Knee Replacement Surgeries and Technique at World's Best Hospitals in India

Knee replacement surgery

Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

What is the cause of knee joint disintegration?

One of the major reasons that affect the knee joint and hinder routine activities is Arthritis. The slowly wearing condition of the tissue on the ends of the bones leads to reduction of joint space, severe joint pain, regular shifts in bone movement and friction in the exposed bone surface. There are three types of arthritis:-

Osteoarthritis

Osteoarthritis occurs from ‘wear and tear’ and is the most common reason for the total knee replacement. It usually occurs after the age of 50 and is a genetic problem. When the tissue covering the bones softens and wears away, the bone began to rub against each other and leads to severe pain.

Rheumatoid Arthritis

When the tissues surrounding the bone releases excessive fluid due to inflammation, it causes damage to cartilage and other parts of the joint and causes pain and stiffness.

Traumatic Arthritis

This type of arthritis usually occurs after a serious knee injury. Due to the knee fracture, the connective tissue and the tissue covering the ends of the bone wears away, resulting in pain and stiffness.

Types of Knee Replacement Surgery

There are two main types of surgery, depending on the condition of the knee:

•Total Knee Replacement (TKR) – both sides of your knee joint are replaced

• Partial (half) Knee Replacement (PKR) – only one side of your joint is replaced in a smaller operation with a shorter hospital stay and recovery period

Knee surgery is recommended for older people, although adults or teenagers of any age can be candidates for the procedure, since they are physically active and will more rapidly wear the joint out. The weight, gender, or age of the person is never a factor when considering knee replacement surgery. When considering the option of knee replacement surgery, doctors take into account a number of symptoms:

• Severe knee pain or stiffness: Do symptoms seriously undermine the patient's ability to carry out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair, etc?

• Moderate but continuous knee pain: Is pain present while sleeping or resting?

• Chronic knee inflammation and swelling: Does the swelling not improve after taking medications or resting? Do drugs cause unpleasant side effects?

• Knee deformity: Is there is a noticeable arch in the inside or outside of the knee?

• Nothing else worked: The doctor has prescribed medications and physical therapy without any substantial improvement.

Knee Replacement Surgeries and Techniques Available in India

Total Knee Replacement : Also called total knee arthroplasty, this surgery is for people who have extensive damage in several parts of their knee. The surgeon removes the diseased cartilage, as well as some of the underlying bone, and then fuses an artificial joint to the bone that remains.

Partial Knee Replacement : If the cartilage in just one of the knee's sections becomes damaged, Mayo Clinic surgeons can sometimes replace just the damaged section instead of the whole knee joint. Recovery is easier than with total knee replacement, but the results may not last as long, because arthritis could develop in other areas of the knee.

Minimally Invasive Surgery : Minimally invasive techniques allow surgeons to replace a knee using smaller incisions. This usually results in less pain and a quicker recovery. But minimally invasive knee replacement requires special surgical training, and it may not work for everyone. Your orthopedic surgeon will determine whether you're a good candidate for the minimally invasive approach.

Bilateral Knee Replacement : Having both knees replaced at once can reduce the overall time spent in rehabilitation following surgery, but it's not recommended for some people, such as those with heart or lung disease.

Rotating Knee Replacement

With the Rotating Knee Replacement, the metal implant installed not only move back and forth but can also rotate inwards and outwards. This procedure has been designed to replicate the rotating motion of a normal knee joint.

Oxinium Total Knee Replacement

In Oxinium Total Knee Replacement, the surgeons treat the knee injuries in young men and women. Owing to their high activity levels, most conventional knee implants last only for 10 to 15 years. Oxinium knee implants offer a durability of 30 to 35 years at at a stretch. These implants are designed of metal composites made up of ceramic and coated with oxygen which made them extremely durable and long lasting.

Benefits and Post Operative Care

The advantages of Total Knee Replacement are pain relief, improved mobility and improved quality of life. During your stay in the hospital, a physiotherapist will teach you exercises to make your knee stronger. You stay in the hospital will not be more than 6 to 10 days. Usually, patients who undergo half knee replacement have a shorter hospital stay.

FAQ's For Knee Replacement Surgery in India | Best Orthopedic Hospital in India

Q. How do I know I need a Total Knee Joint Replacement Surgery?

A. If you have knee deformities or severe X-ray changes, or advanced symptoms of arthritis, you require a total knee replacement surgery.

Symptoms of advanced knee arthritis are pain, crepitus, stiffness, limping, muscle weakness, limitation of motion, and swelling. Total Knee replacement surgery is generally delayed by the doctors in favor of less invasive procedures. But, if you have difficulty walking or performing everyday activities such as getting dressed, you do require knee replacement surgery. Total knee replacement surgery offers great relief from pain and it restores normal activities in life.

