Knee prosthesis

Evolution

Complications that may arise include:

Un unsealing (avulsion) is exceptional in total knee replacements. Emergency reduction is recommended as there is a risk of damage to the vessels and nerves.

Infections with staphylococcus in particular, are more important for example than in hip prosthesis, and are unmasked by temperature monitoring. The use of antibiotics without having first carried out a antibiogram (which allows the effective antibiotic to be highlighted), should not be carried out because they risk masking the signs of infection. These knee prosthesis conditions seem to be explained by the fact that this joint is more superficial than others. Certain pathologies promote the occurrence of an infection, this is the case, among others, of the rheumatoid arthritis, In thehematoma (blood collection) occurring after surgery, tissue destruction, healing problem, history of infection, knee surgery before prosthesis placement, leg ulcer ipsilateral (on the same side).

There is also a risk of occurrence of thromboses (obstruction of a vessel by a blood clot), orembolisms (obstruction of a pulmonary artery). Usually the use of anticoagulants prevents these kinds of complications.

synovial in too large a quantity in the joint). A algodystrophy is equal is also likely to occur as the cause of postoperative pain on a knee prosthesis. The mechanism of algodystrophy would be a bad one trophicity (conditions necessary for nutrition and development of an organ). It is characterized by pain and problems of vasomotor, that is to say an inability of the body to regulate the closure of arteries, veins and vessels. Finally, wear and tear can lead to inflammation of the membranes synovial (membrane producing the liquid synovial) result of a reaction to the presence in the joint of debris from wear of the prosthesis. In this case, certain examinations such as X-rays and punctures which allow liquid to be removed and examined in order to highlight wear debris as well as a scintigraphy can be useful in proposing the diagnosis of algodystrophy (see above). Finally, if necessary, arthroscopy (direct visualization of the inside of the joint through a tube equipped with an optical system) allowing a sample of membranes to be taken synovial, sometimes gives rise to pain that is otherwise unexplained. Weight bearing on the leg is generally permitted during hospitalization, except in exceptional cases (bone graft, uncemented prostheses, knee prosthesis revision). At home, the patient does not need to adapt their daily life to their prosthesis most of the time. However, it is necessary to warn the patient of the following points:

• Going up and down stairs should be introduced gradually, and usually late.
• All movements are permitted, however, given the risk of damage to the prosthesis, the patient is advised not to remain squatting.
• Reorganizing the rooms in the home is also not mandatory.
• Driving should be avoided until the end of the second month after surgery. As a passenger, the car is not prohibited.
• Some sports are permitted (swimming, cycling). Skiing and golf can be practiced very gradually.
• Brushing, as well as oral hygiene, are also important in order to prevent infectious foci that could superinfect the prosthesis.
• Nosocomial superinfections (secondary to hospitalization) such as the placement of an intravenous catheter, a major dental condition, a leg ulcer) also fall within this framework, and require treatment with penicillin and in the event of an allergy with erythromycin at home.