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Knee Replacement

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Mr. Gonsalves was leading a normal and active life till arthritis crept up and set his life in turmoil. From being an active 60+ grandpa, he soon became confined to his bed and dependent on his walker. After years of physical therapy, medication and non-invasive procedures, the pain simply did not subside. Faced with debilitating pain that prevented the senior citizen from even getting a good night’s sleep, his family doctor and orthopedic surgeon recommended a Total Knee Replacement as the solution to the problem at hand. Six months post-surgery,
Mr. Gonsalves is now a changed man who has gained a new lease at life. Here is his side of the story.

What made you choose to undergo a Total Knee Replacement?

Unfortunately, all the initial efforts at managing my condition like physical therapy, medicine and more, failed and I was left battling the pain and restricted movement. As someone who previously led a very active life, picking up my grandchildren from the bus stop, going for a walk with my friends every morning, this condition started affecting me mentally and emotionally. Lastly, my family doctor and orthopedic surgeon recommended Total Knee Replacement as the solution to my condition.

Was it an easy decision to make?

To be honest, I was a little apprehensive about undergoing the surgery as would anyone who is in this situation. Fortunately, both my family doctor and orthopedic surgeon were very helpful when it came to assuaging my doubts and fears. They told me that this procedure is one of the most common orthopedic surgeries in the world with a vast majority of people experiencing significant improvement in pain and mobility after the procedure. The final decision to undergo the surgery was made cooperatively by me, my family, my family physician, and my orthopedic surgeon. Here I must add that my family physician first referred me to an orthopedic surgeon for a thorough evaluation to determine whether I might benefit from this surgery.

Would you recommend a knee replacement surgery to lakhs of people suffering from knee pain?

Only if your condition is unmanageable through non-invasive means like mine was, will they recommend the surgery.  In fact, your orthopedic or family doctor won’t recommend you undergo one without due cause. In most cases, the patient’s family doctor will recommend the patient to an orthopedic surgeon who will evaluate if the patient is the right candidate for Total Knee Replacement. This was the process that I myself underwent before undergoing the surgery. From what I realized after having spoken at length with my orthopedic surgeon is that they only recommend surgery if:

  • The patient has severe knee pain that restricts their movements. These include regular movements like walking, climbing stairs and sitting in and getting off chairs. The knee pain in such cases is usually so severe that one cannot walk too far without significant pain or the use of a cane or walker.
  • The pain interferes with the patient’s resting or sleeping both during day and night.
  • The inflammation and swelling are severe and do not improve with rest and medications.
  • The knee starts showing signs of a deformity like bowing in and out.
  • Lastly, when everything from anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries have failed.

How is your life post-surgery?

To say that it is incredible is an understatement! I feel as if I have got a new lease in life. The reduction in stiffness was almost immediate after the surgery. The pain took some time to go, but that was because of the surgery itself. Now I can confidently state that I am pain-free and happy! I was able to walk with the help of a walker almost 24 hours after surgery and was driving within 6 weeks. I am back to my old routine and my grandchildren are thrilled to have their grandpa back at school pick-up duty! Going for walks and socializing with my friends is also something I really enjoyed getting back to. All those years of pain and discomfort seem like a bad memory now. I am so glad to have undergone the surgery and would advise anyone in severe and unmanageable knee pain to undergo the surgery instead of waiting for their condition to worsen. I made my choice and I am truly thankful that it was the best one for me!

Are you recovering from Total Knee Replacement or TKR? Congratulations! You made it past the first hurdle! With a little attention and care, you will soon be back on your feet! Can’t figure what is allowed and what is not? Here is a simple guide to post-op healing to help you put your best foot forward!

The knee is human body’s largest joint and is made up of the lower end of the thighbone, the upper end of the shinbone and the kneecap. A knee replacement includes replacing some or all of the component surfaces of the knee joint with artificial implants. A knee replacement is performed to repair the damaged weight-bearing surfaces of the knee joint caused due to inflammatory diseases or injury. The damage overtime leads to extreme pain and can restrict joint mobility. Knee replacement is a major surgical procedure requiring hospital admission for 2 to 3 days.

A knee replacement could be more precisely termed as knee “resurfacing” as this procedure actually involves replacement of the surface of the bones.

What should I particularly pay attention to post surgery?

No surgery is 100% painless and TKR is no different. While the chances of intense pain, complications and inflammation are minimal, there are some things you can do to make the situation more comfortable. The first and foremost thing to remember is to follow your surgeon, medical team and physiotherapist’s orders.

Remember RICE. Rest. Ice. Compression and Elevation should be the new best friend of every post-op TKR patient. The first one needs no explanation. One should rest and that too as advised by the doctor. Keeping the ankle above the heart also helps to decrease the swelling, raise blood circulation and prevent blood clots. Apply an ice pack for 10-20 minutes for 3-4 times a day. If the initial swelling has subsided, you can also opt for a heat pack. Use a compression cloth for additional help.

