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Who should have knee replacement surgery ?

No matter what your age, pain in your knees may keep you from activities you enjoy. Problems often build up over a period of time. But you don’t have surrender your life to pain and loss of function. Advances in orthopaedic medical care have made total joint replacement a common and viable option for many suffering from knee joint pain. This surgery has enabled many people who are severely disabled to lead a normal healthy active life.

Surgery is often considered when medications, change in activity level and walking support are no longer helpful. By resurfacing your knee’s damaged and worn out surface, total knee replacement surgery can relieve your pain, correct your deformity and help you resume your normal activities.

What are the alternatives to knee replacement surgery?

Arthritis of the knee is one of the most is debilitating form of arthritis. Routine activities are often painful, even miserable. Climbing a fight of stairs, standing and walking can cause severe discomfort.

The goal in treating arthritis of the knee is to relieve pain and improve mobility. Available treatments include reducing your activity level, maintaining a healthy weight, and physical therapy as well as anti-inflammatory drugs analgesics injections, and nutritional supplements. In India we also consider alternate therapy in the form of ayurveda and homeopathy. Surgery may be considered when these nonsurgical options do not provide relief.

What is involved with knee replacement surgery?

You will be taken to the operating room where you will be given anesthesia to help you sleep through your surgery. The surgeon will make an incision on the front or side of the knee to access the knee joint. Any damaged bone is cleaned away and the new joint is put into place. The incision is closed with staples or stitches. Stainless steel staples are popular with many orthopaedic surgeons because they are easy to put in and take out. They also have a very low risk of allergic reactions by the patient. Some surgeon prefer using sutures that dissolve on their own after several weeks. These stitches are normally put in just under the skin.

What should I expect once I decide to have a knee replacement surgery?

Once your have decided to undergo the surgery and finalized a date for the same your doctor will brief you on what to expect after the surgery.Broadly speaking after the surgery you will not feel the pain of arthritis anymore. However the pain which is a result of surgery will be there and will settle down in a few days. You will start walking with a walker within 24 hours from the surgery and gradually become more and more confident in your activities.

What’s the difference between a cemented and cementless knee ?

A cemented knee replacement uses acrylic bone cement to fix the metal and the plastic surface to your bone.A cementless knee is designed to avoid the use of this acrylic bone cement and has a surface that allows your own bone to grow into the prosthesis (implant) itself and provide stability.

What should I expect after surgery?

You will be transferred from the recovery room to the Intesive Care Unit where nurses will check frequently to ensure that you are comfortable. You will have an IV to receive fluids ,antibiotics and pain medications. You may have very thin tubes going into your groin (Femoral Catheters) which will dispense pain relieving medication and keep you  comfortable. The physiotherapist will start helping you with the exercises as soon as you regain sensations in your legs. You may be made to sit up and stand within a few hours from your surgery. You will begin walking with a walker within 24-36 hours after surgery.  It will be very important for you to work hard at fully strengthening your knees and bending them to about 90 degrees. Before being discharged form the hospital, you will be able to move about on your own with a walker . We will discuss your home recovery and exercise program and assess your ability to manage for yourself before your discharge from the hospital. A physical therapist from the hospital will visit you at home for a few days after your discharge to help you with your exercises and help you in acquiring confidence in performing your activities of daily living independently.

How long does the joint replacement surgery take?

The surgery time varies from patient to patient and can take from 30 min to 45 min per knee. For patients who are having both their knees replaced the total time in the operating room is about one and a half hour.

How many people have had knee replacement?

Knee replacement surgeries are very common, outnumbering hip replacements in India. Millions of people world wide have undergone this procedure.These replacement surgeries typically have excellent long-term result.

What activities can I participate after recover?

We encourage patients to resume a healthy lifestyle after knee replacement surgery. Walking, swimming, cycling and low impact sports are encouraged. Patient may play golf but with some caution. Whether or not patients should participate in more aggressive pivoting sports after knee replacement surgery is controversial and should be discussed with the surgeon.

How old are people who have knee replacement surgery?

The average age of patients who need knee replacement is about 60 years . However , the age range can vary from the 20’s to the 90’s depending on the condition of the knees and associated medical condition of the patient. Typically more than the chronological age the state of the knees of the individual determines the need for this kind of surgery.

How long does the replaced knee last?

Knee replacement can be very durable surgeries, giving years of pain relief to those with arthritis. From studies on the hundreds of thousands of prostheses implanted over the past 30 years, we expect that about 90% of the surgeries performed today will remain successful for at least 25 years. Our longest follow up is 28 years and the patient is still going strong!!!

Why do knee replacements fail?

Knee replacement can fail for several reasons. Infections around the knee implant is one cause of failure. Implant loosening and wearing away of the polyethylene bearing surface are other causes of implant failure.

Are knee replacement and revisions covered in my insurance plan?

Most insurance companies will cover elective total joint replacement at the present time. Some may require pre-authorizations or a second opinion prior to allowing the procedure to be performed. Depending on their insurance coverage, many patients may be required to make a co-payment or pay a part of the bill for the procedure.