Total Knee Replacement Surgery India - International Patient Services

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Published: 05th October 2009
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Total Knee Replacement In India


OVERVIEW


Total Knee Replacement Surgery in India

If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.

If medications, changing your activity level, and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. By resurfacing the damaged and worn surfaces of the knee can relieve pain, correct leg deformity and help resume normal activities.

One of the most important orthopaedic surgical advances of the twentieth century, knee replacement was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness...


Anatomy

The knee is the largest joint in the body. Normal knee function is required to perform most everyday activities. The knee is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shin bone (tibia), and the kneecap (patella), which slides in a groove on the end of the femur. Large ligaments attach to the femur and tibia to provide stability. The long thigh muscles give the knee strength....


Common Causes of Knee Pain and Loss of Knee Function

  • Osteoarthritis usually occurs in people 50 years of age and older and often in individuals with a family history of arthritis. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness...


  • Rheumatoid arthritis is a disease in which the synovial membrane becomes thickened and inflamed, producing too much synovial fluid that overfills the joint space. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness...


  • Traumatic arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function....



Is Total Knee Replacement for You?

Reasons that you may benefit from total knee replacement commonly include : -

  • Severe knee pain that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.
  • Moderate or severe knee pain while resting, either day or night
  • Chronic knee inflammation and swelling that does not improve with rest or medications
  • Knee deformity: a bowing in or out of your knee....



The Orthopaedic Evaluation

The orthopaedic evaluation consists of several components : -

  • A medical history, in which your orthopaedic surgeon gathers information about your general health and asks you about the extent of your knee pain and your ability to function
  • A physical examination to assess knee motion, stability, strength, and overall leg alignment
  • X-rays (radiographs) to determine the extent of damage and deformity in your knee
  • Occasionally blood tests, MRI (magnetic resonance imaging), or bone scanning may be needed to determine the condition of the bone and soft tissues of your knee....


Realistic Expectations About Knee Replacement Surgery

An important factor in deciding whether to have total knee replacement surgery is understanding what the procedure can and cannot do.

 
More than 90% of individuals who undergo total knee replacement experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. But total knee replacement will not make you a super-athlete or allow you to do more than you could before you developed arthritis....


Preparing for Surgery

Medical Evaluation : -

If you decide to have total knee replacement surgery, you may be asked to have a complete physical examination by your family physician several weeks before surgery to assess your health and to identify any conditions that could interfere with your surgery.

Tests : -

Several tests may be needed to help plan your surgery: blood and urine samples may be tested and a cardiogram may be obtained.

Preparing Your Skin and Leg : -

Your knee and leg should not have any skin infections or irritation. Your lower leg should not have any chronic swelling. Contact your orthopaedic surgeon prior to surgery if either of these conditions is present for a program to best prepare your skin for surgery.

Blood Donation : -

You may be advised to donate your own blood prior to the surgery. It will be stored in the event you need blood after your surgery.

Medications : -

Tell your orthopaedic surgeon about the medications you are taking. He or she will tell you which medications you should stop taking and which you should continue to take before surgery.

Dental Evaluation : -

Although the incidence of infection after knee replacement is very low, an infection can occur if bacteria enter your bloodstream. Treatment of significant dental diseases (including tooth extractions and periodontal work) should be considered before your total knee replacement surgery.

Urinary Evaluations : -

A preoperative urological evaluation should be considered for individuals with a history of recent or frequent urinary infections. For older men with prostate disease, required treatment should be considered prior to knee replacement surgery.

Social Planning : -

Although you will be able to walk on crutches or a walker soon after surgery, you will need help for several weeks with such tasks as cooking, shopping, bathing, and doing laundry. If you live alone, your orthopaedic surgeon's office and a social worker, or a discharge planner at the hospital can help you make advance arrangements to have someone assist you at home. They also can help you arrange for a short stay in an extended-care facility during your recovery, if this option works best for you....


Your Total Knee Replacement Surgery in India

You will most likely be admitted to the hospital on the day of your surgery. After admission, you will be evaluated by a member of the anesthesia team. The most common types of anesthesia are general anesthesia, in which you are asleep throughout the procedure, and spinal or epidural anesthesia, in which you are awake but your legs are anesthetized. The anesthesia team will determine which type of anesthesia will be best for you with your input....


Unicompartmental Knee Replacement

Although not as common as total knee replacement, the partial or unicompartmental knee replacement (commonly called the "uni") is a viable alternative in limited situations. The designs of the unicompartmental types of knee replacements have improved over the years, as has the sophistication of the instruments used to implant these types of artificial joints. The unicompartmental knee replacement also has smaller, less invasive incisions.....


Minimally Invasive Knee Replacement

A recent advance in the performance of total knee replacement is the use of minimally invasive surgical approaches. This technique, still in its relative infancy, is more challenging than standard total knee replacement. The incisions are approximately half the size of those used in a standard approach. The smaller incisions and new techniques to expose the joint may result in short-term advantages such as a quicker rehabilitation, less pain, and a shorter hospitalization, according to some reports....


Complications

The complication rate following total knee replacement is low. Serious complications, such as a knee joint infection, occur in fewer than 2% of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit full recovery....



Your Recovery at Home

Wound Care : -

You will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal....

Diet : -

 Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and to restore muscle strength....


Activity :-

Your activity program should include : -

  • A graduated walking program to slowly increase your mobility, initially in your home and later outside
  • Resuming other normal household activities, such as sitting and standing and climbing stairs
  • Specific exercises several times a day to restore movement and strengthen your knee. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery....


Avoiding Problems After Surgery

Blood Clot Prevention : - Follow your orthopaedic surgeon's instructions carefully to minimize the potential of blood clots that can occur during the first several weeks of your recovery....


Warning Signs 

Warning signs of possible blood clots in your leg include : -

  • Increasing pain in your calf
  • Tenderness or redness above or below your knee
  • Increasing swelling in your calf, ankle, and foot


Warning signs that a blood clot has traveled to your lung include : -

  • Sudden increased shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing


Notify your doctor immediately if you develop any of these signs....


Preventing Infection

The most common causes of infection following total knee replacement surgery are from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your knee replacement and cause an infection...


Avoiding Falls

A fall during the first few weeks after surgery can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile..


How Your New Knee Is Different ?

You may feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending activities. Improvement of knee motion is a goal of total knee replacement, but restoration of full motion is uncommon. The motion of your knee replacement after surgery is predicted by the motion of your knee prior to surgery. Most patients can expect to be able to almost fully straighten the replaced knee and to bend the knee sufficiently to climb stairs and get in and out of a car.....


Your orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves....



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