Total Knee Replacement - Mountcarmelhealth
Total Knee ReplacementWhat to Expect and How to Prepare
WelcomeThank you for choosing Mount Carmel to meet your healthcare needs.Our team of specialized healthcare professionals are dedicated to providing you with thehighest quality care. This guide contains information to help you better understand thedifferent aspects of your care and will be a helpful resource throughout your surgery andrecovery.A large part of your recovery will be using your new joint by walking and doing theexercises that your surgeon orders. Because each patient responds differently, your careand exercise plan will be tailored to meet your needs. Please share your questions andconcerns with your healthcare team.Please review this book for information about: How to prepare for surgery What to expect during your hospital stay How to prepare for your recovery and discharge Activity and physical therapy after surgery2
Table of ContentsUnderstanding Your Surgery. 4Going Home.18The Knee Joint. 4Discharge Process.18Knee Replacement Surgery. 4Your Care at Home.18Partial or UnicompartmentalActivity Guidelines.20(“Uni”) Knee Replacement. 5What to Expect in the Future.20Anesthesia. 6Physical Therapy.21Preparing for Your Surgery. 7Bed Mobility.21Before Your Surgery. 7Standing Up and Sitting Down.23Planning for Care after Surgery. 9Using a Wheeled orPacking for Your Hospital Stay.10Standard Walker.24Getting Ready for Surgery.10Using Crutches.27Using a Toilet.30Your Surgery andHospital Stay.13Taking a Shower.31The Patient Care Team.13Exercise Program.33Getting In and Out of a Car.32Your Surgery Day.13Notes.36Plan of Care.14Continuous Passive Motion (CPM).16Managing Your Pain.16Positioning in Bed.173
Understanding Your SurgeryThe Knee JointKnee ReplacementSurgeryThe knee is the largest joint in the body. Thebones of the knee form a hinge joint. Thesebones include the lower end of the thighbone (femur), the upper end of the shin bone(tibia), and the kneecap (patella).Knee replacement surgery involves removingparts of the damaged knee and replacing themwith artificial parts called implants. Damageis the result of arthritis and/or injury. Thedecision to have a knee replacement is madewith your surgeon and is based on yourgeneral medical health and how much yourdaily life is affected by your knee:The rough surfaces of the ends of the femurand tibia are protected with shock- absorbingtissue called cartilage. In a healthy knee, thecartilage cushions the joint for movement andallows the femur and tibia to move smoothlyagainst each other without causing pain. Pain — affects your activities of dailyliving, your walking, or your sleepKNEEFront View Swelling — does not improve with rest ormedications Stiffness — unable to bend or straightenthe kneeThighboneThighbone(femur)(femur) No improvement with medications,therapy, or knee injectionsKneecapKneecap(patella)(patella) one(tibia)(tibia)4
The knee replacement consists of three parts(components):Partial orUnicompartmental(“Uni”) KneeReplacement Femoral component — metal piecethat caps the end of the femur and hasa groove, which allows the kneecap tomove up and down as the knee bends andstraightens.A unicompartmental knee replacement maybe an option when only one compartment ofthe knee needs to be replaced: Tibial component — flat piece of metalwith a plastic plate that covers the top ofthe tibia. Medial compartment — inner side. Lateral compartment — outer side. Patellar component — dome-shapedpiece of plastic that allows it to glidesmoothly over the new knee.Certain other factors need to be considered,and your surgeon will discuss these with tPatellarcomponentTibialcomponent5
AnesthesiaSurgical ConsentAs with any major surgery, there are riskswith knee replacement surgery. You willbe asked to sign a surgical consent formbefore your surgery. This form gives consentto the surgeon to perform your surgery.Before signing the consent form, make sureto ask any questions you may have so thatyou understand your surgery and its risksand benefits. It is important that you fullyunderstand the information and are an activepartner in your care.Anesthesia is medication that is used tocontrol pain and make you comfortableduring surgery. An anesthesiologist is adoctor specially trained to give anesthesiaand monitor you during the procedure. Youranesthesiologist will meet with you beforesurgery to discuss your anesthesia options.The type of anesthesia you receive will dependon the kind of