What is Total knee replacement?
Total knee replacement is a procedure carried out when the cartilage at the end of the thigh bone(femur) and shin bone(tibia) are worn out to a stage where they cannot be repaired (advanced osteoarthritis ). These worn-out ends are resurfaced with a metal prosthesis. So the term total knee replacement is actually a misnomer as the worn ends are resurfaced with metal and not replaced. The bone ends are fashioned with the help of special bone cutting jigs and the prosthesis is fixed to the ends with the help of bone cement. A highly cross-linked polyethylene insert is placed within the ends of the prosthesis which acts as a bearing.
Do you require total knee replacement?
If you have severe knee pain that limits your everyday activities like walking, climbing or coming down the stairs, getting in and out of chairs or you use a stick/walker for walking. If you are taking medications for pain relief on a regular basis. You may require a total knee replacement.
What are the benefits of total knee replacement? How will it help you?
After knee replacement surgery, you get relief from joint pain. your mobility increases, your legs get straightened and you have a better quality of life. I believe that “movement is life and life is the movement”. You can even play your favorite sport like golf, swimming, etc. Running, jumping or high-impact activities are discouraged.
What is the age at which Total knee replacement is recommended?
Usually old patients, above 60, develop osteoarthritis leading to narrowing of the joint gap and resultant pain. Some patients may even develop arthritis even in their thirties, especially those who had their knee joints damaged secondary to trauma or rheumatoid arthritis. There is no upper age for surgery.
What is the preparation for surgery?
A thorough examination by a knee specialist followed by evaluation of general body status by a physician to rule out any ailments. once your tests are ok, you are fit to undergo surgery.
How long does the surgery take?
It takes around 1 hr for one knee?
How long do I stay in the hospital?
You need to get admitted a day before your surgery and you will stay for 4-5 days in hospital after the surgery.
Will I have a lot of pain after surgery?
No surgery is usually done under combined spinal anaesthesia wherein the nerves responsible for pain are anaesthetised, which means that you are awake but your legs do not feel any pain during or after surgery. Moreover, medicines to decrease pain, are given into the knee joint, during the surgery.
What are the possible complications of surgery?
The complications are the same as with any surgery such as infection, injury to nerves and vessels and deep vein thrombosis(clot formation). The incidence is negligible (less than 0.5%).
When do I start walking?
I make the patients walk with a walker on the next day. A physiotherapist teaches you exercises to strengthen the muscles and walk with a walker. He would teach you toilet training on the 3rd post-operative day. By the fourth day you would be out of your room walking with a walker in the corridor. The next 15 days you would do physiotherapy under supervision at your home and continue exercises on your own thereafter. You will be taught how to get up and down the stairs and you can switch to a stick after 1 month. By the end of 6 weeks, you would be able to walk unassisted.
When should I come back for a follow-up?
You have to visit me 2 weeks after surgery for stitch removal. Thereafter at 1month and 3 months. After that, you have to come for follow-up once in a year. Of course i shall be available whenever you need me.