Why is it needed and what is it

 

Knee joint, being the most complex joint in human body and a weight bearing joint, is prone to wear and tear. Knee degenerative arthritis or osteoarthritis of knee is the leading cause for knee joint replacement surgery. This usually occurs gradually after 50-60 years of age the gravity of the knee problem can differ in different people. Some may have a disabling arthritis in early age whereas some have virtually pain free movement and do not have to depend upon pain medication. When conservative treatment methods fail to provide pain relief and better quality of living, joint replacement prove to be a boon for patients. Indications for knee replacement can be many including difficulty in walking and activities of daily living due to severe pain and swelling in inflammatory and degenerative disorders along with or without deformities like Fixed Flexion Deformity, Varus or Valgus.

 

Total knee replacement, also called total knee arthroplasty involves correction of the deformity by using special measuring devices to cut 6-9 mm of bone from the knee joint and replacing it correct sized implants. It involves correction of all three compartments of the knee namely the medial compartment (inside of the knee), the lateral compartment (outside of the knee) and the patello-femoral compartment (in front of the knee or the knee cap the thigh bone). Total knee replacement in done in patients with arthritic damage of both compartments of knee. In severe arthritis, both medial and lateral side of knee are damaged which give rise to significant erosion and deformity which eventually require repair in both compartments, upper bone (femur), lower bone (tibia) and sometimes patella also. Fixing the implant to the bone can be done through various options including the use of bone cement or bone in growth fixation (providing bony attachment). At present bone cement fixation in knee joint arthroplasty has been giving credible and superior results.

 

We at Gupta Hospital have committed ourselves to give a perfect trouble free and pain-free knee joint arthroplasty experience in our institution.

 

After the first pre-operative OPD consultation with the admitting doctor, a patient who may be advised for knee replacement is thoroughly screened for any other illness and properly assessed regarding his/her fitness for the operation. This requires to take all routine and sometimes special blood and urine lab tests, Chest radiographs, ECG, Echocardiography as well physician and anesthetist opinion. Patients are also educated and counseled by a Counselor or a Physiotherapist and finally by the operating surgeon himself about the do’s and don’ts as well what all to expect after a surgery.

 

All consenting patients are admitted a day before the date of surgery and the patient is then adequately planned for surgery. The choice of chosen implant is shared with the patient and his family. Most current implant system have nearly similar designs and materials and therefore do not differ in terms of long-term or short term results. The surgeon may prefer a implant system due certain technical considerations particular to a certain patient or due to ease of doing surgery due to familiarity with instrumentation of certain implant systems. Patient are shifted to surgery the next day and while it may take 2-3 hours in the operation theater complex the actual surgical time is usally less than 1 hour. The preparation for anesthesia and surgery usually takes up 30-40 minutes and the anesthesia normally preferred is combined spinal and epidural anesthesia. After shifting in the private room the epidural catheter is used to relive all pain post-operatively. We do use a multi-modal analgesia technique to make the experience of the patient a pain-free one. The epidural catheter is normally removed on the first dressing which is on the second day of operation. By the second day most patients are able walk with a a walker support and able to sit in the toilet of their room. Patients are encouraged by the physiotherapist to do certain exercises which gradually advanced each day of the stay. Most exercises to be done by the patients after a Total knee replacement are simple and can be done by the patient himself without any help. Most patients are usually ready for discharge and relived on day 6-7 of surgery but still certain patients who are obese or have been showing sluggish improvement may be discharged late as per their recovery.

 

We at Gupta Hospital are devoted for your complete and faster recovery after a knee replacement surgery.