Knee Replacement Surgery In India – Types And Procedure

Posted By: admin | Posted on: 06 July, 2017 07:07 am

Diagnosis of knee pain to know if you require knee replacement surgery in India
Person Suffering Form Knee Pain In Everyday Activity

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What is Knee Replacement Surgery?

Knee Replacement surgery, also known as Total Knee Arthroplasty (TKA), is a surgical procedure where the damaged cartilage and the bone from the surface of the knee joint is replaced with artificial components. Knee Replacement Surgery in India is performed on people of all ages except children, as the bones of children are still growing.

The knee functions as a hinge between femur (thigh bone), the tibia and the fibula (lower leg bone). The surfaces of these bones wear out over time in case of arthritis or other such conditions that cause pain and swelling. The main goal of knee replacement surgery is to relieve pain, improve quality of life and improve knee function.

What causes Knee Pain?

Osteoporosis - Main Cause Of Knee Pain In Older People and sometimes it requires knee replacement surgery
Osteoporosis – Main Cause Of Knee Pain In Older People

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Temporary knee pain is different from chronic knee pain. Temporary knee pain is a result of an injury or accident. Certain medications can treat it.

On the other hand there is chronic knee pain which is long term knee pain. It can cause swelling or sensitivity in one or both the knees. There are many conditions which cause chronic knee pain and therefore many treatments exist.

  • Osteoarthritis: This is a type of arthritis which is related to age. Osteoarthritis is normal wear and tear of knee joint. It is caused by inflammation, breakdown and gradual and eventual loss of cartilage in the joints. The result is more friction and pain. It mostly affects people aged over 50 years. But younger people may also have it.
  • Rheumatoid arthritis: Also called inflammatory arthritis. The membrane around knee joint becomes thick and inflamed.
  • Post-traumatic arthritis: It is due to severe knee injury. When the bones around the knee breaks or the ligaments tear. Eventually affects the knee cartilage.
  • Tendinitis: It is the condition where people suffer from pain in the front of the knee, which worsens while climbing, taking stairs etc.
  • Bursitis: Condition which causes inflammation by repeated overuse or injury of the knee.
  • Chondromalacia patella: Damaged cartilage under the kneecap
  • Baker’s cyst: A buildup of synovial fluid behind the knee.
  • Dislocation: Dislocation of the kneecap due to trauma.
  • Meniscus tear: A rupture in one or more of the cartilage in the knee.
  • Torn ligament: Tear in one of the four ligaments in the knee.
  • Bone tumours: Osteosarcoma (second most prevalent bone cancer).

 

Diagnosing chronic knee pain:

Each chronic knee pain requires different diagnostic tests. These tests include: blood work, X-ray, CT scan, MRI, Physical examination etc.

 

How to treat chronic knee pain?

  • Physical therapy
  • Medication
  • Surgery
  • Injections

Some knee pain especially due to osteoarthritis will be permanent. This is because it damages the structure of the knee. It requires surgery or other type of extensive treatment. Some types of knee pain can be treated just by changing the lifestyle and using the above mentioned treatments.

 

How do I prevent chronic knee pain?

You can prevent some of the possible causes of knee pain. However, you can not prevent chronic knee pain. If your chronic knee pain worsens due to overuse, you might want to change your lifestyle. Following are the approaches:

  • Warm up before exercise
  • Try low impact exercises (like swimming and bicycling)
  • Lose weight
  • Walk down hills because running puts extra force on the knee
  • Walk on paved surfaces
  • Get support like shoe inserts
  • Replace your running shoes

 

Knee Replacement surgery is suitable for patients who experience:

  • Daily Pain
  • The pain is severe enough to restrict work.
  • Stiffness in the knee
  • Instability of the knee
  • Deformity (knock-knees or bow-legs) that hinders normal functioning of the knee
  • Damage due to Rheumatoid arthritis, Post-traumatic arthritis, Osteoarthritis etc.

 

What are the benefits of knee replacement surgery?

Benefits of knee replacement surgery-ease in doing everyday activity
Benefits of Knee Replacement Surgery

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  • Pain Relief
  • Improved mobility
  • Improved quality of life

 

What are the different types of Knee replacement surgeries?

Total knee Replacement (TKR):

The traditional method of repairing the damaged knee is TKR surgery. Surgery involves the replacement of both sides of the knee joint. The surgery lasts between 1-3 hours. The individual will have less pain and better mobility.

