When should you consider getting a Knee Replacement Surgery?

 If your knee is severely damaged and deformed by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down. If medications, changing your activity level, and using walking supports are no longer helpful, you may want to consider total knee replacement surgery.

A knee replacement surgery should be considered if you have :

• Severe knee pain that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs.
• Moderate or severe knee pain while resting, either day or night.
• Knee deformity: a bowing in or out of your knee.
• Knee stiffness: inability to bend and straighten your knee.
• Failure to obtain pain relief from nonsteroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis.These drugs may become less effective for patients with severe arthritis.
• Inability to tolerate or complications from pain medications
• Failure to substantially improve with other treatments such as injections in the joint, physiotherapy, other surgical procedures like arthroscopy.

Most patients who undergo total knee replacement are age 60 to 80, but orthopaedic surgeons evaluate patients individually. Recommendations for knee replacement surgery are based on a patient's pain and disability, not age

What to expect after a knee replacement surgery?

Following total knee replacement, more than 90 of patients have no pain, or only slight pain, and their walking is no longer limited by their knee. Most patients can live a full and independent life.

The expected outcome of a total knee replacement are, in order of priority:

1. Pain relief

2. Standing and walking that is not limited by the knee

3. Improved knee motion

4. Improved knee strength

5. Correction of the deformed legs

Total knee replacement is major surgery, which usually involves a 3-4 day stay in the hospital followed by rehabilitation period of 2-3 months. A team of health professionals will work with you to guide your recovery, but you are the most important member of the team! We believe that an informed patient is the best ally in achieving success with total knee replacement surgery. Please read the information given below carefully. Share it with your family and friends. The information will guide you in preparing for surgery and it will give you insight into how to maximize your recovery from knee replacement surgery and enjoy many years of painless knee function.

Can both knees be replaced together?

Yes, both knees can be replaced together simultaneously in one sitting if the patient’s general condition is good. Alternatively one knee is replaced followed by the other after an interval of 6-8 weeks. This allows patient some time to recover between the two surgeries.

What does a MIS knee replacement surgery involve?

Minimally invasive Knee replacement surgery (MIS TKR) is a new method of performing Knee replacement using an incision that is half the length of the standard total knee incision.

This technique minimizes muscle cutting thereby reducing the post operative pain, allowing earlier rehabilitation and reducing the duration of hospital stay.

The knee components are same as those used during the traditional surgery but using special instrumentation only a 4 inch incision is sufficient to carry out the surgery. MIS Knee replacement is possible in majority of patients needing knee replacement, exceptions being large legs due to obesity and bulky muscles.

What is the usual postoperative recovery course after Knee replacement?

On 1st postoperative day, the leg is supported in a knee brace and one or two plastic tubes (drains) are placed to drain excess blood from the knee. The patient is given antibiotics, painkillers and a blood-thinning agent. The patient is made to sit up and walk with support the next day. The drains are removed after 24-48 hours. The patient is discharged 5-6 days after the standard TKR and 3-4 days after a MIS TKR operation. The sutures are removed between 10-14 days, and physiotherapy is started to regain knee function. Outpatient physiotherapy may be required for 3-6 weeks.

How much bend will I get after surgery?

Bending(Flexion) in the knee following Knee Replacement Surgery depend on varoius factors like pre surgery movement in the knees, weight of the patient and type of implants used. Patient with good movements before surgery and patients with lean, non-obese legs usually achieve greater bend in their knees following surgery. All other things being equal, High-flex implants allow increased bending in the knee joints (15-20 deg more) as compared to standard implants. Wth standard implants majoruty of patients will achieve 90-120 deg bending, however with Hi-flex implants patient can achieve 140 deg bending, This increased bending allows better functional abilities espectially in climbing stairs and getting in or out of a car.

How long would my new Knees last?

In many ways, a total knee replacement is similar to buying a new car. How long the car lasts depends on how much the car is driven, on what types of roads the car is driven, how heavy the car is, and whether or not the car is properly serviced and maintained. Similarly, how long a total knee lasts depends on how much it is used, what types of activities it is used for, how heavy the patient is, whether the patient has regular check-ups with the doctor and whether the patient is staying in good physical condition.

No two patients are exactly the same and there is tremendous variability in patient activity. In many patients, their total knee replacement will last their lifetime. In others, it may last less than a year. Total knee replacements are designed to provide painless and unlimited standing, sitting, walking, and other activities of normal daily living. They do very well for golf, bicycling and swimming. You should be aware, however, that the longevity of a total knee replacement may be shortened by frequent, vigorous activities.

In the event that a total knee fails, it is possible to implant another knee replacement. In general, the results of revision total knee surgery are not quite as good or predictable as for primary total knee replacements. Revision surgery is more complicated, longer and techinically challenging than primary replacement. Following revision total knee replacement, most patients have good relief of pain and are able to walk as far as they desire.