Q. How common is total knee replacement surgery?

A. Knee replacement is a routine surgery performed on over 650,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

Q. How old is the average patient for knee joint replacement surgery?

A. The average knee joint replacement patient is around 65-70 years old; however patients of all ages have received knee implants.

Q. What is a total knee replacement surgery?

A. The total knee replacement surgery involves resurfacing the parts of the bones of the knee that rub together with metal and plastic implants. Using special, precision instruments, the surgeon will remove the damaged surfaces of all three bones. The replacement surfaces will then be fixed into place. 

The surface of the femur is replaced with a rounded metal component that comes very close to matching the curve of the natural bone. The surface of the tibia is replaced with a smooth plastic component. This flat metal component holds a smooth plastic piece made of ultra-high-molecular-weight polyethylene plastic that serves as the cartilage. The undersurface of the kneecap may also be replaced with an implant made of the same polyethylene plastic.

Q. Are all knee joint replacements the same?

A. No, there are six different types of knee replacements:

• ·         Uni-compartmental
•        Posterior cruciate ligament (PCL) retaining 
•         Posterior cruciate ligament (PCL) substituting
•         Rotating platform
•         Stabilized
• ·         Hinge

These different prostheses can be made of cobalt chrome, titanium, and polyethylene (plastic), and can be fixed to the bone with acrylic cement or can be press-fit, which allows bone to grow into the implant. Use of a particular implant design, material, and fixation method depends on many factors related to each individual patient.

Q. Which knee replacement is ideal for me?

A. The type of knee replacement and implant best suited for depends on your age, the degree of involvement of each of the three compartments of your knee, choice of your orthopedic surgeon and your level of activity. This would be discussed with you and analyzed by your surgeon before you choose to come here for the surgery.

Usually, total knee replacements are ideal for severe osteoarthritis affecting all the three compartments of your knee and rheumatoid arthritis.

Q. How is the knee replacement surgery done?

A. The knee replacement surgery starts with an incision over the knee that exposes the joint. The special precision guides and instruments are used to remove the damaged surfaces and shape the ends of the bones to accept the implants.

The implants are then secured to the bones. When the surgeon is satisfied with the fit and function of the implants, the incision is closed. The surgery takes two to tree hours to complete, which varies from patient to patient.

A bandage is applied and a special drain is usually inserted into the wound to drain the fluid that naturally develops at the surgical site. You would then be taken to the recovery room, where you would be closely monitored. When you regain consciousness, you would be taken to the hospital room, where a nurse would be with you. You would also be given pain killers and the knee might remain swollen for a few days.

Q. How is the knee rehabilitation done?

A. A total knee replacement rehabilitation program is begun after the surgery.

To help regain strength, balance and range of movement in your knee, a specifically designed rehabilitation programme is started when you are back in the hospital room. The physical therapist will help you perform appropriate exercises. About 24 hours after surgery, you will probably be asked to stand.

Within the next 24 hours, you will probably begin to walk a few steps with the help of a walker. You can expect to stay in the hospital for about five to six days after your surgery. You may or may not be transferred to a rehabilitation facility for a few more days, as determined by your surgeon. Your bandages and sutures will usually be removed before you leave the hospital. At home, you will need to continue your exercises.

Q. When can I return to normal activities after knee joint replacement surgery?

A. Most patients start walking with the cane within six weeks of the surgery. Few patients also start driving within seven to eight weeks after surgery.

But, there are some precautions to be taken even after you have fully recovered. One should not put excessive strain on the knee like jogging, skiing, high impact aerobics and other sports which put strain on the knee joint.

Q. What precautions do I need to take after knee replacement surgery?

A. Though this is not an exhaustive list of the precautions, these are the general guidelines to be followed after the surgery. The surgeon and the physical therapist will guide you in details about the do's and don'ts after the surgery

·         Avoid heavy lifting and excessive stair climbing

·         Maintain appropriate weight

·         Avoid "impact loading" sports such as jogging, downhill skiing and high impact aerobics, twisting or impact stresses.

·         Consult your surgeon before beginning any new sport or activity

·         excessive bending when weight bearing, like climbing steep stairs

·         not lift or push heavy objects

·         Do not kneel

·         Avoid low seating surfaces and chairs.

Q. What is the life of a replaced knee?

A. The longevity of the prosthetic varies with every patient depending upon physical condition, activity level, weight as well as the accuracy of implant placement during surgery.

