The knee joint is the most complicated joint of the body. It consists of three components junction of three bones: the patella (knee cap), distal femoral condyles (thigh bone), and the proximal tibial plateau (leg bone). The ends are covered with articular cartilage- an elastic material that allows the knee to move freely. If damaged, the cartilage cannot repair itself. In such a case, a knee replacement surgery is done.
Max Institute of Musculoskeletal Sciences & Orthopaedics, is equipped with a state-of-the-art Digital Orthopaedic Operating Suite. We offer comprehensive care for several orthopaedic afflictions, including knee, hip, and joint problems. The joint implants are planned pre-operatively for perfect size and positioning as per the anatomy of the patient, thereby safeguarding their health. Our wide range of offerings has made us rank among the best hospitals in India. We focus on providing the highest level of patient care with professional expertise for early mobilization and have taken orthopaedic treatment to a world class level.
The surgery options for knee replacement include:
a) TOTAL KNEE REPLACEMENT
Total Knee Replacement or 'Arthroplasty' is relining of the joint (bone end surfaces) with artificial parts called prostheses. There are three components used in the artificial knee.
The femoral (thigh) component is made of metal and covers the end of the thigh bone.
The Tibial (shin bone) component, made of metal and UHMWPE (medical-grade plastic), covers the top end of the Tibia.
The third component, the patella or kneecap, is made up of polythene. The surgeon decides at the time of operation if it should be replaced in a particular situation or not.
Patients with severe arthritis of both knees can be offered replacements of both knees together after a thorough medical evaluation. Joint replacement is also done using computer assistance which improves implant alignment and surgical precision. Before a total knee replacement surgery is performed, Orthopaedics evaluate the medical history, conduct a physical examination, X-rays, and other tests like MRI and blood tests. The doctor then reviews the results and discusses with the patient if total knee replacement surgery is the best option in their case to improve function and relieve pain.
b) UNICONDYLAR KNEE REPLACEMENT In some patients, only one half of the knee joint is worn out. In these situations, only one side of the knee is replaced. This is termed as Unicondylar Knee Replacement. It can be done in specific conditions, which only the surgeon can judge and advice. This surgery is comparatively economical, and since the operation is less extensive, the post-operative recovery is faster.
If a patient’s knee is sternly damaged by arthritis or because of any injury, it may be difficult for them to perform everyday activities, such as climbing stairs or walking. After a period, they may even begin to feel pain while sitting or lying down. When non-surgical treatments like the use of walking supports and medications prove no longer to be helpful, the doctor may advise the patient to undergo a total knee replacement surgery. It is a safe procedure that helps in pain relief, corrects leg deformity, and allows the patient to resume normal activities.
Surgical treatment is performed when a patient experiences the following:
Pain in and around the joint
Difficulty in squatting and sitting crossed leg
Difficulty in negotiating stairs
Deformities of the joint
Inability to walk for long distances
Decreased movement of the joint
Pain in deformed knee
Certain activities are to be avoided after undergoing Total Knee Replacement Surgery. These include:
Sitting crossed leg
Using indian commode
High level impact activities like sports
Heavy physical work
The problems and aspirations of each patient differ, and these must be discussed with the surgeon at length before the patient accepts the Total Knee Replacement operation.
After the surgery, the patient is shifted to the post-operative observation room (HDU). A bandage is tied over the knee with a drain tube coming out of the bandage. This removes any blood collected in the knee and minimizes the chances of infection.
An intravenous line is used for transfusing blood or fluids into the patient's arm. This is later used to administer antibiotics over the next few days and transfuse blood. In some instances, a urinary catheter may be used to help elderly patients or those who have urinary difficulty. Some leads are attached to the body to continuously monitor the ECG, blood pressure, pulse rate, breathing rate, etc. The patients remain in the observation room for a night. Once the anaesthetists are satisfied, patients are shifted to their respective rooms, the next day.
Post-Operative Management and Physiotherapy
Patients are encouraged to start in-bed exercises within 24 hours of the operation.
After 24-48 hours, drain from the knee joint is removed and the dressing is reduced in size. Patients are made to sit at the bedside with legs supported.
2-3 days after the operation, patients are encouraged to stand and walk using a walker, and a day or two later, they can visit the toilet, with assistance, using a high seat.
Stitches are removed two weeks after the operation.
3 weeks after the operation, patients are encouraged to walk with a walking stick.
4-6 weeks after the surgery, patients are trained to start climbing stairs.
The patients are discharged from the hospital five days after the surgery with instructions regarding medicines and physiotherapy.
12 weeks post-operative, one can usually begin driving vehicles, with due precautions.
One is advised not to squat or sit cross-legged after the operation, particularly on the floor.
The postoperative schedule gets slightly extended in case of surgery being performed on both the knees.
The usual lifespan of a successful Total Knee Replacement is about 15 years. It may, however, vary under individual circumstances.
Restoration of mobility, diminished pain & stiffness.