Knee replacement is required for advanced arthritis of the knee joint, producing painful limitation of movements and restriction in activities of daily living. Knee replacement as a solution should be offered when all non–surgical methods of treatment failed and painkiller medicines and injections also failed to reduce the Knee and hip pains.
Knee replacement can be total or unicondylar, depending on the number of compartments involved. Among the total knee replacement, there are two popular designs- Cruciate Retaining, and Posterior Stabilized. The decision for the design is best taken by the operating orthopedic surgeon based on the integrity of ligaments. Patella resurfacing as a routine is a debatable subject.
Yes, most knee replacement surgeries are minimally invasive, with numerous benefits to the patient, including smaller incisions, less tissue trauma, bleeding and post–operative pain, shorter hospital stays, faster recovery, and earlier return to work and activities — in weeks rather than months. Advantages of Minimally Invasive Knee Replacement Surgery. Patients Start walking in few hours of surgery. Patients start climbing the staircase from second day of his surgery. Patients Discharge with in 3 Days from the Hospital after surgery. No blood loss during the surgery, no blood Transfusion required. Less Physiotherapy.( No Physiotherapist required for home) Less Antibiotic. Stitchless Surgery. Recovery time is just two – three week.
Bilateral knee replacement in the same sitting, can be performed if both the knee joints are damaged to the same extent, however the medical condition of patient, and bone quality must be kept in consideration.
Surgery through Minimally Invasive technique patients start walking on the same day and staircase climbing starts from the second day of surgery. Patients can resume his work after 3 -4 week.
The most significant risks include Infection, Deep vein thrombosis,and Aseptic loosening of implants. The risks correlate with the co-morbid medical condition, and must be discussed with the patient before surgery.
Patients normally require hospitalization for 3-4 days in single knee replacement, and up to 5-6 days in both knee replacement surgery
A single knee replacement takes approximately 90 min- 2 hours. Both knee replacement surgery takes approx 2-3 hours.
Years ago, knee replacement surgery was reserved for elderly patients due to a high complication rate and lack of implant durability. Modern techniques have allowed orthopaedic surgeons to base surgical decisions on a patient’s pain and disability, and not necessarily chronological age. Most patients who undergo knee replacement are between the ages of 50 and 80, but surgeons evaluate patients individually and primarily on their physiologic age and demands.
Patients can resume his/her light work after discharge from the hospital, no need for rest.
Patients are given epidural anesthesia for surgery, and post op pain relief. They are expected to follow instruction from physiotherapist regarding muscle training.
Surgery through Minimally Invasive Technique is Stitch less surgery , patients dont need to come to hospital for removal of stitches.
Under normal circumstances, patients are able to walk without support after 1 weeks in single knee replacement surgery. In both knee replacement surgery, they take approximately 3-4 weeks.
Patients are allowed normal activity after surgery. However, they should avoid high impact sports, running, squatting, cross leg sitting, kneeling. Patients are comfortable to perform walking, swimming, and cycling after surgery.
Due to placement of a foreign implant inside the body, patients should always get a medical opinion in case of any suspicion of infection elsewhere in body, and a proper antibiotic prophylaxis before planned surgical procedures, or even a dental procedure.
The average life of knee replacement is 15 to 20 years. Advanced surface Implants are now available with better biocompatibility and longevity of 30 to 40 years. These implants are made of Ceramic-Gold alloys or have Oxidized Zirconium as their bearing surface.
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