FAQ – Knee replacement surgery
FAQ – Knee replacement surgery
The knee joint is the largest and one of the most complex joints in the body. It is made up of the lower end of the thighbone (femur) and the upper end of the leg bone (tibia) along with the kneecap (patella). The two ends of the thigh and leg bones glide smoothly on each other, allowing us a smooth, painless movement of the lower limb.
Whenever you walk, sit, run, turn around or perform similar activities, you are depending on the knees for support and mobility. Our knees bears the full load of the body and the load on the knee varies with different activities.
For smooth functioning of the knees, smooth gliding surface for the bone ends are mandatory. The surfaces of all three bones come in contact during motion and are covered with a thick smooth gliding surface (articular cartilage). Other components for good functioning knee are well-built muscles around the knee, ligaments, and of course, covering membrane (synovial membrane). All these components normally work in harmony, but disease or injury can disrupt this harmony resulting in pain, thigh wasting, repeated joint effusion, and decrease or loss of functions of the knee.
The most common cause of knee pain and disability is osteoarthritis. In osteoarthritis, the gliding surface of the bone becomes irregular and rough due to age related wear and tear. The painful stiff knee may also develop due to diseases like rheumatoid arthritis, or may develop after injury or infection.
In the early stages, pain is usually relieved by only painkillers or in association with physiotherapy and sometimes injection into the joint. But in advanced stages, i.e. when the pain is severe, medication and other treatment do not relieve the pain anymore, and daily activities become very restricted, you need the operation. A variety of operations are available; the simplest is arthroscopic debridement and the last option is total change of the knee joint and replacement by artificial joint. The artificial joint will give you pain-free, mobile joint for a quite long time, i.e. more than 15 years.
Stage-wise Treatment of Knee Arthritis
• Mild: Painkillers and physiotherapy
• Moderate: Painkillers, injection and physiotherapy
• Moderately severe: Mini-hole (arthroscopic) surgery and therapy after operation
• Severe arthritis with deformity: Total knee replacement
What does Total Knee Replacement (TKR) surgery mean?
Total Knee Replacement is a surgical procedure where the diseased knee is replaced with artificial knee joint (implant). During the total knee surgery, the ends of the thighbone are removed and replaced with metal shell; the end of the leg bone is replaced with a plastic piece over a metal stem. Depending on the condition of damage of the kneecap, the under surface is also resurfaced with plastic kneecap. Many designs and different materials are currently in use for the replacement. At Apollo Institute of Orthopaedics, we are using the advanced implants, delivering best clinical outcomes and increasing the quality of life.
When do you need Total Knee Replacement?
• If you are more than 55 years of age with severe knee pain that limits your daily activities including walking, using stairs getting in and out of the chair, and difficult in walking
• If you are more than 55 with moderate to severe pain while resting during day or night and deformity in the knee
• If you are more than 55 years old with moderate to severe pain, which is not relieved by drugs or you are taking the drugs for a long time, which is causing side effects
Benefits of Total Knee Replacement
• Relief of pain
• Increased movement of the joint
• Correction of deformity, meaning straight leg
• More leg strength (if you do exercises regularly)
• Improved quality of life
• Ability to return to normal life
Things you cannot do after Total Knee Replacement
• Running
• Jumping
• Sporting activities, etc.
Are you fit for the operation?
A proper orthopaedic evaluation is necessary from your treating orthopaedic surgeon to give you his/her opinion. Your orthopaedic surgeon will gather information about your knee problem and general health, and then perform physical examinations to assess your general health and knee motion, strength and alignment. Investigations like x-ray, blood tests, etc. will then be done to complete the evaluation. After that, your orthopaedic surgeon will review the results and discuss whether total knee replacement would be the best method to relieve your pain and improve your knee function.
Preparation for surgery and home planning
You must inform your doctor one or two weeks before your surgery so that he can take necessary steps for your general health, like control of blood pressure, diabetes or any kidney problem, etc.
Hospital admission and stay
After your admission, doctors from our team will evaluate you again and a medicine specialist or cardiologist will take care of existing medical conditions like hypertension or diabetes. Otherwise an anaesthesiologist will visit you and talk about the anaesthesia, which may be spinal or epidural anaesthesia or general anaesthesia.
Then, a suitable time for surgery will be given to you. After the operation you will be in the post-operative room for some time, while your recovery from anaesthesia will be monitored. Later, depending on your condition you may be kept in ICU for observation up to 24 hours. Soon after the surgery you will feel pain, but painkillers will make you comfortable.
Possible risks from the surgery
• Infection
• Deep vein thrombosis
Things to remember when you are sent home
• Visit your doctor after 12 days of the operation for removing of sutures
• Do not soak the wound until the stitches are removed
• Continue the physiotherapy as directed
• Continue medication as prescribed
After some time when you have recovered well, you will need an activity program at home which should include:
• A gradual walking program to slowly improve your mobility, initially at home and then outside
• Specific exercises, several times a day
• Weight control
You should do the following after surgery:
• Participate in regular light exercise program to maintain proper strength and mobility of your knee
• Take specific precaution to avoid fall and injuries
• Notify your operating surgeon as soon as possible if you have symptoms of infection, severe pain, swelling or fever
• See your orthopaedic surgeon periodically for routine follow-up, usually once a year