Our Summary

In simpler terms, this research paper is about treating patients who have had total knee replacement surgery but are struggling with non-healed wounds. These patients often have other health issues (comorbidities) which can complicate their treatment. The usual solution would be another invasive surgery to fix the wound, but this can delay rehabilitation and limit the movement of the joint.

Instead, the researchers used a less invasive treatment which included negative-pressure wound therapy - a medical procedure that helps to heal wounds by applying a vacuum dressing. This was combined with other treatments tailored to the patients’ individual conditions. While being treated, the patients were also able to start rehabilitation earlier.

The researchers found that this approach worked well. On average, it took about 65 days for the wounds to fully heal. The patients’ final treatment to close the wound involved skin grafting (transferring skin from one area of the body to another), dermatotraction (a method of stretching the skin), or a collagen dressing (a type of wound dressing that promotes healing).

After this treatment, four out of the five patients were able to move their joint over 100 degrees. The researchers concluded that this less invasive approach, combined with early rehabilitation, could be a better way to help patients recover after a total knee replacement, especially for those with additional health issues.

FAQs

  1. What is the recommended treatment approach for nonhealed open wounds after a total knee replacement arthroplasty?
  2. How does early rehabilitation affect the range of motion after a total knee replacement arthroplasty?
  3. What is the average duration of complete wound healing after total knee replacement arthroplasty?

Doctor’s Tip

A doctor might advise a patient undergoing knee replacement surgery to follow a comprehensive rehabilitation program postoperatively to promote faster healing and achieve a wider range of motion. This may include early mobilization, physical therapy, and possibly negative-pressure wound therapy for any wound complications. It is important to address any wound issues promptly and work closely with healthcare providers to optimize the healing process.

Suitable For

Patients who are typically recommended for knee replacement surgery are those with severe knee pain that limits daily activities, persistent knee swelling and inflammation, knee deformity, knee stiffness, and failure to respond to non-surgical treatments such as medication, physical therapy, and injections. Patients with advanced arthritis, injury, or other degenerative conditions of the knee joint may be candidates for knee replacement surgery. Additionally, patients with comorbidities such as diabetes, obesity, and cardiovascular disease may also be considered for knee replacement surgery if their conditions are well-managed and they are deemed suitable candidates for the procedure.

Timeline

Before knee replacement surgery:

  1. Patient experiences chronic knee pain, stiffness, and limited mobility.
  2. Patient consults with orthopedic surgeon and undergoes preoperative evaluations, including X-rays and blood tests.
  3. Patient receives counseling on the risks and benefits of knee replacement surgery.
  4. Patient undergoes knee replacement surgery, which involves removing damaged cartilage and bone and replacing it with prosthetic components.
  5. Patient is monitored closely in the hospital for any postoperative complications.

After knee replacement surgery:

  1. Patient begins physical therapy and rehabilitation to regain strength, flexibility, and range of motion in the knee.
  2. Patient may experience pain, swelling, and discomfort in the days and weeks following surgery.
  3. Patient is prescribed pain medication and instructed on how to care for the surgical incision.
  4. Patient gradually increases activity level and mobility with the guidance of healthcare providers.
  5. Patient attends follow-up appointments with the surgeon to monitor healing and progress.
  6. Patient may continue physical therapy for several weeks or months to optimize the function of the new knee joint.
  7. Patient gradually returns to normal activities and experiences improved quality of life with reduced knee pain and improved mobility.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with knee replacement surgery?
  2. What is the expected recovery time and rehabilitation process following knee replacement surgery?
  3. How will my pain be managed during the recovery process?
  4. What restrictions or limitations will I have post-surgery, and for how long?
  5. Will I need any assistive devices or physical therapy after surgery?
  6. How long do knee replacements typically last, and what can I do to ensure the longevity of the replacement?
  7. What are the signs of infection or other complications that I should watch for after surgery?
  8. Are there any specific lifestyle changes or modifications I should make following knee replacement surgery?
  9. Are there any alternative treatment options to consider before opting for knee replacement surgery?
  10. What is the success rate of knee replacement surgery in patients with similar health conditions or comorbidities as mine?

Reference

Authors: Baek SO, Shin J, Song JK, Lee JY. Journal: Int J Low Extrem Wounds. 2021 Dec;20(4):347-354. doi: 10.1177/1534734620919315. Epub 2020 May 7. PMID: 32380929