Knee Replacement at Nordorthopaedics clinic

knee replacement in Lithuania
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Who qualify for knee replacement?
About knee replacement surgery
Implant types
Preparation
Recovery
Possible complications
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Knee replacement price

3.810 € / 3.300 £ / 4.400 $ (knee replacement surgery & rehabilitation)

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from 2.300 € / from 2.100 £ / from 2.760 $ (knee implants )

Interview with a surgeon

Who should consider knee replacement surgery?

Knee replacement surgery (anthroplasty) is a common operation that helps thousands of people to walk freely again and to forget about knee pain.

Chronical illnesses like osteoarthritis and rheumatoid arthritis damage the joints, including the knee. Inside the joint there are so called articular cartilages. These structures are formed of flexible connective tissue and cover the joint forming bone ends. They assure smooth and painless movement.  If damaged these cartilages do not regenerate themselves.

In time, due to illness or trauma they are worn out and scarred so much that all types of conservative treatment (anti-inflammatory drugs, steroid injections, physiotheraphy and other alternatives) cannot help to reduce the pain and ease movements. Usually the joints are deformed and unstable at that time as well, greatly reducing the quality of life. In such cases replacement surgery of one or both knees especially for the elderly and moderately physically active patients is considered.

Knee replacement surgery is not recommended for people who have an acute infection of the joint, osteomielytis or sepsis, the operation can not be performed. Relative contraindications include conditions that alter anaesthesia or post operative healing (such as severe cardiovascular diseases) and obesity. The implants are harder than the bone they are implanted in, therefore they may damage or even deform the bones if they bearing a large weight.

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Knee replacement surgery technique

The surgery is done under general or spinal/epidural anaesthesia. It begins by a cut in the front of the impaired knee. It allows the surgeon to move the patella, ligaments and some muscles a little to the side to uncover the joint itself. Then the joint tissues are cut and affected parts are removed making room for artificial ones. The joint forming bone ends are modified and then the implant itself is securely inserted. The patella and muscles are moved back to their original place and all the cuts are sutured, dressings applied.

Sometimes, polymethylmethacrylate (PMMA) cement may be used during the operation to help the implant to bind to the bone.

Types of implants

Depending on the case, different implants can be used. They can be made with or without plastic, include changing the patella as well, or even only a certain part of the joint. Socalled unicompartmental (partial) knee arthroplasty is done when only a certain part of the joint is damaged.

Preparation for knee replacement surgery

Before the operation knee radiographies are necessary in order to make accurate measurements for the new implant. The knees are also examined to evaluate soft tissues and scars. While estimating the risk of the procedure other typical pre-surgery tests, like blood clotting and electrocyte measurements are done as well.

Medicaments, that effect blood clotting like aspirin are stopped for a few days before the operation to prevent post-operative bleeding. The patient is also asked not to smoke or drink alcoholic drinks before the operation as bad habits increase the risk of infection and interfere with the healing process.

If the patient's leg muscles are weak they might have to be strengthened by pre-operative rehabilitation. Later it helps the healing process and increases the success rate.

Recovery after knee replacement

After the operation are person has to spend a few days (up to a week) in the hospital. Standing and walking is possible and encouraged as soon as in a few hours after the operation.

The knee is inflamed due to natural healing processes and sensitive to pressure. To avoid damaging the tissues, a person should walk only using a stick or crutches. A few weeks are required for physical therapy for faster healing and learning to walk correctly with the new joint(s). Additional radiographies are done to check if the prosthetic is in place and track the osteosintegration process.

Most patients fully recover in 3 to 6 months after the operation. Some sports activities (such as any including jumping) may be restricted for a patient with an artificial knee joint. Bear in mind that the operation does not heal the illness that damaged the knee.

Possible complications

Knee replacement surgery has been performed for more than 30 years all over the world, with a reported success rate for relieving pain and improving joint function in 95% of cases.

Although the procedure is under constant state of improvement, some risk still remains. The most serious possible complications of the operation are an infection in the operated area and deep vein thrombosis. These two complications are the same as to any other operation. Nerve or muscle damage from knee replacement operations are very rare, and in 5 years only a few percent of these artificial joints fail.

Nowadays implants are created to last 20 years and more, and if worn or damaged usually can be replaced by new, more modern and better ones.

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