surgery you are having andother factors, including your medical history.There are various types of anesthesia that maybe used alone or together. They include:General AnesthesiaGeneral anesthesia is medicine that putspatients in a sleep-like state so they donot feel pain or remember the surgery. Abreathing tube may be placed to supportyour breathing during general anesthesia.During the surgery, your heart rate, bloodpressure, breathing and other vital signs willbe carefully monitored.Regional AnesthesiaRegional anesthesia involves the use ofanesthetics and/or pain medication to blockthe feeling in a certain region of the body,such as the lower body (called a spinal block)or just a single leg. Intravenous (IV) sedationmay be given with regional anesthesia.Advantages of regional anesthesia include: It provides a high level of anesthesia to aregion while having little effect on otherareas such as the heart, lungs, and brain. It may decrease the amount of painmedication needed after surgery.6
Preparing For Your SurgeryIf you are taking blood-thinning medicationsfor any reason — such as heart stents, atrialfibrillation, or previous blood clots — contactthe doctor who prescribes them. You willneed to discuss your upcoming surgery andwhether the medication can be stopped beforesurgery.Before Your SurgeryPre-admission TestingAll patients are required to have preadmission testing before surgery. This isto assess your body’s ability to tolerate thesurgical procedure. It will include a reviewof your medical history, a physical exam,and blood tests. Please arrange to have thistesting at the hospital pre-admission testingdepartment or with your primary care doctor.Please check with your surgeon about theirpreference for pre-admission testing.If you have any questions about which of yourmedications to take before surgery, contactthe doctor who prescribes them.Advance DirectivesMount Carmel supports and complies withour patients’ advance directives for medicalcare. In order to comply with your wishes,we will ask you about a Living Will or HealthCare Power of Attorney. If you have one orboth of these documents, please bring a copyto the hospital. If you do not have an advancedirective and would like information aboutwriting one, talk with your nurse.Testing must be completed two to four weeksprior to surgery (two weeks prior to surgeryis preferred). This allows time for follow uptesting to be completed as needed, such asa chest X-ray, EKG, or other testing. Testscannot be used if they are completed morethat 30 days prior to surgery and would needto be redone.MedicationYour pre-admission testing appointmentis the time to discuss the medications youare taking for your medical conditions (forexample: diabetes, high blood pressure,acid reflux, chronic pain, asthma or otherbreathing problems). Bring a list of all of yourmedications, including prescription, over-thecounter, herbal products, and supplements.You may be instructed to temporarily stoptaking certain medications because theycould complicate surgery or interfere withother medications you might need. This mayinclude non-steroidal anti-inflammatorydrugs (NSAIDs) such as aspirin or ibuprofen.7
Flu and PneumoniaVaccinationsSmokingIf you are a smoker or tobacco user, it isimportant to quit at least a few weeks beforesurgery. Smoking greatly increases yourrisk of having complications after surgeryincluding respiratory issues, pneumonia,delayed wound healing, and infections.To keep you well and provide you withthe fastest recovery, we recommendthat you receive a flu and/or pneumonia(pneumococcal) vaccine before you have yoursurgery. You should receive the vaccine(s) atleast 2 weeks before your surgery. You cancontact your primary care doctor, pharmacy,or the local health department to get thevaccines. We will need to know the dates youreceived these vaccines.The support that professional counselingprovides makes it twice as likely you’llquit successfully. At Mount Carmel,our pharmacists are trained to help youquit smoking by providing one-on-onecounseling, planning, and approvedmedications as needed. We offer tobaccocessation counseling at locations acrosscentral Ohio, and most insurance plans coverup to four visits per year.Call your doctor if you have a fever, cold orflu symptoms, or any other changes to yourhealth during the week before your surgery.Dental CareTalk to your healthcare provider about areferral to the Mount Carmel SmokingCessation Program. To learn more, call614-234-8844.If you need dental work, make certain to haveit done well before your surgery. Bacteriafrom your gums can enter your blood streamand cause an infection. Do not schedule anydental work, including routine cleanings, forseveral weeks after your surgery.For more support, call the Ohio TobaccoQuit Line at 800-QUIT NOW, or visitsmokefree.gov.DietEat a well-balanced diet in the weeks beforesurgery. Be sure to include protein such asbeef, poultry, fish, legumes, and eggs.Skin CareAny cuts, open sores, or rashes need to betreated and healed before surgery. If you haveany of these skin problems, report them toyour surgeon.8
