information with them and any previous
x-rays or MRI's. New x-rays will be taken during their appointment.
Patients may want to wear loose clothing for their examination.
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Pre-Admission
Testing
Once a patient has scheduled a date for their surgery
they will need to come to the Columbus office for a
day of Pre-Admission Testing. During their appointment
for Pre-Admission Testing they will meet with our team
of specialists who will help patients become prepared
for their surgery. During pre-admission testing patients
will spend time with a Consulting Physician, a Physical
Therapist and a Case Manager
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Consulting
Physician
Consulting physicians are internal medicine physicians also
called hospitalist. They specialize in the medical needs of
orthopaedic patients prior to surgery and during a patients
stay in the hospital. The consulting physician will review
your medical history, perform an EKG, draw lab samples and
complete a physical examination. These will also be the physicians
who care for the patients medical needs during their stay
in the hospital.
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Physical
Therapist
A Physical Therapist will perform a pre-surgery assessment
including range of motion, strength and function. They will
also instruct patients on pre-operative strengthening exercises
and bed exercises that will be done immediately following
surgery. The patient will be informed of any special equipment they
might need following surgery, such as a walker or other special
products needed to assist with recovery.
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Case
Manager
The Case Managers role is to provide patient education and
discharge planning in conjunction with a social worker. The
Case Manager will show a video that will assist you in understanding
the benefits risks and potential complications of surgery.
The Case Manager will also review the operative consent form
as well as other necessary consent forms that are required
prior to surgery. They will also discuss your options for
discharge and help make arrangements for when you leave the
hospital.
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Patients need to contact Joint Implant Surgeons office the Friday prior to their surgery to obtain their hospital arrival time.
In preparing
for their hospital stay patients should not bring any valuables
to the hospital. A gown and slippers will be provided, however
patients may want to bring a bathrobe. If a patient already
has assistive equipment such as a walker or crutches the staff
will inform them when they should be brought to the hospital.
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The
Day Before Surgery
- Patients
may bathe or shower the night before or early on the day
of surgery.
- No
smoking or drinking alcohol the day before or the day of
surgery.
- Starting
at midnight the night before surgery PATIENTS ARE NOT TO
EAT OR DRINK ANYTHING (NPO nothing by mouth) no, water,
food, liquid, tobacco, cigarettes, gum, mints or hard candy.
Patients may brush their teeth, but are NOT PERMITTED to
swallow any water or toothpaste.
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Going
to the Hospital and Pre-Op Holding
- Your surgery will be performed at
Mount Carmel New Albany
Surgical Hospital, St. Ann's or University Hospitals East. Prior to their
arrival patients will be informed where to register.
- Once
a patient has registered and changed clothes they will be
taken to a holding area until its time for their surgery.
While in the holding area patients will meet with the Anesthesiologist
who will explain the type of anesthesia they'll be receiving
and answer any questions.
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Surgery
and Recovery
- In
the operating room patients will be greeted by a nurse who will verify the patient's name and type of surgery. The operating
room is a sterile environment so staff will be in surgical
gowns and masks. The surgeon and his assistants will also
be wearing a special surgical gown that covers their whole
body, this is to protect the patient from infection.
- Following
surgery, patients are taken to a recovery area where they
are closely watched and their vital signs monitored. The
type of surgery and anesthesia and how a patient responds
to them determines how long a patient will remain in recovery.
Family members are not permitted in the recovery area.
- While
the patient is in recovery their surgeon will speak with
a family member and inform them of the results of the surgery.
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After
Surgery
- Once
a patient has been released from the recovery area, the patient
will be taken to their hospital room.
- Once
a patient is settled and the nurse has completed their check
of the patient's vital signs and level of pain, visitors are
permitted.
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Family
& Friends
- While
a loved one is in surgery it can be stressful for family
or friends. Our staff will keep them informed of any information
regarding the status of a loved one. Family will be informed
of approximately how long it will be before they hear from
the surgeon, but there are instances when things may take
longer than anticipated, this does not indicate there is
anything wrong. There are many things that may delay the
beginning of surgery.
- Family
and friends are an important part of recovery. The support
and encouragement of loved ones can speed a patients progress.
However, quiet and rest are necessary to assist in recovery
so moderation of visitors is important.
- No
more than two visitors per patient and no more than 10 minutes
per visit are requested.
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- Beginning
the day after surgery patients will begin physical therapy
and the rehabilitation process.
- A physical
therapist will instruct patients on exercises and techniques
for strengthening and increasing range of motion and function.
- It
is important to include a family member or friend in the
rehabilitation process for encouragement and support.
To
learn more about after knee surgery precautions, managing
swelling and exercises, click
here.
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