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What is a knee joint?
Knee is a complex joint that connects thigh bone (femur) to the leg bone (tibia). In addition to that, knee cap (patella) articulates with femur.
Normally, joint surfaces are lined with very fine articular cartilage, which ensure movement with minimum friction. There are also other specialised structures inside the knee like the meniscus, which help in knee motion and act as shock absorbers.
What causes knee pain?
If for any reason the cartilage gets worn out, the surface of the joints become rough and movement may become painful.
Joint cartilage usually wears out because of the ageing process, leading to osteoarthritis. Wearing out can also be caused by different forms of arthritis, such as rheumatoid arthritis, post injury arthritis, etc.
How is knee pain treated?
In early stage of knee arthritis, pain can usually be controlled with weight reduction, physiotherapy and mild medication.
During end stage of arthritis, when degeneration or arthritis advances too much, there is severe decrease in joint space and consequently significant amount of pain while walking, getting up from chair, and sometimes even while resting. In such a scenario, surgery may be required to replace the knee.
What is knee replacement?
Knee replacement is a misnomer. It is better to describe it as knee resurfacing or knee arthroplasty. The procedure involves removal of worn out cartilage along with a bit of bone. Then with special tools (jigs), a shape is created to properly fit in an implant. Special bone cement is used to fix the implant to the bone.
Implants help the joint move with very low friction, almost like the original joint. They are metallic on one side and special plastic on the other. At BLK orthopaedics joint centre , implants from various international companies are available and only the best are used for such procedures.
What To Expect From A Knee Replacement Surgery
Joint pain is generally associated with old age. Weakening joints and regular joint pain problem is a synonym to the process of ageing. This, in fact is not true at all and people need to wake up to the new reality. As per a recent study, joint issues can hit you at any age. There are many young people who suffer from arthritis at a young age. Therefore, considering arthritis as a problem in elderlies only is a big myth.
Osteoarthritis – One of the most common forms of Arthritis
Arthritis mostly affect people in the form of osteoarthritis and is the most common form of chronic arthritis which generally occurs in older people. It starts with the breakage of cartilage, a protective tissue that covers the two bones of knees making it a joint. The breakdown of the cartilage leads to stiffness while moving and pain in the joints. It not only adds to lot of discomfort for a person suffering from it but also results in lack in physical activities.
Knee Osteoarthritis – When to consider surgery
Arthritis is generally related with knees but it can affect any joint in the body. Knee is responsible for mobile movement; therefore it is more severe and affects daily routine of a person. Even a simple movement like walking or climbing stairs, sitting or even lying down is slowed down in a person suffering from osteoarthritis.
Treatment options include physical therapy and surgery. While physical therapy gives you some relief, replacement surgeries make sure that your ailment is permanently cured.
Knee Replacement Surgery
Knee replacement surgery is a very common surgery in India and is considered most effective treatment in dealing with osteoarthritis. The surgical procedure involves removing the weakened part of the knee and replacing it with an artificial joint. The prosthetic perfectly gels with bones and results in pain free joints. The surgery also helps in curing diseases like rheumatoid arthritis and psoriatic arthritis.
Total Knee Replacement surgery- In some cases total knee replacement surgery is recommended. In this procedure the whole knee joint is replaced with an artificial one. This is done in case of extreme knee osteoarthritis and is a very successful procedure due to latest technology and advancement in medical sciences.
Preparing for the Knee Replacement Surgery
Knee Replacement Surgery has a very high success rate but the procedure before the surgery has to be strictly followed in order to make it a 100% success for patient. Before the surgery, your surgeon will perform required X-rays and blood tests to ascertain the damage to the knee. The surgeon will study your medical history and type of medications you were taking before the surgery for knee pain. All these information will help him in learning about your condition deciding on the procedure.
What happens during the surgery?
The surgery is done on a general anesthesia and patient will be admitted for a week at least prior and post the surgery. On the operation table, the surgeon will start the procedure by inserting an intravenous line (IV) through which you will be given general anesthesia. The surgery will be performed in 1-2 hours during which you will be unconscious. The surgeon will make an 8-10 inch incision in your knee to perform the procedure of taking out the damage or whole joint (in case of total knee replacement) and replacing it with artificial parts. In case of minimal invasion procedure the size of the incision would be not more than 6 inches.
It will only take you a day to be able to help yourself. After a few days, you will see a great improvement in the condition of your knee including greater flexibility and lesser pain.
Uses of Navigation/ Computer Assistance/ MIS surgery
Navigation may not be required in routine knee replacement. It may be more useful if there are deformities in thigh or leg bones. In routine cases, available jigs are extremely good and accurate.
While long incisions were made earlier, nowadays smaller incisions are utilised with the help of MIS jigs.
What is the surgery process?
How to prepare for surgery?
What is the recovery process?
Discharge from hospital
What precautions should be taken after surgery?
Short- term precautions
Long term precautions
Care At Home
What are the risks / complications of the procedure?
All surgical procedures and anaesthetics carry some risks, particularly if there are other medical problems such as the patient being overweight etc. Our team has been trained to make sure such risks are minimized and the treatment is carried out safely. However, there are some specific risks related to knee surgery that patients need to be aware of. However, chances of immediate complications are less than 2 %.
How soon does a patient recover from surgery?
Frequently asked questions
Q. Do I need knee replacement?
A. It depends on the extent of pain and difficulty in walking. Advice is given after analyzing X-ray findings. It is you who’s suffering from pain and you are as much a part of decision making as your doctor.
Q. Do I need computer assisted or navigation / MIS for my knee replacement?
A. For routine knee replacement, available jigs are extremely good and accurate. Only in cases of complex deformities of thigh and leg bone that computer aided assistance may be required.
Computer navigation is an evolving technology and needs time to achieve perfection in all cases.
While long incisions were made earlier, nowadays we utilize smaller incisions with the help of MIS jigs.
Q. Can I get both knees operated at the same time?
A. It depends on how badly both knees are affected and how sound is your medical status. Knee replacement for both knees can be performed in one sitting
Q. Is knee replacement painful?
A. There are modern methods available for pain relief, such as continuous epidural anaesthesia, patient controlled anaesthesia (PCA) and a mix of certain drugs that can control pain very effectively.
Applying cold compresses around the knee also helps in reducing swelling and pain.
Q. Can I get full bending (flexion) of knee after surgery?
A. There are reports in the media that some knee implants are capable of giving high flexion or full bending of knee. The degree of movement achieved depends on your mobility status before surgery, your weight and good technique of surgery. Surgery is likely to increase your knee movements partially. Implants can only absorb high stress associated with full movement.
Q. Can I sit cross-legged on the floor?
A. Knee replacement implants are bonded to the bone with bone cement. Even though most patients are able to sit cross-legged, it is not recommended. Preventing excessive stress on the bond increases the life of the implant significantly.
Q. Do I need physiotherapy?
A. Physiotherapy is important in achieving early mobility and good knee movement. Physiotherapy starts immediately after surgery. You may need physiotherapy for 4 - 6 weeks. This can be organized at your home or a nearby clinic.
Q. How frequently do I need to visit the hospital?
A. You are required to visit the hospital 10 days after surgery for stitch removal. After that you may be asked to return in 2-4 weeks to track your progress. Subsequent visits are required only after 3 months and 1 year of surgery - unless medical condition dictates otherwise.
Q. Is knee replacement detected by a metal detector?
A. Yes. You should collect a credit card shaped certificate from the orthopaedic office certifying that you’ve had knee replacement. This can be shown to the security staff.
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