Planning for CareAfter SurgeryHome PreparationsThe best place for you to recover from surgeryis in your own home. Plan to have someonehelp you until you are safe with your dailyroutine. Make certain you have secure handrailsalong stairways and in the bathroom.Consider installing grab bars.There are times when other arrangementsneed to be made. If you live alone, yourcaregiver is unable to care for you, or you arehaving difficulty meeting physical therapygoals, your multidisciplinary health care teammay make other recommendations. It maybe necessary for you to have home healthcare or be discharged to a skilled nursing orrehabilitation facility. The case manager willwork with you in the selection of a facility.They will also work with your insurancecompany to determine eligibility. Make sure that you have good lighting andthat the light switch is within easy reach.For your safety, you or your family should: Place a non-skid bath mat in your tub. Remove anything in your walking paththat may cause you to trip, such as throwrugs, cords, and furniture. Have a telephone within easy reach. Use a cushion to raise the seat of a lowchair with arms. Run errands and grocery shop beforesurgery. Stock up on food that is easy to prepare,and store it at waist to shoulder level toavoid bending and reaching.Outpatient physical therapy is very beneficialto your recovery as it requires you tocomplete your daily hygiene, dress, get in andout of the car, and walk to the appointment.If you are homebound and unable to dooutpatient therapy, your physician may orderhome health services. Make sure your pets can be out of yourway when you return home.Durable MedicalEquipment (DME)Driving Check with your surgeon about specialequipment you may need after surgery,such as a walker, shower chair, elevatedtoilet seat, crutches, or a cane. Arrange to have someone drive youhome or to the skilled nursing facilityupon discharge from the hospital.Transportation costs will be yourresponsibility. Check with your insurance plan to findout which items will be covered. Someequipment may need your doctor’sauthorization, and not all equipment iscovered by insurance. A higher vehicle is easier to get into thanone that is low to the ground. Do not drive after surgery until you aregiven permission from your surgeon. Thismay be several weeks. Do not drive whileyou are taking narcotic medications. If you already have a walker or brace, planto bring this to the hospital with you. You will also need someone to drive you toand from your follow-up appointments.9
Packing for YourHospital StayGetting Readyfor SurgeryWhat to BringA Few Days Before Surgery A list of your medications and yourpreferred pharmacy informationYou will receive multiple phone calls inthe days leading up to your surgery. Thesecalls are critical in helping to prepare foryour surgery. A hospital staff member willcontact you to verify information, includinginstructions on which medications youshould take the morning of surgery. Your driver’s license and insurance card Copy of Living Will and/or Health CarePower of Attorney Credit card or money for insuranceco-payment Follow all instructions given by yourdoctor. Glasses, contacts, hearing aids, dentures,and cases Call your doctor right away if there are anychanges to your health before your surgery,including a cold or other infections. CPAP or BiPAP Walker or brace Pair of non-skid shoes that are not tight —you may have swelling.The Day Before SurgeryMany details are involved in determiningyour final surgery time. Depending onwhere your surgery will be performed, youwill be notified of your arrival and surgerytimes either at your pre-admission testingappointment or by phone. You may receivea call with additional information or timechanges up to the evening before yoursurgery. One set of clothes — loose-fitting shirt andpants or shorts. If