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Total Knee Replacement

Total knee replacement is performed to treat and to restore the function of painful, disabled knee joints. The affected knee joints are replaced by artificial knee joints, a combination of metal and plastic. These are available in various designs. The metal meets the end of the bones and a plastic spacer acts as a buffer between them.
Orthopedic-doctor-showing-model-of-total-knee

Details of Procedures:

Total knee replacement is recommended when severe knee pain:

  • Disrupts night sleep
  • Is insensitive to other treatments
  • Limits usual activities

The pain and limited function of the knee could be because of:

  • Osteoarthritis or rheumatoid arthritis
  • Avascular necrosis
  • Accidental injuries to knee joints

Facts and figures

  • The knee is one of the strongest, largest, and most complex joints of the body. A man of 70kg applies about 210kg force on the knee while playing football, basketball, and running.
  • About 270,000 knee replacements surgeries are performed each year in the USA. About 70% of these patients are age 65+
  • The first artificial knee implants inspired by successful hip replacement surgery were tried in the 1940s and, currently, it is one of the most successful surgeries in the modern era.

Risk and Complications

  • Loosening of the prosthesis from the bone
  • Infection
  • Bleeding
  • Excessive scarring
  • Medicinal or anesthesia reaction

Advantages

  • 95% of the patients experience relief from the symptoms due to its high success rate.
  • It not only provides relief from joint pain but also increases leg strength and mobility for about 10 to 15 years
  • It improves the quality of life by allowing the patient to participate in activities which were restricted prior to surgery.

Disadvantages

  • Unwanted stiffness of joint and loss of knee motion.
  • Patellar complications can occur

Preoperative Preparation

  • Complete physical examination
  • Blood and urinalysis
  • ECG and x-ray chest for the patient above 50 years
  • Consult with the surgeon week prior and get the correct medicinal prescriptions.
  • Inform the surgeon about smoking and alcohol habits.
  • Visit a physiotherapist to understand the post-surgery rehabilitation program and using crutches.
  • Plan for leave from work and domestic help at home.
  • Don’t consume anything after midnight before surgery.
  • Medical tourists are advised to wear comfortable clothes and to select a handicap-accessible hotel room  for recovery after getting a discharge from hospital

Post operative care

  • Patients need to wear special compression stockings to improve blood flow in legs for proper healing.
  • Starlight activities using crutches or a walker from the first day after surgery, and physiotherapy 48 hours later.
  • Carry out exercises regularly as per instructed by the physiotherapist for the best results.
  • Normal recovery after surgery is seen within 7 to 10 days.

The patient will get discharged from the hospital only after the following criteria are met:

  • Able to bend the knee at a 900 angle
  • Get out of bed without any support
  • Able to extend knee straight out
  • Can walk using crutches or walker
  • Carry on prescribed home exercises.
Traumatologist-pointing-pen-to-meniscus-in-a-kneejoint

Dos, Don’ts and Precautions

  • Strictly follow the diet regime
  • Take prescribed medicines as per schedule
  • Exercise regularly as advised by the physiotherapist
  • Early mobilization will help strengthen the knee muscles
  • Don’t bathe until the sutures or staples are removed.
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