Unfortunately, as is the case with all surgery, there could be potential problems with a knee replacement. YOUR KNEE CONSISTS OF THREE COMPARTMENTS: General complications, specifically cardiovascular • Patello-femoral compartment: between the problems, are a small possibility. With the knee we are specifically concerned about the possibility of an infection. • Medial compartment: between the inner half Statistically the chances are remote; approximately 0.3%. of the upper and lower leg.
• Lateral compartment: between the outer half In an effort to reduce possible complications to a minimum we will arrange for a pathologist to do a few Only one of the three compartments (medial, lateral special investigations, specifically to rule out the small or patellofemoral) in your knee is worn. The other two possibility of a low grade infection in another part of the body. We may also arrange for you to be seen pre- operatively by the anaesthetist and if he feels it is With a uni-compartmental replacement, only the indicated, by a physician or cardiologist.
surface of the damaged compartment is replaced. This differs from a total knee replacement, where all three compartments are replaced.
MEDICATIONAnti-inflammatory drugs like Voltaren, Brufen, etc. ADVANTAGES AND DISADVANTAGES increase the incidence of post-operative bleeding and it is important that the use of this type of medication A uni-compartmental replacement can be compared should be stopped for at least 3 days before the with a total knee replacement as follows: operation. Platelet aggregation inhibitors such as Disprin, Plavix, etc should be stopped 10 days before the operation. If you use Warfarin you will need to stop taking it 4 days before the procedure and replace • Recovery slightly faster and easier.
it with heparin. Women on hormone therapy should • Functionally it gives a better result, especially stop the use of this for a week before and 2 weeks considering range of movement and the 'feeling' If you usually have a drink at night, please continue • Easy to convert to a total knee replacement.
doing so while in hospital; it will speed up your recovery. The hospital however does not supply liquor; • The non-replaced compartments of the knee can It is important to plan your homecoming. Remember deteriorate over time which might necessitate • Although a smaller procedure, a uni-compartmental crutches. You will be able to negoti- replacement is technically more difficult.
• The lifespan of a uni-replacement is slightly shorter than that of a total knee replacement. The life expectancy of a uni-replacement is approximately 10 - 15 years compared to the 15 - 20 years of a total replacement. It is however very easy to convert a uni-replacement to a total replacement.
some moral support during the first two weeks at home.
quite self-sufficient. You can shower on the 3rd day after the operation after a water-tight dressing is applied You will be admitted to the hospital at 14h00 the to the wound. The stitches do not need to be removed as afternoon before the operation. To reduce the possibil- they are beneath the skin and dissolve on their own.
ity of thrombosis, heparin injections are used the night before surgery. We usually continue with this therapy Bending the knee for the first few weeks after the for approximately 1 week after discharge.
operation is often quite difficult. It is therefore impor-tant to continue with your knee exercises at home as The operation is normally performed under a spinal the physiotherapist has shown you. Make a point of anaesthetic where an injection is given into the lower going for a short walk every day, preferably outside. spine causing you to lose all sensation in the lower You can start driving your car as soon as you feel you can extremities. This is usually combined with a very light do so safely; usually about 2 - 3 weeks after the operation.
anaesthetic to make you unaware of the activities in the theatre. The anaesthetist will also perform a femoral nerve block in theatre after we have finished the procedure. This will help to provide excellent pain We expect that you would walk well within 3 months. relief post-operatively, but will also mean that your It is however important to understand that healing is a thigh muscle will not function until the local anesthetic slow process and that there will be progressive wears out. It usually lasts 24-36 hours. This means improvement in the knee for up to a year after the that you will only start to walk on the second day after operation. We do not want you to jump, run or sit on your haunches. There are no restrictions on sports like bowls, golf and recreational doubles tennis. Walking, A uni-replacement takes approximately 1 hour.
swimming and cycling would also be fine. You can For the first 24 hours after the operation you will be expect to feel a 'click' in the knee at times. This is nursed in a high-care unit. You should feel comfort- normal and is caused by the metal on the one side moving on the plastic on the other side. You will probably also have decreased sensation on the scar over the knee. This is the result of cutting through the thin nerves in the skin when opening the knee. On the day of the operation you would be on an This numb area will gradually get smaller but s intravenous drip through which we infuse antibiotics ensation in that area may not totally return.
and pain medication. There will also be drainage tubes in the knee. We use medication to decrease the It is advisable not to undertake any long haul amount of bleeding, making the need for a blood (international) flights for the first 3 months after the transfusion highly unlikely. The intravenous drip and operation due to the risk of a thrombosis. Local flights the wound drains are usually removed on the 1st day are not a problem. The artificial joint will trigger the metal detectors at security check-points at the airport. It is advisable to wear loose-fitting clothes that allow The physiotherapist will visit you daily from the day of you to easily show your scars if you are requested to.
the operation. The rehabilitation exercises may seem simple and easy but it is of the utmost importance that Should you need any other surgery in the future, they should be done regularly and correctly to ensure especially dental, you should inform your doctor/ a quick and thorough recovery. You will start walking dentist that you have had a knee replacement and on the second day after the operation and every day that he/she should prescribe a prophylactic antibiotic.
you should note an improvement in your walking ability.
If you are not allergic to penicillin we suggest one of the following: Cefalexin (e.g. Keflex), Cefradine The hospital stay for a uni-replacement is approxi- (e.g. Cefril) or Amoxacillin (e.g. Amoxil). The dose is 2 grams one hour before the procedure. If you are allergic to penicillin we suggest: Clindamycin (e.g. Dalacin-C) 600mg orally one hour before the procedure.
You will receive a supply of medication to take home upon discharge from the hospital. This will include PLEASE NOTE: under NO circumstances should pain medication, antibiotics and drugs to decrease the anyone, except an orthopaedic surgeon, chances of a blood clot. For the first 4 weeks we insert a needle into your replaced knee, would prefer you to walk using two crutches. However, either for an injection or aspiration.
during this period you can take full weight on the operated leg. By the day of discharge you should be

Source: http://www.orthoclinic.co.za/files/uni-compartmental-knee-replacement.pdf

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