Total Knee Replacement In Nashik

Total Knee Replacement

Introduction

A Total Knee Replacement (TKR) or Total Knee Arthroplasty is a surgery that replaces an arthritic knee joint with artificial metal or plastic replacement parts called the ‘prostheses'.

The procedure is usually recommended for older patients who suffer from pain and loss of function from arthritis and have failed results from other conservative methods of therapy.

The typical knee replacement replaces the ends of the femur (thigh bone) and tibia (shin bone) with plastic inserted between them and usually the patella (knee cap).

What is Arthritis?

Arthritis is the scientific term for wear and tear of the joint.

As we age, the smooth gliding surface of the knee joint, which is also called as cartilage, starts getting thinner due to constant use throughout our life time. This process is continuous and irreversible and gradually the entire thickness of the cartilage is lost.

The purpose of the cartilage is to serve as cushion between the bones and to provide a frictionless gliding surface.

Once the cartilage gets worn out completely, the thigh bone (Femur) directly touches the shin bone (Tibia). At this point, patients start getting severe knee pain and the only option to treat this pain is to perform a Total Knee Replacement (TKR) surgery.

Arthritis In Nashik

Symptoms of Arthritis

  • Pain on walking or prolonged standing
  • Pain at night
  • Swelling in the knee joint
  • Bowing of the legs

Diagnosis

The diagnosis of osteoarthritis is made on history, physical examination & X-rays.

Benefits

  • Relief of pain
  • Improvement in movements of the knee
  • Straightening of the legs
  • Improvement in the ability to walk, climb stairs
  • Re-establishment of normal pattern of walking

Surgical Procedure

Surgery is performed under sterile conditions in the operating room under spinal or general anaesthesia. Surgery takes approximately two hours.

The surgeon cuts down to the bone to expose the bones of the knee joint.

The damaged portions of the femur and tibia are then cut at the appropriate angles using specialized jigs. Trial components are then inserted to check the accuracy of these cuts and determine the thickness of plastic required to place in between these two components. The patella (knee cap) may be replaced depending on a number of factors and depending on the surgeon's choice.

The real components are then inserted with or without cement and the knee is again checked to make sure things are working properly. The knee is then carefully closed and drains usually inserted, and the knee dressed and bandaged.

Post-Operation Course

Once stable, you will be taken to the ward. The patient is allowed to sit out of bed and start moving you knee and walking on it within a day or two of surgery. The dressing will be reduced usually on the 2nd post op day to make movement easier. Rehabilitation and mobilization will be supervised by a physical therapist.

Usually, patients will remain in the hospital for 5-7 days.Patients are discharged on a walker or crutches and usually progress to a cane at six weeks.

The surgical stitches are sometimes dissolvable but if not, are removed at approximately 12-14 days after surgery.

Bending your knee is variable, but by 6 weeks should bend to 90 degrees. The goal is to obtain 110-115 degrees of movement. Physiotherapy exercises are essential for achieving satisfactory movements of the knee.

Patients are allowed to take bath once the stitches are removed and the wound has healed.Patients are allowed to drive once they have obtained satisfactory control which is usually 6 weeks from surgery.

Patients usually have a 6 week check-up to assess their progress in terms of movements of the knee, pain and the ability to do routine activities. Patients are encouraged to continue to follow-up with the surgeon for the rest of their life to check the knee and take X-rays. This is important as sometimes the knee can feel excellent but there can be a problem only recognized on X-ray.

Summary

TKR is one of the most successful operations available today. It is an excellent procedure to improve the quality of life, take away pain and improve function. In general 90-95% of knee replacements survive 15 years, depending on age and activity level.Satisfactory results can be obtained in patients with realistic expectations.

Although most people are extremely happy with their new knee, complications can occur and you must be aware of these prior to making a decision.

If you have any further queries regarding Total Knee Replacement, please consult Dr.Kunal Dhurve.

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