you wish to wear a robe,bring one that opens along the entire frontand is no longer than calf length.What Not to BringPlease leave all valuables such as jewelry,keys, and electronic devices at home. Afterregistering for your surgery, plan to giveyour purse/wallet, checkbook, credit cards,cell phone, and any other valuables to yoursupport person to be responsible for theseitems. It is recommended that these items aretaken home.Do not smoke, eat, drink, chew gum, or eatmints or candy after midnight the nightbefore surgery until you are allowed to havefluids after surgery.Shower using a CHG solution the nightbefore surgery. Follow the directions on thenext page unless your surgeon gives you otherinstructions.Leave your medications at home unless youhave been instructed to bring them to thehospital.10
The Day of SurgeryThe Night Before andMorning of SurgeryBefore you come to the hospital:Your surgeon has directed that you use aChlorhexidine product such as Hibiclens ,Dyna-Hex , and others. Use half the bottlethe night before and the other half themorning of your surgery. Shower again using CHG solution. Followthe steps below. Remove all jewelry, including weddingbands and body piercings. You mayreplace body piercings with temporaryplastic posts before coming to the hospital.If you have rings that will not come off,please tell a staff member.Your doctor may instruct you to begin usingCHG wash earlier. Follow your doctor'sinstructions. Do not wear makeup, perfume, powders,lotions, or creams.Follow these steps as you shower: Shower or bathe as usual with soap andwater. Then wash off the soap completely.If you plan to wash your hair, use regularshampoo on your hair and rinse well. You may brush your teeth, but do notswallow the water. Wear glasses instead of contacts or bringa container to remove your contact lensesbefore surgery. Thoroughly rinse your entire body withwarm water from the neck down. Turnoff the water or step out from under theshower stream to avoid rinsing the CHGsoap off too soon. If you have been told to take certainmedications the morning of surgery, takethem with a small sip of water. Do not smoke or use tobacco productsbefore your surgery. Apply the CHG product directly to yourskin from the neck down and wash gently.Do not use above your neck, in your genitalarea, or on wounds that are deeper than ascratch. DO NOT touch your eyes, ears, ormouth while scrubbing.Preparing Your Skin withChlorhexidine Gluconate(CHG) Solution Pay special attention to washing the areaof your surgical procedure very well. Use aback and forth motion to gently scrub thearea.Infection is a risk with any surgery. Our careteam takes every measure to protect you andto prevent infection while you are in our care.You play an important part in this. Allow the product to soak on your skin for2 to 3 minutes.To help reduce the risk of infection, beforeyour surgery: Turn on the water or step back under theshower stream to rinse well. Do not useregular soap after applying and rinsing theproduct. Use a special soap to clean your body.The soap contains an antiseptic calledchlorhexidine gluconate (CHG). Cleaningyour body with CHG soap before surgeryhelps prevent infection. Pat your skin dry with a clean soft towel. Do not shave the surgical area. Put clean sheets on the bed you will besleeping in the night before surgery.11
It is a good idea to read the label for fullproduct information and precautions. Donot use this product if you are allergic to it. Ifyour skin becomes red or irritated, stop usingthe solution and contact your surgeon forfurther instructions. Do not use any makeup, perfume,deodorant, powder, lotion or cream afteryou have showered. Put on clean nightwear or clothes.*Repeat these steps the morning of yoursurgery.12
Your Surgery and Hospital StayThe Patient Care TeamYour Surgery DayYou are the most important member of thehealthcare team. Your health and wellbeingis our highest priority. In our efforts to makeyour hospital stay as comfortable as possible,you will be asked your preferences duringyour time with us. Please let the healthcareteam know if you have any questions orconcerns.RegistrationWhen you arrive at the hospital, go to PatientRegistration. You will need to have yourdriver’s license and insurance cards. You willreceive a “find code” to ensure your privacyand confidentiality. This is a four-digitnumber that only you can give out to familyor friends. It is important for you to knowthat anyone calling or asking how you