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Home  Medical Treatment - Total Knee Replacement |
Total Knee Replacement
The knee joint is the largest joint in the body. It is commonly known as a ‘hinge joint' because it allows the knee to flex and extend (bend and straighten like a door hinge)
When is it time to discuss knee replacement with my doctor ?
If you answer yes to any of the questions below, it may be time to speak with your orthopaedic surgeon about knee replacement surgery.
- Does your knee hurt one or more days per week?
- Does the pain interfere with your sleep?
- Is it painful for you to walk more than a block?
- Are pain medications no longer working?
- Is knee pain limiting your participation in activities?
- Has inactivity from knee pain caused you to gain weight?
- Can you limit activities for a few months to recover from surgery?
- Are you willing to commit to work hard during rehabilitation for a successful recovery?
Discuss your answers with your orthopedic surgeon to learn more about your treatment options.
So you have arthritis in one or both of your knees. Now what?
You have many options to control your pain and stiffness, you just need to find the one that's best for you. Treatments for knee osteoarthritis can include exercise, weight control, physical therapy, medications and surgery, among others.
Medical Treatment:
Depending upon the severity of patient’s condition and the doctor’s judgement various surgical interventions are available. These include:-
- Arthroscopic debridgement : A telescope is inserted into the knee and products of wear and tear are removed .
- High Tibial Osteotomy : The shin bone (tibia) is cut at the end and realigned to distribute the load in a knee . This is possible only in arthritic knees.
- Total knee replacement
- Unicondylar knee replacement
Total Knee Replacement :
Lateral view (Xray). |
Total Knee Replacement :
AP view (Xray). |
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Knee replacement, or arthroplasty of the knee, is a commonly performed operation done to relieve the pain and disability from rheumatoid arthritis or more often osteoarthritis of the knee.
TKR or ‘Arthroplsty’ is relining of the joint (bone and surfaces) with artificial parts called Prostheses. This has a new design called High Flexion permitting near complete range of movement . 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 metal usually Titanium in fixed bearing knees and cobalt chrome in mobile bearing knees. Two varieties of knee design form the base of this component . The polyethylene is attached to the top of the metal to serve as a cushion and form a smooth gliding surface between the metal of the femoral and tibial components.
These components are usually cemented to their respective bones , tough some uncemented models are also available .
The third component , Patella or knee cap, is made up of polyethylene. 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 through medical evaluation. Joint replacement is also being done using computer assistance which improves implant and surgical precision.
Hi-Flex Knees:
A new design called high flexion knees are now being commonly used. These allow patients, near-complete range of movement at the knee. The patients can comfortably sit cross-legged on the bed. It is suitable for patients with slim legs.
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 called Unicondylar Knee Replacement. It can be done in specific conditions, which only the surgeon can judge and advice.
Unicondylar Knee Replacement, is comparatively economical and since the operation is less extensive, the post-operative recovery is faster.
What happens if a patient delays Knee Replacement:
Early diagnosis of knee osteoarthritis (OA) with proper treatment is important for the future of your long-term mobility. If your doctor has recommended a knee replacement, it is important not to delay your surgery. Delaying surgery can lower your quality of life even more than OA does on its own, both before and for up to two years after surgery.Remember, there is no cure for OA and it is degenerative, which means that your pain and limited mobility can get worse over time.
Over the years , we at Mediserve have understood that it is advisable to get the knee replacement done early as even the artificial knee has a life which is about 20-25 years . The normal life span of a human being is about 75-80 years . So if you are advised replacement when you are 55yrs old and you procrastinate the decision for another 10-12 years , not only you will face increase immobility and other symptoms but chances are that you will not be able to enjoy the full life of the implant.
Recovery
Post operative hospitalization varies from one day to seven days on average depending on the health status of the patient and the amount of support available outside the hospital setting. Usually full range of motion is recovered over the first two weeks (the earlier the better). Walking with protected weight bearing begins almost immediately after surgery. At 6 weeks patients have usually progressed to full weight bearing with a cane. Complete recovery from the operation involving return to full normal function may take three months and some patients notice a gradual improvement lasting many months longer than that. Factors such as quad-sparing surgery, pre-operative function, weight, and recovery regimen may shorten or lengthen recovery time.
To receive an approximate idea of cost and other information regarding treatments, please contact us.
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