I have fluid on my knee, which swells up very badly.
It affects everything I do, from walking to any physical activity that I undertake.
I find it very hard to sleep because of the pain in my knee.
My doctor took four syringes of fluid out of my knee the other day. He advised me about having a steroid injection in my knee, but could not guarantee it would help.
The next option is having a knee replacement operation.
Could you please give me some information?
It is important to realize that a knee 'replacement' is actually just a resurfacing of the knee joint.
The femur or thigh bone is covered with a metal covering and plastic is placed on the tibia so that instead of irregular arthritic surfaces, one has metal and plastic articulating which produces a smooth non-patent surface.
Knee replacements have been done since the early 1970s and current designs appear to have 85 to 90 per cent survival at 20 years.
The actual procedure of knee replacement involves either general or epidural aneesthesia with a four to six day hospitalization. The surgery itself takes between one and a half and two and a half hours.
In most cases patients donate two units of autologous blood to be used in the postoperative period.
Weight-bearing begins immediately the first postoperative day. Patients usually use a walker for a period of one to two weeks, going to crutches and then a cane.
Patients are off all walking aids anywhere from three weeks to two months.
Success rates in knee replacements are approximately 90 per cent, with 10 per cent not doing as well. This can be due to either stiffness or ache or swelling in and about the knee.
The most significant complications, aside from general medical complications (heart and lung) involve infection of the prosthesis.
If this occurs, in some cases the prosthesis can be saved and the patient taken back to the operating room, the knee irrigated with antibiotic irrigation and then be on antibiotics.
In some cases if this does not respond, then the entire prosthesis must be taken out and antibodies given for six weeks and then another attempt at re-implantation of the prosthesis must occur.
In an extremely small percentage of cases, conceivably if the infection could not be controlled, then one is left a knee fusion in which the femur and tibia are fused in one bone.
Activities after knee replacement that should produce no difficulty are simple walking, cycling, golfing and swimming.
The prosthesis is not designed for impact loading sports such as skiing, basketball and racquetball. However, people have been known to play doubles tennis with bilateral knee replacements.
You really need to see an orthopaedic surgeon before you know whether your only options are injections or replacement.
It's not clear from your question whether or not you've had a proper diagnosis
The NetDoctor Medical Team
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