- Need a new hip? Someday you may grow your own.
- 'Fix-me itis' fueling boom in joint surgeries
- Risk Assessment Tool for Osteoarthritis
- Wall Street Journal: Pushing Limits of New Knees
- New York Times: Getting a New Knee or Hip? Do It Right the First Time
- Dr. Bal in the News...
TestimonialsDr. Bal's Patients Tell Their Stories
"I am very satisfied with the outcome of my surgery and the improved quality of life I am now enjoying..."
Shamsy Kazemi-Bardool, Iran
"I am looking forward to being able to boat and golf this summer, without having to endure the pain and limitations of prior years..."
Greg Voreis, Mo.
"Just 9 ½ weeks following my surgery knee replacements, I traveled to Hawaii and went scuba diving..."
David Booker, Mo.
"Dr. Bal did great a job explaining the procedure through conversation and with his hip surgery book. He changed my life..."
Dennis Disselhoff, Mo.
"It is so important to have a physician who you trust, and who will listen to you. That's critical. I have never seen a doctor who cares so much for each and every patient..."
Faye Bleigh, Mo.
"I am glad to have come to Dr. Bal; his office staff was great to work with; the hospital experience was very good, and the outcome of surgery was all I had hoped for..."
Craig Jacobson, Ne.
"I feel so free now. Last weekend I rode my bike to Cooper's Landing and enjoyed a great meal as I watched the Missouri River roll by and listened to the bluegrass music..."
Marilyn McCreary, Mo.
"The staff at Capitol Region were very gracious, attentive and thorough. I would go back there anytime. They made sure I was comfortable..."
Bob Smith, Mo.
"It has been a real pleasure to meet and get to know Dr. Bal. He is caring, thorough in his explanations, and a great friend...."
Richard Wallace, Mo.
10. Life with an Artificial Knee
Information for Knee Patients
1. Anatomy of the Knee
2. Arthritis of the Knee
3. Treatment Options
4. Surgery Options
5. Knee Replacement Surgery Basics
6. Artificial Knee Components
7. Preparing for Knee Replacement Surgery
8. Recovery from Knee Replacement Surgery
9. Managing Pain or Discomfort
10. Life with an Artificial Knee
Exercise Guide for Knee Patients
(click to download PDF)
How do I know if I have a metal allergy to the knee part?
Orthopaedic implants are made of alloys of cobalt-chrome and titanium that have been implanted in millions of patients over the past three decades. Allergies to solid metal alloys are sometimes speculated, but are rarely seen in practice. Most instances of a painful knee after replacement have to do with a problem related to the surgery, or possibly an infection. A true metal allergy is extremely rare, and seldom encountered in clinical medicine.
What will weather changes feel like in the knee?
Some patients report increased pain and stiffness, or can feel changes in the weather after knee surgery, especially with an artificial joint. These sensations are not common though, and usually will disappear over one to two years after surgery. For the first couple of years, the bone adapts and grows around the metal prosthesis, and this bone activity probably leads to increased sensitivity to weather and pressure changes that some patients can feel in their joints.
What do I need to know about future dental work and other surgery?
Because you have an artificial knee joint in place, you must take care to protect it from infection. The same applies to any artificial implant in your body. Before having dental work (teeth cleaning, fillings, extraction or root canals) or certain medical procedures (colonoscopy, biopsy, endoscopies, etc.), you must take an antibiotic.
The antibiotic will help prevent bacteria from getting into the blood stream and thus into your knee. The odds of this happening are very rare, but the antibiotic can reduce this already small risk.
For routine dental prophylaxis following knee replacement surgery, antibiotics are required for only two years after the surgery. Patients with depressed immune function, cancer, diabetes with uncontrolled blood sugars, and the very elderly may need to take antibiotic prophylaxis forever before routine dental cleaning and other invasive procedures.
What antibiotics are used to protect the prosthetic knee joint if I have dental work?
Cephalexin and amoxicillin are antibiotics commonly prescribed before and after dental work. You may take azithromycin or clindamycin if you are allergic to amoxicillin. You also may take any antibiotic recommended by the American Heart Association.
What other situations will I need antibiotics for, after the knee replacement?
Antibiotics given for other medical procedures may vary. Contact us for advice if there is any doubt. Keep in mind that it will be necessary for you to be treated with a full course of antibiotics if you develop an infection such as an abscessed tooth, pneumonia, bronchitis, and skin or urinary infections.
If you cut your foot, or have broken skin on the leg, or infection in a toenail after a knee replacement, seek medical attention immediately. Ignoring a festering sore means that there is a risk the bacteria could migrate to the knee implant, resulting in a serious deep infection, even though it happens rarely.
Will the knee set off a metal detector at the airport?
Most likely, it will. Tell airport personnel that you have an artificial joint prior to entering the metal detector. Metal detection sensitivity at airports is highly variable, and it is impossible to say if a certain detector will set off the equipment. We will supply you with an implant identification card that you can carry to prove that you have metal knee replacement parts.
Can I have a MRI scan after knee replacement?
Yes. MRI scans of other parts of your body are safe after knee replacement. Although some old MRI scanning equipment may not be compatible with your prosthesis, the majority of MRI scanning equipment today is safe and compatible with knee replacement parts. You may also have a CT scan of any part of your body after a knee replacement.
How will I know if my knee implants happen to be recalled?
In the extremely unlikely event of a recalled implant, you will be contacted by the company who made the device. All implants have lot numbers registered with the implant maker. This information is kept in your medical record. If you want a copy of your X-ray or exact implant type and model for your records, please let us know.
Rest assured that of the millions of artificial joints implanted each year, the incidence of recall is exceedingly rare. Implant companies monitor the performance of their products very carefully.
Is there a long-term risk of failure of knee implants?
No, the implants are engineered to withstand your body weight and activity level, but the moving parts of a knee replacement do wear over a period of several decades. A properly aligned knee replacement done by a competent, experienced surgeon will usually last the lifetime of most patients.
Subtle component malpositioning and suboptimal orientation can however compromise the lifespan of the implant. This is why the skill and expertise with which the knee is implanted in your body is a critical determinant of how long the knee will last and how well it will perform.
How many times can you replace a total knee?
With modern technology, cases that were considered hopeless a few years ago can undergo successful knee replacement surgery. Such complex knee replacements are done every week in our specialty practice, and are referred from all over. So, there is no hard and fast rule as to how many times a knee can be replaced. Knees that have had multiple operations may be missing structural bone support, muscle cover, and quadriceps support.
While we hope that you never need such complicated knee operations, it is possible to get patients mobile again in situations that would have resulted in an amputation in the past. This reflects advances in surgery techniques and related technology.
What if I receive conflicting advice and opinions from other people taking care of me in the hospital or during home health visits?
Please use this book as your reference. As your surgeon, I provide you with information, such as what is contained in this publication, specifically for the operation you will receive in my care. If there is any question at any time, please feel free to e-mail me or contact any member of my staff.
What if I have a question not covered here in this guide?
Please ask me or any member of our staff. We welcome your questions, learn from them, and may include them in this guide for the benefit of other patients like yourself.
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