Do go undergo physiotherapy sessions: Following one’s physical therapist’s orders is paramount to regain one’s health as soon as possible. Perform them just as advised even though it may be uncomfortable at first. Exercise is a great way to get used to your new knee and heal faster too! In fact, post-operative exercises increase circulation which prevents dangerous blood clots. Gentle exercises like quadriceps sets, straight leg raises, ankle pumps, knee straightening exercises and more, are just some of the exercises a post-op TKR patient will be asked to do.

Take the prescribed medications: Adhering to the medical schedule as prescribed by one’s doctor is crucial for one’s healing process. It not only helps in reducing inflammation and pain but also helps avoid infection and blood clots.

Do manage your weight: An increase in weight means more stress on your new knee or even chances of arthritis on your other knee. So keep an eye on your diet and let your body heal itself.

Avoid unnecessary stress to the knee: A healthy body heals faster, more so in case of surgeries like TKR. So while it may not be time to hit the gym yet, one can walk, swim or indulge in other low-impact activities to keep the blood flowing and your body healing. Remember to not twist your knee, sit cross-legged and pick heavy weights of more than 9 kilos at this time.

Consult your orthopaedic surgeon prior to getting any other surgeries: Whether it is a dental surgery or a major operation, it is best to get the green light from one’s surgeon before going ahead as these surgeries may up your infection risk.

Avoid smoking and alcohol: Goes without saying that both these substances can interfere with your healing process and make you more prone to complications. Alcohol especially should be avoided if the doctor has put you on a course of blood thinners or high dose painkillers.

Maintain your posture: Do not engage in activities that jerk your knee or can cause you to fall down. Both these situations must be avoided at all costs.

Don’t hold yourself to milestones: Everybody heals differently. Every patient will progress at their own rate, so don’t be disappointed or stressed if your or your loved one is not progressing as steadily as one would like. Celebrate the accomplishments that you have made and strive for the next.

Warning signs to be on the lookout for

TKR is one of the most common and low-risk surgeries in the world. It sees very few complications with serious complications at a chance of less than 2% and even lesser when it comes to fatal complications. 90% of implant recipients observe a significant improvement in the quality of life and increased mobility. However, there are some risks associated with the procedure that may surface months or maybe even years after the surgery. While there is nothing to be scared of, any chronic significant pain should be discussed with your orthopaedic doctor. Here’s what the pain might signify:

Infection: This is by far the most common complication. An infection is not necessarily postoperative, it can happen months or even years after the main surgery. Sometimes an infection in a different part of the body can affect your implant and cause infection.

Fracture of bone around the knee.

Loosened implant: A loosened implant is not something that happens days or even weeks after the surgery. It can take years to develop and is one of the most common causes of pain post surgery.

Kneecap problems: Issues with kneecaps are a major cause of total knee replacement surgery. However, due to its complex nature, it is difficult to ensure that the new kneecap works just like the original. This requires expertise from skilled surgeons.

Alignment problems: If an implant is badly aligned it may end up not performing as per expectations or indeed exacerbating the issue.

Others: Bursitis, pinched nerves or complex regional pain syndrome are few other rare complications and causes of pain post TKR.

Thanks to advances in technology, TKR patients can now become mobile even faster than before. Adequate rest, exercise, medication and strict adherence to post-op instructions can ensure faster recovery rates and healing outcomes. So go out there and enjoy your new knee without any stress in your mind!

 

Deciding to get any surgery is an important decision and Total Knee Replacement or TKR is no different. What makes this decision even more vital is the crucial role our knees play in our lives. Needed for the single most common movement in our lives, walking, our knees are a feat of natural engineering. Everything from climbing stairs, running, kicking, squatting and even sitting requires this joint to function smoothly. Which is why it is no surprise that chronic knee issues can make life very difficult for both those who are suffering from the disease and their caretakers or family. In such a scenario, opting for TKR gives the patients and their family a new chance at enjoying an improved quality of life. Wondering if it is the best option for your or your loved ones? Here’s some information that could help your decision-making process.

What is TKR?

One of the most common surgeries conducted in the world today, Total Knee Replacement is a complete replacement of the knee joint with a suitable metal implant. The procedure is conducted under general anaesthesia and takes about 2-3 days of hospital stay. While the final decision rests on you and your orthopaedic surgeon, Total Knee Replacement surgery is advisable for those who are not responding to other treatments, are in significant distress or have been reduced to limited mobility.

The knee is human body’s largest joint and is made up of the lower end of the thighbone, the upper end of the shinbone and the kneecap. A knee replacement includes replacing some or all of the component surfaces of the knee joint with artificial implants. A knee replacement is performed to repair the damaged weight-bearing surfaces of the knee joint caused due to inflammatory diseases or injury. The damage overtime leads to extreme pain and can restrict joint mobility. Knee replacement is a major surgical procedure requiring hospital admission for 2 to 3 days.

A knee replacement could be more precisely termed as knee “resurfacing” as this procedure actually involves replacement of the surface of the bones.

What is the procedure like?

