Our Summary

This research paper discusses knee replacement surgeries, which are commonly performed to treat severe arthritis in the knee. Over 100,000 of these surgeries are done every year in the UK. There are generally two types of these surgeries: total knee replacement (TKR) and partial knee replacement (PKR).

In TKR, the entire knee is replaced. This is a more invasive surgery, but it can potentially eliminate the need for further surgeries by replacing the whole joint in one go.

On the other hand, PKR only replaces the part of the knee that’s affected by arthritis, leaving the rest of the knee intact. This is a less invasive surgery and may have fewer complications. However, it leaves behind parts of the knee that may become arthritic in the future, potentially requiring more surgeries.

The best surgery option depends on the specific condition of the patient. For patients with arthritis affecting the entire knee, TKR is generally recommended. However, for patients with arthritis only in part of the knee, there is a debate about whether TKR or PKR is the best option.

Some argue that PKR provides better function and quicker recovery with fewer complications. Others counter that PKR has a higher failure rate and may require more follow-up surgeries.

The paper aims to compare these two types of surgeries to determine which one should be recommended to patients for whom both are viable options.

FAQs

  1. What are the two types of knee replacement surgeries mentioned in the research paper?
  2. How does Total Knee Replacement (TKR) surgery differ from Partial Knee Replacement (PKR) surgery?
  3. What factors should be considered in deciding whether to recommend TKR or PKR to patients with arthritis in the knee?

Doctor’s Tip

Here are a few tips a doctor might give to a patient considering shoulder replacement surgery:

  1. Follow your doctor’s pre-operative instructions carefully, which may include stopping certain medications, fasting before surgery, and getting any necessary medical tests done.

  2. Make sure you have a strong support system in place for after the surgery, as you may need help with daily activities for a period of time.

  3. Attend all physical therapy sessions as recommended by your doctor to help regain strength and mobility in your shoulder.

  4. Take pain medication as prescribed by your doctor to manage any discomfort after the surgery.

  5. Avoid lifting heavy objects or engaging in strenuous activities until your doctor gives you the green light to do so.

  6. Keep all follow-up appointments with your doctor to monitor your progress and address any concerns that may arise.

Overall, it’s important to communicate openly with your doctor throughout the process and follow their recommendations to ensure a successful recovery from shoulder replacement surgery.

Suitable For

In terms of shoulder replacement surgeries, patients who are typically recommended for this procedure are those who have severe arthritis in the shoulder joint that is not responding to conservative treatments such as physical therapy, medications, and cortisone injections. Other conditions that may warrant shoulder replacement include severe shoulder fractures, rotator cuff tears, and avascular necrosis.

Patients who have significant pain, stiffness, and limited range of motion in the shoulder joint that affects their daily activities and quality of life are also candidates for shoulder replacement. Additionally, patients with rheumatoid arthritis, osteoarthritis, or post-traumatic arthritis may benefit from this surgery.

Overall, patients who are in good overall health, do not have active infections, and have realistic expectations about the outcomes of the surgery are considered suitable candidates for shoulder replacement. It is important for patients to discuss their individual circumstances with their healthcare provider to determine if shoulder replacement is the best course of action for their specific condition.

Timeline

  1. Initial consultation: The patient meets with an orthopedic surgeon to discuss their symptoms, medical history, and treatment options. X-rays and other imaging tests may be done to assess the extent of damage in the shoulder joint.

  2. Pre-operative preparation: The patient undergoes pre-operative tests, such as blood tests and electrocardiograms, to ensure they are healthy enough for surgery. They may also meet with a physical therapist to learn exercises to improve strength and range of motion in the shoulder.

  3. Surgery: The patient undergoes shoulder replacement surgery, which typically takes a few hours. The damaged parts of the shoulder joint are removed and replaced with artificial components made of metal or plastic.

  4. Hospital stay: The patient stays in the hospital for a few days after surgery to monitor for complications and begin physical therapy. Pain management medication is provided to help with discomfort.

  5. Rehabilitation: The patient continues physical therapy exercises to improve shoulder strength and range of motion. They may also use assistive devices, such as slings or braces, to support the shoulder during the healing process.

  6. Follow-up appointments: The patient has regular follow-up appointments with their surgeon to monitor their progress and address any concerns. X-rays may be taken to assess the healing of the shoulder joint.

  7. Recovery: Over the following weeks and months, the patient continues to work on improving shoulder function through physical therapy and home exercises. They gradually increase their activity level and may be able to return to normal daily activities.

Overall, the timeline for a patient before and after shoulder replacement surgery can vary, but the goal is to improve shoulder function and reduce pain to enhance the patient’s quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about shoulder replacement include:

  1. What are the risks and complications associated with shoulder replacement surgery?
  2. What is the success rate of shoulder replacement surgery in patients with similar conditions?
  3. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  4. How long will the shoulder replacement last, and are there any potential limitations or restrictions in activities after the surgery?
  5. What alternative treatment options are available for my shoulder condition, and why is shoulder replacement recommended in my case?
  6. What is the experience and expertise of the surgical team performing the shoulder replacement surgery?
  7. How will my pain be managed after the surgery, and what is the expected level of pain during the recovery period?
  8. Will I need physical therapy after the surgery, and if so, for how long?
  9. What type of implant will be used in the shoulder replacement, and what are the potential risks or complications associated with the implant?
  10. How often will I need follow-up appointments after the shoulder replacement surgery, and what signs should I watch for that may indicate a complication or problem with the shoulder replacement?

Reference

Authors: National Guideline Centre (UK). Journal: London: National Institute for Health and Care Excellence (NICE); 2020 Jun. PMID: 32881461