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Joint Surgery
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The knee is a complex joint, which is made up of the distal end of the femur (the femoral condyles), and the proximal end of the tibia (the tibial plateau). The femoral condyles usually glide smoothly on the tibial plateau, allowing for smooth, painless motion of the lower leg.

Indications

Indications

The most common cause of knee damage requiring knee replacement is osteoarthritis, which is a degenerative disease of the bones of the knee which cause the surfaces of the knee joint to become irregular and rough, preventing smooth painless motion of the knee joint.

Knee joint replacement may be recommended for:

* knee osteoarthritis or arthritis, which causes knee pain that has failed to respond to conservative therapy (NSAID medication for 6 months or more)

* decreased knee function caused by arthritis

* inability to work because of knee pain

* inability to sleep through the night because of knee pain

* inability to walk more than 3 blocks because of knee pain

* loose knee prosthesis

* some knee fractures

Procedure

Procedure

The operation is performed under general anesthesia. The orthopedic surgeon makes an incision over the affected knee. The patella (knee cap) is removed, and the heads of the femur and tibia are shaved to eliminate any rough parts and to permit a better adhesion of the prosthesis. The two parts of the prosthesis are implanted into the thigh bone and the tibia bone using a special bone cement.

Aftercare

Aftercare

You will return from surgery with a large dressing to the knee area. A small drainage tube will be placed during surgery to help drain excess fluids from the joint area. Your leg will be placed in a continuous passive motion (CPM) device (a mechanical device that flexes (bends) and extends (straightens) the knee at a pre-set rate and amount of flexion). Gradually, the rate and amount of flexion will be increased as tolerated. The leg should always be in this device when in bed. The CPM device helps speed recovery, decreases post-operative pain, bleeding and infection. You will experience moderate pain after surgery. However, you may receive patient-controlled analgesia (PCA), or epidural analgesics to control your pain for the first 3 days after surgery. The pain should gradually decrease, and by the third day after surgery, oral analgesic medications may be sufficient to control your pain. Try to schedule your pain medications about one half hour before walking or position changes. You will also return from surgery with several IV lines in place to provide hydration and nutrition. The IV will remain in place until you are taking adequate amounts of oral fluids. Prophylactic (preventive) antibiotics may be given to reduce the risk of developing an infection, necessitating removal of the artificial joint. You will also return from surgery wearing anti-embolism stockings or an inflatable pneumatic compression stockings. These devices are used to reduce your risk of developing blood clots, which are more common after lower extremity surgery. Additionally, you will be encouraged to start moving and walking early after surgery. You will be assisted out of bed to a chair on the first day after surgery. When in bed, bend and straighten your ankles frequently to prevent development of blood clots.

For more information on knee surgery click here

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    • I figured I would update those who were wondering.  I have gotten the appt. so far moved up to August 30. I am waiting to have gene testing done via swab for all 3 of my kiddos tomorrow. My daughters celiac antibodies came up negative but her IgA is low which the ped said could cause false negative antibodies for celiac so she will need to see a GI dr. also. The pediatrician is going to call the GI to try to get them in sooner. I am keeping them all on a gluten diet until the GI dr. decides what to do. I am on the cancellation list already for my son, however I am not going to be persistent with my phone calls to them until I have the results of the gene test. I really want that result in my hand before going to the GI dr if I can. Maybe if he is positive, along with his bloodwork and my history they can forgo the endoscopy. But he will eat gluten till then.  My husband and I have been very honest and upfront with him as to what is going on and the possibility of the endoscopy and what that entails and although scared in general he seems ok after assuring him that since I have it he has me to help him every step of the way.  Going through his current diet with him I realized that he is truly on such a low gluten diet that I am actually surprised his bloodwork shows antibodies at all!  So I told him to make a list of allllll the gluten he could possibly think of eating and he needs to pound it until the GI visit or endoscopy. Funny thing is everything he keeps thinking of to want to eat...is already gluten free!  The other night we were at a friends and he asked if he could be done with his hotdog. I made him finish just the bread 😂 Thanks for your help and advise and I will keep y'all posted on both kids!  My oldest is a ok as far as all his antibodies. Just actually had a follow up for other immune issues and all his levels are now normal!
    • I like your plan Cara, I may have to include it in my sons.    Poor little guy is still very very sick. I think he is resisting and cheating, despite having the support of two other siblings and a 100% gluten-free home. 
    • Despite it being a nightmare, I did wait for my kids to get biopsies. At one point I had one severely ill child gluten-free and two more waiting having to eat it. It was worth the wait though and I think long term a biopsy may be worthwhile, especially for school. I have already had issues with schools and camps so having a firm diagnosis has been helpful. 
    • Knowing that the reaction to gluten in celiacs is an uncalled for immune system reaction, I was thinking of how a cure would be possible. Maybe a medicine that somehow turns off the immune system. The only thing that i've heard do that... HIV.  obviously that's way worse than celiac. Just some food for thought.
    • Well, you can probably get an apple or something.  You might be able to get someone to boil you some eggs.  But be careful of things like nuts that should be naturally gluten free.  They have almost always been soaked in a flavor solution that usually containes caramel coloring, "soy" (wheat) sauce and other aditives.  If I am really hungry and must eat in a Chinese restaurant, I order plain white rice and steamed vegetables.  But even so, you must monitor it carefully.  The rice sometimes has other substances added to give it a better texture, and very often the vegetables have in fact had "just a little bit" of soy sauce added.  To be fair, celiac disease is hardly ever found in East Asians, so understandably people are not tuned it to it.  Also, culturally, with the exception of fruits, it is generally thought that the flavor of foods needs to be enhanced, so it is had to find anything natural even in the "western" gorceries. Even in the western restaurants, be careful.  Fish and meat and often vegetables are usually pre-marinated. I will not even attempt to address the issue of cross-comtamination, since that is a whole higher order of things. I do know what I am talking about; I have celiac and have worked here for nearly 7 years.  
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