aredoing cannot be told any information unlesshe or she has this find code.There are many other members of thehealthcare team who will be working withyou. They will provide care, evaluate yourprogress, and communicate with each otherand with you and your family.Pre-opYour surgeon, anesthesia provider, andprimary care physician or hospitalist willmanage your medical care. Your healthcareteam will also include a team of speciallytrained nurses, patient care technicians,physical therapists, and occupationaltherapists to care for you as you recover fromsurgery.Once your paperwork is completed, you willbe directed to the pre-operative area. You willchange into a hospital gown. A nurse will startan IV line and take your blood pressure andtemperature.The anesthesiologist will meet with youand review your health history. He or shewill discuss the types of anesthesia that canbe used. Once a decision is made, you willbe asked to sign a surgery and anesthesiaconsent form. Please ask your surgeon oranesthesiologist any questions you havebefore your surgery.A number of other clinicians will work withyou to meet your healthcare needs. Thesemay include respiratory therapists, dietitians,social workers, discharge planners, and nursecase managers.SurgeryYour surgeon will tell you how long itshould take to complete the surgery.Family members should not be alarmed ifyour surgery takes longer. Surgery timesare sometimes delayed or changed due toemergencies or cancellations. Every attemptwill be made to notify your family if yoursurgery is delayed.13
Your family should wait in the surgerywaiting room so they can receive updatesthroughout your surgery and recovery.The surgeon will talk with your family aftersurgery.process. Early activity after surgery alsohelps prevent many surgical complications,including: Infections PneumoniaPost-Anesthesia Care Blood clotsAfter surgery, you will go to the recoveryroom, also called the post-anesthesia careunit (PACU). This is where you will wakefrom anesthesia. You may have a dry mouth,nausea, itching, chills, or feel confused. Tellyour nurse if you experience any of thesesymptoms. Also tell your nurse if you awakenwith pain. Urinary tract infections Urinary retentionThe therapist will work with you before youare discharged from the hospital. You willlearn how to properly use a walker, how to getin and out of bed, how to use stairs safely, andmobility and strengthening exercises.You may be given medication for pain andnausea. An X-ray may be taken of your newjoint. Most patients stay in the recovery roomfor 1 to 2 hours, although some patientsrequire a longer stay.Call, Don’t FallAlways call for help before getting out of bed.A staff member should always help you whileyou are in the hospital. Preventing a fall is akey part of your safety and recovery.Nursing UnitHand HygieneOnce you have recovered from anesthesia,you will begin your therapy and makeprogress toward your discharge.Plan of CarePreventing infection is important aftersurgery. One of the best ways to preventinfection is by washing your hands often —after using the bathroom, before meals, andbefore and after you touch your incision orchange your dressing. Follow these five stepsevery time:Members of the care team will be checking onyou around the clock to ensure your safety asyou recover and progress.Wet your hands with clean, running water(warm or cold), turn off the tap, and applysoap.ActivityLather your hands by rubbing them togetherwith the soap. Lather the backs of your hands,between your fingers, and under your nails.Please make sure to let us know what we cando to make your stay more comfortable.Your first step in getting active again will besitting on the side of the bed, followed bystanding and walking. With the help of thetherapist or another staff member, you willstart to increase your activity. Moving afterknee surgery is one of the most importantthings that you can do to speed your recoveryScrub your hands for at least 20 seconds.Rinse your hands well under clean, runningwater.Dry your hands using a clean towel or letthem air dry.14
