Arthroplasty - Knee
Total knee replacement1.what is Total knee replacement?
Ans: In osteoarthritis of the knee, the worn out ends of the femur and tibial ends are replaced with metal implants and a plastic insert is put in between the metal implants. This surgery restores the normal alignment of the leg and allows the patient to have a pain free walking.2. Who would require knee replacement?
Ans: Any person who is suffering from severe arthritis of their knee joint.
- Difficulty in walking and climbing stairs.
- No relief with medication, feeling necessity to take pain killers daily since a long time
- Deformity is noticed at the knee joint – bowed legs or knock knees
- Rest pain – having disturbed sleep due to pain.
Ans: Knee replacement is usually advised to persons over 60 years with severe arthritis, but Rheumatoid arthritis patients can present at a much younger age of even in their twenties presenting themselves with severe arthritis. These patients also undergo knee replacement to have good quality of life. we even see patients in late forties and fifties presenting with degenerative arthritis who would require knee replacement4. What are the prerequisites to undergo knee replacement?
Ans: A person once advised surgery have to undergo tests to assess fitness for surgery in which tests are conducted to evaluate heart & kidney function along with sugar, thyroid, blood Haemoglobin, urine examination.
Also the patient should have Blood pressure and sugar levels under normal levels if they are hypertensive or diabetic. There should not be any neurologic deficits.5. How long does a knee replacement last?
Ans: With the follow up patients till now of the implants that have been used, 95 % people do well by 15 years, 90% do well by 20 years. With the latest implants now, knee can last over 30 years as claimed by the lab studies.6. What is the success rate of the surgery?
Ans: Knee replacement is one of the most successful surgery. There are more benefits than complications. In our hands the success rate is 99.5%.The most important complication that I explain to all my patients is infection which is affected by surgeon, theatre conditions, and patient factors.
We take utmost care from our side in preventing infection, our operation theatres are laminar air flow theatres for infection control. Patient factors include uncontrolled sugars, dental caries, and urinary tract infection, in short any infection in the body can transmit to the knee joint and get infected. Most of the infections have been mainly due to patient factors. So I explain every one this so that they improve their personal hygiene and health.
Another complication is loosening of the implant which is again either due to poor bone quality or improper fixation. Loosening can be prevented by proper judgement of bone stock and use of special implants with stems and good surgical skills. Loosening has been very rare in our hands.7. How long does it take to recover?
Ans: Patient can move their knee on the day of surgery and some can even walk with walker on that day but it is individualised based on the patient’s recovery and strength. Thin built and strong patients are able to walk on same day and obese and weak patients walk on 1st or 2nd day post-surgery. Every patient is able to walk with walker to rest room while in hospital so that further rehabilitation is easy at home under the supervision of a physiotherapist. Patients would discard their walker in 10 days to 3 weeks’ time.8. What are the activities that can be done and what cannot be done after surgery?
Ans: Patients can walk normally without support, climb stairs, cycling, and drive vehicles – two wheelar or car. They can sit on ground with the high flex design implants but are not allowed to squat or use Indian toilet.9. What is latest in knee replacement?
Ans: Newer implants have come with new designs and long lasting properties like Oxynium Verilast technology, Gender specific knees for male and female knees separately, Attune known to last a life time.10. What is your speciality in total knee replacement?
Ans: We perform with minimal invasive technique, less tissue trauma, no blood loss during surgery, dissolvable sutures, less post op pain and early ambulation with fast track anesthesia.