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.
INDICATIONS OF TOTAL KNEE REPLACMENT (TKR)
- Rheumatoid Arthritis
- Post traumatic Arthritis
- Gouty arthritis
- Pain in Deformed Knee
Osteoarthritis most commonly referred to as the wear and tear of the joint usually affects the elderly and middle age to elderly people.
In osteoarthritis the cartilage between the joint breaks down.
- Older age
- Previous traumatic joint injury/overuse of joints
- Joint deformity
What are the Symptoms of Osteoarthritis?
- 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
- Joint swelling
- Decreased movement of the joint
HOW TO DIAGNOSE?
- History and clinical examination
- Standing X rays of the knee joint
- Some patients may knee CT Scan/ MRI
Who are the right candidates for Knee Replacement Surgery?
The surgical treatment becomes an option in severe cases and the medical treatment fails.
Medical treatment includes:
- Activity modification.
- Anti-inflammatory medications
- Joint injections
Surgical Indications are:
- When the medical treatment fails to relieve the pain
- There is severe deformity of the joint so much so that it affects the daily activities of the patient
- There is instability of the knee joint
- There is decreased range of motion of the joint
What is Knee Replacement Surgery?
Knee replacement surgery is a procedure that decreases the pain and improves the quality of life. During total joint replacement surgery, the worn-out surfaces of the joint are removed/shaved off and replaced with implants. The femoral(thigh bone) and tibial(leg bone) component is made up of a metal alloy that covers the end of these bones. The insert/spacer that is put between the two metal components serves as a cushion, a smooth gliding surface between the two.
The patella (knee cap) is resurfaced with a special polyethylene.
The Post-Operative Physical Therapy
The surgeon will supervise the knee rehabilitation programme, which usually begins 24-hours after the surgery.
- Isometric quadriceps exercises are started 24 hours after the surgery
- The patient is allowed bed side sitting 24 hours after the surgery
- The patient is made to stand on the next day of surgery
- The patient is made to walk with the help of walker 48 hours after the surgery.
- Knee bending exercises are started 48 hours after the surgery
- Patient walk with the aid of walker up to 6 weeks
- After 6 weeks walker is replaced with stick for next 6 weeks
- Patient walks unaided after 3 months
The knee physiotherapy is continued for 6 months after the surgery.
Activities to be avoided after total Knee Replacement Surgery
- Sitting crossed leg
- Using Indian commode
- Avoid high level impact activities like sports and heavy physical work