Though total knee replacement has become a common and predictable surgery, with very high success rates, it should be kept in mind that there is no guarantee that a prosthetic joint will last the rest of patient's life.

As with any mechanical joint, the knee components move against each other. Natural fluid in the joint space, called synovial fluid, helps to lubricate the implants just as it lubricates the bones and cartilage in a natural joint. Still, the prosthetic components do wear as they roll and slide against each other during movement. As with car tires or brake pads, the rate of wear depends partly on how the knee joint is used. Activities that place a lot of stress on the joint implants, as may be the case with heavier and more active patients, may reduce the service life of the prosthesis. Implant loosening and wear on the plastic portions of the implant can lead to the necessity for revision surgery to replace the worn components, or all of the components.

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Some of the Most Important Benefits of Knee Replacement Surgery

Your knee joint is made up by the lower end of your thigh bone (femur) and the upper end of your shin bone (tibia). These normally glide over each other easily because they are covered by smooth cartilage. If your cartilage is damaged by injury or worn away by arthritis, it can make your joint painful and stiff . A new knee joint will usually improve your mobility and reduce pain, although your new knee won’t be able to bend quite as far as a normal knee joint.

Depending on the condition of your knee joint, you may need to have part, or all, of your knee joint replaced. If you have arthritis just in one area of your knee joint, usually the inside part of the joint called the medial compartment, you may be offered a partial knee replacement (called a unicondylar knee replacement). However, a total knee replacement is more common. Artificial knee parts are almost always made of metal (on the femur side) and plastic (on the tibia side) and a knee replacement can last for up to 20 years. 4

Knee Replacement Surgeries :

Total Knee Replacement : Also called total knee arthroplasty, this surgery is for people who have extensive damage in several parts of their knee. The surgeon removes the diseased cartilage, as well as some of the underlying bone, and then fuses an artificial joint to the bone that remains.

 • Partial Knee Replacement : If the cartilage in just one of the knee's sections becomes damaged, Mayo Clinic surgeons can sometimes replace just the damaged section instead of the whole knee joint. Recovery is easier than with total knee replacement, but the results may not last as long, because arthritis could develop in other areas of the knee.

 • Minimally Invasive Surgery : Minimally invasive techniques allow surgeons to replace a knee using smaller incisions. This usually results in less pain and a quicker recovery. But minimally invasive knee replacement requires special surgical training, and it may not work for everyone. Your orthopedic surgeon will determine whether you're a good candidate for the minimally invasive approach.

• Bilateral Knee Replacement : Having both knees replaced at once can reduce the overall time spent in rehabilitation following surgery, but it's not recommended for some people, such as those with heart or lung disease. 

Some of the most important benefits of knee replacement surgery include:

1. Dramatic reduction in knee pain & increased activity levels- Total Knee replacement surgery makes you regain your lost mobility & helps you do your everyday activities like walking, shopping, visiting friends, household chores, etc. by taking care of the culprit- severe knee pain. According to the American Academy of Orthopaedic Surgeons (AAOS), more than 90% of total knee replacement patients experience a dramatic reduction of knee pain & thus much improved quality of life.
2. Increased Range of Motion at Knee joint- The Range of Motion (ROM) refers to the distance and direction a joint can move to its full. Severe Osteoarthritis of the knee limits the joint’s ROM to a large extent & thus limits the functions that knee can perform. Once the worn out parts of the joint are replaced after the surgery, the ROM of is restored & thus you can perform the normal functions again.
3. Correction of Deformity & Stiffness- Severe Osteoarthritis may lead to either bowlegs or knock knees deformity, which is corrected after the knee replacement surgery
4. Peaceful sleep- Once you get relief from the severe knee pain after the joint replacement surgery, you would also have peaceful sleep at night & there would no more be pain waking you at night
5. Improved Sexual life- Studies have shown that more than 90% of patients in the younger age group of 55-60 years undergoing knee replacement surgery have improved overall sexual function, including frequency and duration.

With an overall increase in Total Knee replacement surgeries, India has emerged out as the hub for the procedure. Indian Joint replacement surgeons are considered among the best orthopedic surgeons in the world. They are board certified & extensively trained and have years of experience behind them in performing the procedure. The knee replacement surgery in India reviews, are excellent & International patients travelling to India are all praise for Indian doctors.

Besides excellent facilities & highly trained doctors, Total knee replacement surgery cost in India is also a very lucrative factor which attracts a lot of medical tourists in India. The Knee joint replacement surgery cost in India is as less as USD 5,000 for a single joint & USD 8,500 for both joints. The cost of knee replacement surgery in India thus works well for those people also who are on a tight budget but want to get relief from their knee joint problems.