Soap and water are best, but an alcohol-basedhand sanitizer that contains at least 60%alcohol can be used as long as your hands arenot visibly soiled. Ask all visitors to wash theirhands when they enter and leaveyour room. Don’t be afraid to remind thestaff about hand hygiene.DietYou may begin with ice chips. If you are ableto tolerate these without nausea, you willprogress to clear liquids such as broth, gelatin,Popsicles, and clear soda. Once your nursefeels your stomach is able to handle solids,you will be able to start your normal diet.MedicationsBreathing ExercisesYou will resume your regular medicationsonce you are able to take them. Your doctormay also order other medications such asantibiotics, stool softeners, blood-thinners,pain medication or medicine for nausea. Askyour nurse for more information.You will be taught coughing and deepbreathing exercises to help keep your lungsclear and prevent pneumonia. You will alsobe instructed on how to use an incentivespirometer: Just after you exhale normally, put yourlips tightly around the mouthpiece.Treatments Breathe in as deeply as you can. The meterwill rise.You will wear compression hose and mayhave compression pumps, also calledsequential compression devices (SCDs),throughout your stay. The compressionpumps are worn while you are in bed.Both help prevent blood clots fromforming in the legs. You may have a Foley catheter in yourbladder to drain urine when you wakeup from surgery. This will be removed assoon as possible. You may have a dressing (bandage) overyour incision. The nursing staff will carefor your incision, change your dressing,and teach you how to do this at home. You will have ice packs to help relieveswelling and pain. When you feel that you’ve taken a fullbreath, keep trying to breathe in more andmore for about 2 seconds. Repeat this deep breath action 10 to 15times each hour while you are awake.You can see how much air you have taken inby reading the number on the meter. Yourbreathing technique will improve as youare more awake, have less pain, and movearound more. If you have trouble using thespirometer on your own, please ask yournurse or respiratory therapist for help.Circulation ExercisesExercise improves blood flow (circulation)and reduces the risk of blood clots. Exercisingwill also help you gain strength and mobility,and decrease your recovery time. Aftersurgery, you will be instructed to do anklepumps, quadriceps sets, and gluteal sets. Doeach exercise 10 times every hour when youare awake. See pages 33-34 for instructions.Be sure to ask the staff any questions you havethroughout your stay.15
best rates your pain. Many people hesitate toreport their pain and to take pain medication.It is most helpful to take pain medicationbefore the pain becomes severe. If you waittoo long to take pain medication, it becomesharder to get relief.ContinuousPassive MotionYour surgeon may order that your knee beplaced in a continuous passive motion (CPM)machine. The benefits of CPM are the sameas those of gentle exercise: decreased pain,decreased stiffness, and improved circulation.Your doctor and anesthesiologist will ordermedication to help manage your pain. Thismay include oral pain medication (pills) orintravenous (IV) pain medications. Yournurse will explain what medications areavailable to you and discuss other pain reliefoptions.The CPM will slowly bend and straightenyour hip and knee. You will start with a smallamount of flexion (bend) in your knee. Theamount of flexion will be increased slightlyeach day.Your pain medication may cause side effectssuch as nausea, itching, confusion, andconstipation. Ask your nurse any questionsyou may have about side effects.Your doctor will determine if the CPM isright for you.Managing Your PainTalk to your healthcare team about otherways to relieve pain. Rest is not alwaysthe best solution, especially after surgery.Changing your position in bed and gettingout of bed can make you more comfortable.Taking your mind off the pain by listening tomusic, watching TV, reading, or visiting withfamily and friends can also be helpful.After surgery, some pain is to be expectedwhile your knee is healing. You and yourhealthcare team will work together to manageyour pain for a smoother recovery. Althoughwe want your pain controlled, we do not wantyou too groggy or sedated so you are able todo your therapy.As you heal, your need for pain medicationshould decrease. Talk with your doctor if youhave any questions or concerns about yourpain management at any time during yourrecovery.You will be asked to rate your pain. This willhelp us know how your medication and othercomfort measures are helping. You can usea number or choose a face on this scale that0No Pain1234516678910Worst Pain
