Total Knee Replacement Surgery Surgery in Mumbai


Overview on Knee Replacement

A knee replacement is a surgical procedure in which the diseased knee joint is replaced with an artificial material. The knee is a joint which provides motion at the point where the thigh meets the lower leg. The thighbone abuts the large bone of your lower leg at the knee joint. During a knee replacement surgery, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone is also removed and replaced with a channeled plastic like piece with a metal stem.

Depending on the condition of the kneecap portion of the knee joint, a “button” may be added under the kneecap surface. The artificial components of a knee replacement surgery are referred to as the prosthesis.

Total knee replacement is one of the most successful surgeries procedures across all the medicine with 99% proven results. As per Times of India (TOI) reports over 1,20,000 Knee replacement surgeries take place every year in India.

If your knee is severely damaged by arthritis or an injury, it may be difficult for you to perform simple everyday activities such as walking or climbing up or down the stairs. You may even begin to feel excruciating pain while sitting or lying down.

If nonsurgical treatments like medications or using walking supports are no longer helpful, it is better that you consider opting for a knee replacement surgery. Joint replacement surgery is a safe and effective procedure to relieve pain, correct any form of leg deformity and help you resume your daily activities.

Knee replacement surgery was first performed in the year 1968. Since then, improvements in surgical materials and techniques have greatly increased its effectiveness. Knee replacements are one of the most successful procedures to be practiced in all of medicine.

According to the Agency for Healthcare Research and Quality, in 2017, more than 754,000 knee replacement surgeries were performed in the United States.

Types of Knee Replacement Surgery

Total Knee Replacement

Most total knee replacement operations involve replacing the joint surface at the end of the thigh bone (femur) and the joint surface at the top of the shin bone (tibia). A total knee replacement involves replacing the under-surface of your kneecap (patella) with a smooth plastic dome. There are some surgeons who prefer to preserve the natural patella but sometimes the decision needs to be made during the operation. If you have had a previous operation to remove the patella altogether (patellectomy), this will not stop you from having a knee replacemen

Unicompartimental Partial Knee Replacement

If arthritis affects only one side of your knee, which is usually the inner side, it may be possible to have a partial (unicompartmental) knee replacement. Partial knee replacements can be carried out through a smaller cut than a total knee replacement, using techniques called reduced invasive or minimally invasive surgery. A smaller incision can further reduce the recovery time.

Kneecap Replacement

A kneecap replacement involves replacing just the under-surface of the kneecap and its groove if these are the only parts affected by arthritis. It is possible to replace just the under-surface of the kneecap and its groove if these are the only parts affected by arthritis. This is also known as a patellofemoral replacement or patellofemoral joint arthroplasty.

Revision Knee Replacement

A revision knee replacement may be needed if you are having a second or third joint replacement in the same knee or if your arthritis is extremely severe. Some people may require a more complex type of knee replacement. The most common reasons for this could be a major deformity of the knee or a fracture.

Benefits of Knee Replacement Surgery

A knee replacement surgery requires doctors to remove a diseased or damaged knee joint and replace it with an artificial implant. After the recovery, most people return to their daily activities that they used to enjoy.

At the same time, it is very important to keep in mind that the safest activities for your new knee are low impact. This may include activities like walking and sports, such as golf, biking and swimming.

Basically, anything with movements that do not overly stress your joints will be fine. However, you are most likely to be told by your doctor to avoid high-impact activities, such as running or sports which involves jumping. This means that you may need to find new ways to stay active.

Knee replacement is a highly successful surgery and most people see improvements in pain, stiffness and other symptoms after they have fully recovered. The success rate remains high 15 years after the surgery, with more than 90% of knee implants still functioning very well.

Procedure Prep

Before the surgery, joints adjacent to the diseased knee are carefully evaluated. This is very important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield a significant improvement in function as the nearby joint may become much more painful if it is abnormal.

Furthermore, all medications that the patient is taking are carefully reviewed. Routine blood tests of liver and kidney function and urine tests are evaluated for any signs of anemia, infection or abnormal metabolism. Finally, chest X-ray and EKG are performed to exclude significant heart and lung diseases that may preclude surgery or anesthesia.

Complications

The possibility of severe complications, such as an infection, are rare. They occur in fewer than 2 percent of the cases. However, relatively few complications happen during the hospital stay after a knee replacement. About 1 percent of people develop an infection after the surgery and fewer than 2 percent of people may also develop blood clots.

In some rare cases, a person may have Osteolysis. This is an inflammation that occurs due to microscopic wear of the plastic in the knee implant. The inflammation causes bone to dissolve and weaken. A surgeon may use general or local anesthesia during the surgery. It is usually safe, but it can have adverse effects. The most common side effects include vomiting, dizziness, sore throat, discomfort and drowsiness.

Other possible effects may include breathing difficulties, allergic reactions and even nerve injury. To reduce the risk of these problems, make sure you tell your doctor in advance about any prescription or over-the-counter medications, supplements, tobacco use or any sort of recreational drugs or alcohol.

Recovery

A total knee replacement surgery generally requires between one and a half to three hours of operative time. Post-surgery, patients are taken to a recovery room, where vital organs are monitored frequently. When stabilized, patients are returned to their room. Passage of urine can be quite difficult in the immediate postoperative period and this condition can be aggravated by pain medications.

A catheter inserted into the urethra allows free passage of urine until the patient becomes more mobile. Physical therapy is an extremely important part of rehabilitation and requires full participation by the patient for great outcomes. After the surgery, patients can begin physical therapy only after 48 hours. There is a possibility for a patient to experience some degree of pain, discomfort and stiffness during the early days of physical therapy.

Answer to Common Questions About Total Knee Replacement:

  • Is it the right time to undergo a knee replacement?

    There is no particular formula for deciding when you should have a knee replacement. The main reason to get it done is pain, but if you have tried all other forms of non-operative treatment including lifestyle remedies, anti-inflammatory medication, physical therapy and injections, it may be time to think about surgery.

  • What happens during surgery and how long does it take?

    The surgeon will make an incision over the front of your knee to expose the damaged area of your joint. During the operation, the surgeon moves your kneecap to the side and cuts the damaged cartilage and a small amount of bone. After this, they replace the damaged tissue with new metal and plastic components. Most knee replacement surgeries take about 60 to 90 minutes to complete.

  • What is an artificial knee and how does it stay in place?

    Artificial knee implants consist of metal and medical grade plastic called polyethylene. There are two ways of attaching the components to the bone. One is to use bone cement which usually takes about 10 minutes and the other is a cement-free approach in which the components have a porous coating that allows the bone to grow onto it. In some cases, a surgeon may use both the techniques during the same operation.

  • Should I worry about anesthesia?

    Any operation done with anesthesia has it’s own set of risks, although it is rare that severe complications result from any type of anesthesia.

  • What should I expect immediately following surgery?

    If you have had a general anesthetic, you may wake up feeling a little drowsy and confused. You will probably wake up with your knee raised to help with swelling. Your knee may also be cradled in a continuous passive motion machine that gently extends and flexes your leg while you are lying down.

  • Will I need any special equipment?

    Some surgeons recommend using a continuous passive motion machine (CPM) in the hospital as well as at home while lying in bed. A CPM machine helps increase knee motion during the first few weeks of the surgery. The doctor will prescribe any mobility equipment that you may need such as a walker, crutches or a cane.

Knee Joint Pain that can be Resolved with Total Knee Replacement Surgery

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