The surgeon removes all weight bearing, damaged knee cartilage and bone. Replaces it with a manmade metal or plastic prosthetic joint that replicates the knee function.

Partial Knee Replacement (PKR):

PKR or Uni Compartmental Knee replacement is an option if only one part or compartment of the knee is severely damaged. During PKR, the surgeon removes the arthritic portion of the knee including bone and cartilage. Replaces that compartment with metal or plastic components.

Surgeons usually perform PKR on younger patients (under age 65) who have plenty of healthy bone remaining.

Minimally invasive Knee Replacement (MIS):

MIS uses specialised surgical techniques that allow a 3-5 inch incision. This procedure reduces trauma to tissue, lessens pain, and decreases blood loss—consequently speeding recovery. However, hospital stays are from 1-3 days.

Revision Knee Replacement:

Revision knee replacement is for removing and replacing a prosthetic knee joint that is worn out or that has failed. It can be repeated multiple times. But scar tissue formation from previous knee surgeries can make the procedure increasingly difficult with each replacement event.

Computer assisted Surgery (CAS):

It is a computer-driven technology that uses computer guided imagery during surgery. The computer helps the surgeon align the knee components more precisely in the bone. Also, increases the odds that the device will work effectively. A more precise fit can also reduce wear and increase the longevity of the new joint.

Bilateral Knee Replacement:

For those who have both knees equally affected by cartilage damage and decreased mobility, bilateral knee replacement is an option. Both knees undergo any of the above mentioned knee replacement type surgeries at the same time.

How do I Prepare for Knee Replacement Surgery In India?

Before the surgery:

Before the knee replacement surgery the surgeron takes physical examination of patients knee to see the working of knee
Physical Examination Of The Patients Knee Before Knee Replacement Surgery

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  • The orthopaedic surgeon takes your medical history before the procedure. Also, they perform the physical examination. This determines the range of motion, stability and strength.
  • You need to undergo X-Ray exam to determine the extent of the knee damage.
  • You need to undergo a full medical exam, including blood tests, an electrocardiogram and a urine test before surgery.
  • Knee replacement surgery requires anaesthesia to make you comfortable during surgery.
  • You need to give personal preference to choose the type of anaesthesia.
    • General anaesthesia renders you unconscious.
    • Spinal or epidural anaesthesia, during which you are awake but can’t feel any pain.
  • Your doctor may advise you to stop taking certain medications and dietary supplements before the surgery.

 

During the surgery:

  • The doctor attaches several monitors to your body so as to make sure your heart rate, blood pressure and blood oxygen levels are at safe level.
  • Artificial knee joints are typically made of metal and plastic. Metal alloys parts replace the damaged thighbone and shinbone. High density plastic on the shin component replaces lost cartilage.
  • During the surgery your knee is in bent position to expose all the surfaces of the joint.
  • The surgeon makes an incision between 6 and 12 inches in length.
  • Then they moves aside your kneecap and cuts away the damaged joint surfaces.
  • They take measurements to ensure a good fit for your new prosthesis and smoothes your bones’ rough edges.
  • The surgeon inserts the prosthesis. They then rotate your knee to test the balancing and functionality. Then they close the incision.
  • The surgery will last for 2-3 hours.

After surgery:

Hospital Staff Encouraging Patient to Walk After Knee replacement surgery
Hospital Staff Helping Patient To Walk

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  • After surgery, you will be taken to the recovery room for 1-2 hours.
  • You will have to stay in the hospital room, as advised by your doctor, for a couple of days before going home.
  • You will feel some pain, but medicines will help you through that pain.
  • During your hospital stay you the staff will encourage you to move your foot and ankle. This will increase blood flow to your leg muscles and prevent swelling and blood clots.
  • You may need to wear support hose or compression boots to further protect against swelling and clotting.
  • The day after surgery, a physical therapist shows how to exercise your new knee.
  • During the first few weeks after surgery, you are more likely to experience good recovery if you follow all the instructions.
  • Your physical activity program needs to include:
    • A graduated walking program – first indoors then outdoors
    • Slowly resuming other normal household activities. It includes walking up and down the stairs.
    • Knee strengthening exercises you learned in the hospital.

What are the types of prostheses used in knee replacement surgeries?

