Q. What is Total Knee Replacement?
Ans. Knee replacement, or knee arthroplasty, is a surgical procedure to replace the degenerated, weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for age related. Common Indications for surgery are:
- -PRIMARY OSTEOARTHRITIS
- -RHEUMATOID ARTHRITIS
- -PSORIATIC ARTHRITIS
- -POST TRAUMATIC ARTHRITIS
- -POST INFECTION ARTHRITIS
In general Total Knee Replacement consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
Q. WHEN TO GO FOR KNEE REPLACEMENT SURGERY
Ans. When the pain is incapacitating, continuous even at rest & hinders in our daily activities. When the alignment of the limb changes and deformity is obvious puts strain on our other lower limb joints and spine.
BENEFITS OF THE TOTAL KNEE REPLACEMENT SURGERY.
- Freedom from pain
- Improved mobility
- Improved quality of life because everyday activities and exercise are easier.
- Better social & emotional outcome
- Controlling/ Treating the co-morbidities like hypertension, diabetes & chest complications which are very common in this age group in which this surgery is required & walking works as a medicine in such situations.
SURGICAL TECHNIQUE FOR TOTAL KNEE REPLACEMENT
The knee joint is exposed by a midline incision.
After soft – tissue release, patella is displaced to one side of the joint allowing exposure of the distal end of the femur and the proximal end of the tibia. The degenerated articular cartilage, anterior cruciate ligament , the posterior cruciate ligament are removed but tibial & fibular collateral ligaments are preserved. Minimal portion of the ends of the bones are accurately cut. After proper preparation of the cut ends of the tibia & femur the corresponding metal components are impacted by using polymethylmethacrylate (PMMA) cement. Surgical site is closed back in layers after checking the alignment & tracking of the patella.
THE RESULTS OF TOTAL KNEE REPLACEMENT IN SIR GANGA RAM HOSPITAL,NEW DELHI
Dr. Deepinder Chaudhary, Associate Professor & Consultant in the department of joint Replacement & Reconstruction surgery is vastly experienced with over 10 years of Experience and having an experience of over 5000 surgeries. Improved & improvised surgical techniques including minimal invasive technique of Joint Replacement surgeries by Dr. Deepinder Chaudhary has grotesquely improved the surgical & functional outcome in all our patients. Our surgical technique has provided bloodless & painless surgery to our patients. We are using the best available implants in the world which provides squatting & gives full range of motion that is 0 – 135 deg. After this surgery patient gets U – turn in their lives and they lead a fruitful & meaningful life thereafter.
Q. Do I need knee replacement?
Ans. It depends on extent of pain and difficulty in walking. Your problem is correlated to x-ray finding and advice is given accordingly. It you who is suffering from pain and you are as much a party in decision making as your doctors
Q. Can I get both knees operated at the same time?
Ans.If depends on how badly both knees are affected and your medical status is good, we perform knee replacement both knees is one sitting.
Q. Do I need computer assisted or navigation/MIS for my knee replacement?
Ans. For routine knee replacement, available jigs are extremely good and accurate only in complex deformities of thigh and leg bone , computer assistance help may be required. Computer navigation is an evolving technology and needs time .to achieve perfection on all cases. Whereas long incisions were used previously, we now utilize appropriately small incisions with the help of MIS jigs.
Q. Is Knee Replacement painful?
Ans. These are modern methods available for pain relief such as continuous epidural infection, patient controlled Anesthesia (PCA) and cocktail of certain drugs which can control porn very effectively.
Apply cold compresses around knee also helps in reducing swelling and pain.
Q. Can I get full bending (flexion) of knee after surgery?
Ans.There are reports in media that some knee implants capable of giving high flexion or full bending of knee. Degree of movement achieved depends on how much movements you have before surgery, your weight and good technique of surgery. Surgery is likely to increase your knee movements. Implants can only absorb high stresses associated with full movements.
Q. Should I sit cross legged on the floor?
Ans. Knee replacement implants are bonded to the bone with bone cement. Even though most patients achieve capability to sit cross legged, we do not recommend this to prevent excessive stresses on bonding of implant to bone. This way life of the replacement can be increased significantly.
Q. Do I need physiotherapy?
Ans.Physiotherapy is important in getting early mobilization and good Knee movements. Physiotherapy starts immediately after surgery. You may need physiotherapy for 4 to 6 weeks. This can be organized at your home or nearby clinic also.
Q. How soon will I recover from my surgery?
- Ans.After single knee replacement, you can stand with assistance of physiotherapist, 1 - 2 days after surgery and start mobilizing with walking aid.
- You can use toilet seat (raised) 3 - 4 days after surgery.
- By the time you get home, you should be able to go to toilet independently with walking aid.
- You will need to use crutches or walking frame for 2 - 4 weeks.
- If will take 8 - 1 2 weeks to achieve full benefit of surgery.
- In case both knees were done together, the process is a little slower but same principles are followed.
Q. How frequently do I need to visit the hospital?
Ans.You will come to hospital 10 days after surgery for stitch removal. After that we may see you 2 - 4 weeks later to see the progress. Other visits after 3 months, 1 year after surgery unless medical condition dictates otherwise.
Q. Is Knee "Replacement detetected by a metal detector?
Ans.Yes. Please collect a credit card shaped certificate from orthopedic office certifying that you had joint replacement. This can be shown to the security staff.