Total Knee Joint Replacement

Knee Joint Replacements are also termed knee arthroplasty, which is done when the knees of a person have stopped working and their working needs to be restored. 

You can also watch this video of Total Knee Replacement Surgery, where Dr Shwetabh Rai talks about when to get a knee replacement surgery.

One of the known hospitals of Varanasi, The Heritage hospital offers the best Knee Joint Replacements to people in India. The Doctors at Heritage Hospitals are specialized in what they do. The OPD department has full-time consultants so that no patient has to wait too much. The department is also well-equipped with modular operation theatres, Critical Care, and Diagnostic facilities.

The foremost priority of Doctors at Heritage Hospitals is to provide the patient best treatments that they deserve. The department is solely dedicated to bones and covers diseases and conditions like:

• Fracture of Bones
• Arthritis
• Joint injuries
• Ligament tears

Knee Joint Replacements are done when the knees are either severely injured or the joints are worn out or if a person suffers from extreme Arthritis.

Knee Replacement involves checking how much movement, strength, and stability is left in your knee joints before going for the surgery. This can be done through X-Rays so that the extent of damage can be exactly determined. If the person must undergo surgery, the damaged cartilage from the thighbone, kneecap, and shinbone is removed and replaced with a prosthesis made of high-quality polymers and metal alloys.

Knee replacement prostheses and the technique of surgery can differ from person to person depending upon the patient’s age, weight, knee size and shape, overall health, etc.

What the Heritage Hospital OPD offers?

As a patient, you need to know what the OPD department has to offer. It has the best facilities and offers:

• Daily Consultation with the patients (Monday to Saturday
• Emergency Consultation 24/7
• ICU Care
• Blood Bank Support
• Fracture treatments by different methods
• Joint Replacements- Knee and Hip
• X-Ray, CT & MRI of Joints and Bones, Arthroscopy
• Bone Tumour Surgeries
• Deformities correction formed in Bones and Joints
• Interarticular Orthoscopic Surgeries

Patients can be assured to get the quality treatment that they deserve with the best facilities at Heritage Hospital.

Anatomy of Knee

Joints in the human body are places where two or more bones meet. Joints in the body can be movable, partially movable, or fixed. The knee is a partially movable joint where two leg bones are held together through muscles, ligaments, and tendons. The bone ends are protected by cartilage which acts as shock absorbers. The knee joints include 2 groups of muscles. These two groups are the quadriceps which straighten the legs and are located in the front and hamstring muscles located at the back and bend the legs at the knees. There is a difference between tendons and ligaments.

Tendons are connective tissues connecting muscles to bones and ligaments are connecting bands joining bones to bones. Ligaments present in the knee joint provide stability, and protection, and limits the movement of the tibia. 

The knee consists of the following parts:

1. The tibia is the larger bone present in the lower leg.
2. The femur is the thigh bone.
3. Kneecap which is known as the patella.
4. The cartilage reduces the friction so that joints keep moving.
5. The synovial membrane seals the joint into the joint capsule. It also consists of synovial fluid which lubricates the joint to keep it moving.
6. The ligament limits the movement of joints and gives them support.
7. Tendons that control joint movements.
8. Meniscus which acts as a shock absorber and deepens the joint.

When is Knee Joint Replacement Needed?

Knee Replacements are of various types and are done under various circumstances. A few Reasons why one can need knee joint replacement surgery include:

• Kneeling for long hours might have damaged your tissues and reduce your mobility.
• Deformed Knee
• Severe knee injuries
• Lack of blood supply because of death of bone in the knee
• Gout
• Arthritis

Types of Arthritis

The condition in which swelling of joints occurs is termed Arthritis. It can be described in more than 100 conditions where Arthritis affects the joints, tissues around the joints, connective tissues, etc. Different types of arthritis have specific symptoms but one common symptom is pain and muscle stiffness.

Different types of arthritis are:

• Osteoarthritis
• Rheumatoid Arthritis
• Gout
• Fibromyalgia
• Childhood Arthritis
• Psoriatic Arthritis

Osteoarthritis

Osteoarthritis is the most common form of arthritis also termed “Wear and Tear” arthritis. It occurs frequently occurs in the hands, hips, and knees.

Rheumatoid Arthritis

Rheumatoid Arthritis is a severe kind of arthritis where your immune system mistakenly starts attacking the healthy cells of your body.

Gout

Gout is a common yet painful form of Arthritis. It affects one joint at a time. Sometimes symptoms are visible and sometimes they aren’t. Visibility of symptoms is called flares and their absence is called remission.

Fibromyalgia

Fibromyalgia is a condition that causes pain in the entire body. Sleep problems and fatigue are the most common symptoms.

Childhood Arthritis

It is a common type of childhood arthritis which can cause permanent damage to the joints and might result in disabilities.

Psoriatic Arthritis

It is a chronic disease marked by the inflammation of the skin and joints and causes immense pain and stiffness in the affected areas.