Positioning in BedAn important part of knee replacementrecovery is maintaining knee extension. Fullknee extension, which is straightening theknee and leg, is needed to have a normalwalking pattern.You may place a towel or blanket roll underyour ankle to promote extension.To ensure knee extension, when you are inbed:If your leg tends to roll outward when youare lying down, you may place a blanket rollalong the side of your leg to keep your toespointed straight up.Do not place anything under your knee.17
Going HomeDischarge ProcessYour Care at HomeKnee surgery typically requires a shorthospital stay. You may be discharged thesame day as your surgery. You will continueto heal and recover at home.You will be given written dischargeinstructions and prescriptions for anymedications needed after discharge. Thenursing staff will review these with youand your family member. If there is anyinformation that you do not understand,please ask the staff before you leave.Your surgeon and your general medicaldoctor will release you when you have metrequired medical and therapy goals. Theseinclude:Incision Care Your oxygen level is adequate.Your incision may be closed with sutures,staples, or surgical glue. If you have sutures orstaples, arrangements will be made to removethem in the doctor’s office or by a homehealth nurse. You are able to urinate on your own. Your pain level is tolerable on oralmedications. You are able to meet your therapy goals.If you have Steri-Strips in place, allow them tofall off on their own. Do not pull them off.Please keep in mind that the dischargeprocess may take time. Make sure to discussyour discharge goals with your health careteam. Your c
Knee Replacement Surgery Knee replacement surgery involves removing parts of the damaged knee and replacing them with artificial parts called implants. Damage is the result of arthritis and/or injury. The decision to have a knee replacement is made with your surgeon and is based on your general medical health and how much your
Partial Knee Partial knee replacement surgery replaces or resurfaces one area of the knee joint. This surgery can prevent or delay the need for total knee replacement. The implant used for partial knee replacement has a plastic bearing that lasts a long time with normal activity. Partial knee replacement surgery means: A smaller incision or .
Total Knee Replacement 9 Total Knee Replacement Overview What is a total knee replacement? It is a surgery to replace damaged parts of the knee joint with artificial implants. It is done by opening the knee capsule and taking out the ends of the: Thigh bone (femur) Shin bone (tibia) Underside of the kneecap (patella)
the knee. 7 TOTAL KNEE REPLACEMENT www.tbrhsc.net Patient Information: Total Knee Replacement What is a Total Knee Replacement (TKR)? Strong ligaments and tissues, both inside and outside the joint, support the knee. The thigh bone (femur) has a rounded end that fits onto the shin bone (tibia). Both ends of these bones
Total Knee Replacement Surgery Patient Guide 4 Needing Total Knee Replacement Surgery Welcome to North York General Hospital (NYGH). Our goal is to prepare you for a successful outcome from your knee replacement surgery. Total knee replacement will improve your quality of life, independence and overall health.
Why ob iterate 100% of your knee when on y about 25% is arthritic? ChronIc knee pain? A total knee replacement OOIiterates 100% 01 the cartilage and up to 50% of the ligaments in the knee.But why undefgo a total knee replacement only 25% of your knee is arthritiC?That's the logic behind a partial knee f'EiPacemenl performed by [)", Kefina at Tri-County
A unicompartmental knee replacement is an alternative to a total knee replacement when only one compartment of the knee needs replaced. The knee joint can be divided into three separate compartments: the medial (inner) compartment, the lateral (outer) compartment, and the patellofemoral (knee-cap) compartment.
A total knee replacement is the most common surgical treatment for advanced osteoarthritis of the knee. Dr. Gallivan will determine whether partial knee replacement is right for you. Partial knee replacement involves the resurfacing of only a portion of the knee and is reserved
Implication zootechnique du menthol cristallisé comme additif. alimentaire chez le poulet de chair. E. AZEROUAL. 1, M. OUKESSOU. 2, K. BOUZOUBAA. 2, A. MESFIOUI. 1, B. BENAZZOUZ & A. OUICHOU (Reçu le 15/04/2012; Accepté le 18/06/2012) Résumé. Le menthol est utilisé pour ses vertus aromatiques, culinaires, cosmétiques et médicinales. Chez l’homme, il est employé contre les . troubles .