Knee Prosthesis is a combination of metal and plastic
Knee Prosthesis Used In Knee Replacement Surgery

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  • Most prostheses parts are made from a combination of metal and plastic. But a surgeon might also use prostheses that are all metal, all ceramic, or ceramic and plastic.
  • Another difference is how they are affixed to the bone. Components may be attached with bone cement or they may be “cementless,” allowing existing bone to grow into them.

 

How do I recover at home after knee replacement surgery?

After Knee Replacement surgery You Need To use Supports To Walk
After Knee Replacement Surgery

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According to American Association of Hip and Knee Surgeons (AAHKS), it can take up to 3 months to recover completely from a knee replacement surgical procedure.

The doctor may ask you to:

  • Take iron supplements to aid wound healing and muscle strength.
  • Not to bend down and lift heavy objects.
  • Not to stay standing still for long periods, as ankles might swell.
  • Use crutches and a waking stick.
  • Use all medications according to the instructions.
  • Carry out the recommended exercises.
  • Keep the affected leg raised on the footstool while sitting.
  • To avoid soaking the wound until the scar is completely healed. To avoid the risk of infections.
  • Monitor for any signs and symptoms of infections, blood clots etc.

After surgery, if you have any unexplained pain, swelling, or redness. You should see your doctor as soon as possible.

 

Risks and Complications:

Complications can be medical or local complications specific to the knee.

Medical complications may include those of anaesthetic and your general wellbeing.

Medical Complications include:

  • Allergic reactions to medications
  • Blood loss requiring transfusion with its low risk of disease transmission
  • Heart attacks, strokes, kidney failure, pneumonia, bladder infections. Complications from nerve blocks such as infection or nerve damage.

Local Complications:

  • Infection: Infection rates vary. If it occurs, it can be treated with antibiotics. But may require further surgery. It is very rare.
  • Blood clots: These can form in the calf muscles and may travel in the lung. If you get calf pain or shortness of breath at any stage, you should notify your doctor.
  • Stiffness in the knee: Ideally the knee should bend beyond 100 degrees. But on occasion, the knee may not bend as expected.
  • Wear: The plastic liner eventually wears out over time. It requires replacement in over 10-15 years.
  • Wound irritation and breakdown: The operation will always cut some skin nerves, so you will have some numbness around the wound. This does not affect the function of joint. You can get some aching around the scar.
  • Cosmetic appearance: The knee may look different than it was because it is put into the correct alignment to allow proper function.
  • Leg length inequality: This is due to the fact that a new knee is straighter and is unavoidable.
  • Dislocation: The ends of the knee joint lose contact with each other or the plastic insert can lose contact with the tibia (shinbone) or the femur (thigh bone). This happens rarely.
  • Patella problems: Patella can dislocate.
  • Ligament injuries: The ligaments can be torn during surgery or break or stretch out any time afterwards. You may need to undergo surgery to correct this problem.
  • Damage to nerves and blood vessels: It happens rarely during the surgery. It can be repaired. But sometimes it requires second operation. Nerve damage causes numbness. Also affects the movement of the knee.

 

Knee Joint Replacement Surgery Cost In India:

The cost of knee replacement can vary depending on doctor’s fees, hospital charges and the choice of implant etc.

A bilateral knee replacement can be carried out in a single sitting or staged. It depends on the patient’s health and condition of joint.

It is helpful for the patients to have detailed information about the pre and post-operative costs. Also, the cost of medications, physiotherapy etc.

Surgery cost includes:

  • Surgeon’s, assistant’s and Anaesthesiologist’s fees
  • Operation theatre charges
  • Implant cost
  • Surgery consumable charges
  • Medicines
  • Blood tests etc.

Knee replacement post-surgery cost:

  • Medications for pain relief
  • Physiotherapy and other rehabilitation
  • Consumables and cost of safety etc.

To know more about knee replacement costs in India Click here.

To check the cost of knee replacement surgery in your nearby clinic and hospitals click here.

Also, for quality and affordable Medical services provided by the best doctors near you, visit ChooseDoctor.

 

Other Useful Links:

Knee Replacement Surgery Cost In India

Reference:

Knee Replacement Surgery in  India

Chronic Knee Pain

Knee Replacement Surgery: What You Need To Know

Facts And Considerations For Total Knee Replacement

A Guide To Knee Replacement Cost In India