Types of Knee Replacements

Knee replacement surgery is of varied types and differs for different people and in different situations. Four main Knee replacement surgeries include:

1. Total Knee Replacement: Total knee replacement includes replacing the joint at both your thigh and shin bone. It might also happen depending on what your surgeon suggests that the lower area of your knee cap is also replaced. At times surgeons do prefer preserving the natural patella but this completely depends on the severity of the surgery and the surgeon operating the patient. The new parts are cemented and if not they are coated so that the bone can grow onto it and form a natural joint.
2. Partial Knee Replacement: Partial knee replacements are done mostly in cases of Arthritis. Arthritis affects only one side of your knee and not all three compartments of the knee. So when only the inner side of your knee is affected it is possible to get it partially replaced through a smaller cut. Techniques carried out during partial knee replacements are termed reduced invasive or minimally invasive surgery. It is advisable because it reduces the time taken to recover.
3. Patellofemoral Replacement: If it is just the knee cap that is affected it is possible to replace just them. This is known as Patellofemoral joint arthroplasty. In this type of surgery, just the undersurface of the knee cap and its groove are replaced. However, it is a less preferred operation carried out on 1 out of 40 people. This takes less recovery time but is only done when arthritis doesn’t progress.
4. Complex Replacement: When the arthritis is severe and you already have a prosthesis, then Complex replacement is done. In complex replacement second or third time the knee gets replaced by a new prosthesis. Some other reasons for a complex replacement include severe knee deformity and weakness in the knee ligaments. In these types of knee replacement operations, a longer piece of metal is securely interlocked in the knee joint to provide more stability and to last longer.

How successful Is A Knee Replacement Surgery?

Knee Replacement Surgeries are quite successful and have a positive impact on people. According to a US research agency American Academy of Orthopedic Surgeons, 90% of people who undergo Knee arthroplasty see a subsequent fall in pain and enjoy activities they otherwise couldn’t. For example, walking or golfing.

People have experienced better mobility and life after undergoing Knee arthroplasty and many prostheses last even after 25 years. People have experienced an improvement in stiffness, pain, Vitality, and social functioning.

However, one can experience continued pain after knee arthroplasty and exists till the knee recovers. Continued pain lasts for 2 to 4 months until the knee has healed and the patient has returned to his normal routine. Sometimes patients may experience pain for up to 6 months as well.

How long does it take to recover from Knee Replacement Surgery?

The knee continues to recover internally for two years however after 3 to 6 months of surgery depending on how severe the case was person can go back and resume his normal routine life. Walking and Socialising can be done too.

What is the best age to have a Knee Replacement?

There is no ideal time for knee replacement surgery. It completely depends on the severity of the patient’s problem. If you feel tremendous pain, and your day-to-day work and social life starts getting hindered then you are a perfect fit to undergo that surgery. 

However, people between 50 to 70 years mostly undergo this surgery. However, the rise in the number of patients suffering from arthritis at a young age has led people at a younger age to get a knee replacement. 

A patient who is 45 years or less is however not recommended to get the surgery done at such a young age and should opt for therapy. 

Physical Therapy for Knee Joint Replacement

Physical therapy is extremely essential and plays a vital role in Knee pain and Knee joint replacement. It helps the patients to restore mobility and muscle strength in the knees after it is replaced. Your physical therapists are likely to recommend you a walk for at least half an hour more than twice a day. Physical therapists also recommend various exercises that should be done 2 to 3 times a week or more, but this varies from patient to patient.

Common exercises that can be recommended to you by your therapists to increase muscle strength include straight leg raises, ankle pumps, knee straightening exercises, and more.

It helps to relieve pain in your muscles. Some other ways to relieve pain after knee joint replacement are:

• Going for a walk every day 
• After your daily activities apply a cold pack to the incision area. This helps to reduce pain and stiffness.
• If you feel discomfort in the new leg, elevate your leg above the level of your heart. 
• Try massage therapy to relieve pain and stiffness.
• Try pain medicines as prescribed by the doctor.

Risks involved in the Surgery

Any surgery involves some risks and complications. These aren’t compulsory risks but a few of them are:

1. Infection
2. Bleeding
3. Fracture
4. Blood clots
5. Stiffness
6. Swelling and continuous pain

The joint in the knee that is replaced might not work as intended and have to be replaced if needed. It may also happen that the joint becomes loose or dislodged. It might also happen that in the area that has undergone surgery the veins there are injured or damaged causing numbness. 

These are not the only risks involved and many of them depend on your medical conditions. It is advisable to ask your doctor the same before you undergo the surgery.

What happens before the procedure?

Before you undergo the replacement procedure, following series of steps are to be followed.

1. The doctor explains the entire process and gives you a chance to ask questions in case of any doubts. You can clear all your doubts and get assurance in case you are nervous about anything.
2. After your doubts are clear you are given a consent form. You need to sign the form to give your consent so that the procedure can be carried out on you. One is advised to read the form carefully and ask in case of doubts if something lacks clearance.
3. You will be asked to submit your complete medical history. In addition to this, it may happen that doctor does a complete physical check-up of the patient to be updated with recent reports. 
4. It is very essential to keep your doctor updated on any allergies that you have. If you are allergic to medicines, latex, tapes, or any other thing your doctor needs to be informed.
5. Keep your doctor informed in case you intake any herbs, supplements, or medicines.
6. Also, keep your doctor informed in case of a bleeding history or if you are on medicines used for blood thinning. Aspirin or any other medicines need to stop before the procedure begins and thus your doctor must know of it.
7. In case you are a female and pregnant or suspect any pregnancy you should inform your doctor.
8. Before the procedure begins you might be asked to fast for say eight hours.
9. You may receive a sedative so that you can relax after the surgery is completed. 
10. You need to also essentially meet a therapist to discuss the rehabilitation post-surgery.

Frequently Asked Questions