TKR is actually a misnomer which leads people to believe that the entire knee with get replaced. This is certainly not the case! Only the damaged parts of one’s knee are replaced. The surgeon will first remove all the damaged cartilage from the ends of the bones and reshape them. The new implant is then attached to the ends of the bone and a plastic spacer is put between them to reduce friction and ensure smooth movement. If the damage is significant, the surgeon might also replace the back of the kneecap with a plastic button.

Is getting TKR done in India a wise decision?

Absolutely so! In fact, India is fast becoming a hub for TKR, with many foreign patients opting to get operated in India in order to not only save costs but also get treated with the latest tools and technology. What’s more, is that the success rate of TKR in India is deemed to be one of the finest in the world! To add to that, the costs of undergoing TKR in India is significantly less than in other countries. Careful regulation of implant prices by the government also means that TKR need not be a major drain on one’s resources. With a huge pool of trained and skilled orthopaedic surgeons and hospitals equipped with advanced infrastructure, one can rest assured that one’s loved ones are in good hands.

I have heard that TKR recovery involves both pain and inflammation?
Recovering from any surgery requires time, care and precaution, and TKR is no different. As long as you carefully listen to the orthopaedic and follow their instructions carefully, there are very few chances that anything can go truly wrong. To ensure that you or our loved one experience minimal discomfort, here are some things that one can do, like apply an ice pack 3-4 times daily for a minimum of 10-20 minutes. If the cold is an issue, one can also opt for heat packs, but only once the first swelling subsides. Keeping the leg elevated above the heart and performing ankle pump exercises also help to decrease swelling, raise blood circulation, and most importantly, prevent the formation of blood clots. If in case the swelling does not reduce even after regular icing, then it is best to consult your doctor/PT to get a prescription an NSAID medication. Alternatively, one can wear a compression cloth provided by one’s doctor to get relief from the inflammation.

How will TKR benefit my & my loved one’s life?

95% of patients see a significant improvement in the quality of life and mobility post surgery and physi-cal therapy. In the rare 10% of cases, the patient may still end up a degree of pain. That being said, the chances of unsuccessful implantation are pretty rare and complications rarer still and the benefits far outweigh these chances. The biggest benefit of TKR though is the immense quality of life improvement it bestows on the patient. Instead of being bedridden, wheelchair bound or on crutches, they can take on life with a greater enthusiasm and take up their previous hobbies and interests. They can go for walks with their friends and loved ones, attend social gatherings without fear of pain or discomfort and even become more independent. This is especially crucial for older patients as being housebound or having limited mobility reduces their social interactions which can be detrimental to their mental health in the long run.

Is an imported implant better than an Indian one?
Not at all! Indigenous knee implants are not only more cost-effective than their imported counterparts, but they are also a better fit for the Indian knee morphology that is different from those of westerners. Do consult a doctor to get credible solutions for your healthy life.

Many people put off undergoing or discourage their loved ones from undergoing TKR as they feel that medicine and alternative treatments may be better than going under the knife due to the potential complications. Unfortunately, this only makes the patient lead a progressively poorer quality of life. Opting for a TKR with its low complications and the high success rate is not only the right option for those in significant pain and discomfort, but it is also the best way to regain one’s or one’s loved one’s previous quality of life.

The bearer of our weight and an indispensable joint for movement, our knees are truly a miracle of nature. From walking to squatting and kicking, our knees play an important role in our lives. So it is quite understandable that when our knees get damaged due to old age, disease or injury, the results can be quite painful indeed! Living with a chronic knee condition can not only be unbelievably uncomfortable for the person living with it, but also for their caregivers and family members who hate to see their loved ones in pain. Fortunately, there are quite a few things that one can do to ease the pain and lead a relatively comfortable life. These include medicines, physical therapy, injections, arthroscopic surgery (minimally invasive surgery), and osteotomy (where a cut is made in the shin or thigh bone to reduce the load on the damaged knee). However, when all else fails, then one must look at total knee replacement as an option.

What is Total Knee Replacement (TKR)?

Total Knee Replacement is one of the most common surgeries in the world with a large majority of patients going on to lead rich, happy and healthy lives. It requires a surgery of 1-2 hours followed by a hospital stay of 2-3 days.

The knee is human body’s largest joint and is made up of the lower end of the thighbone, the upper end of the shinbone and the kneecap. A knee replacement includes replacing some or all of the component surfaces of the knee joint with artificial implants. A knee replacement is performed to repair the damaged weight-bearing surfaces of the knee joint caused due to inflammatory diseases or injury. The damage overtime leads to extreme pain and can restrict joint mobility. Knee replacement is a major surgical procedure requiring hospital admission for 2 to 3 days.

A knee replacement could be more precisely termed as knee “resurfacing” as this procedure actually involves replacement of the surface of the bones.

Will the entire knee be replaced?

No. Though the name of the surgery is Total Knee Replacement, in reality, it is more like knee resurfacing where only the surface of the bone is actually replaced. So if you or your loved ones are having nightmares about you turning into a part robot overnight, rest assured, there is no such thing to be worried about! During the surgery, the damaged cartilage is removed and metal components are cemented or press-fitted into the bone. If the damage is too much then the undersurface of the kneecap or patella may also be replaced with a plastic button. To ensure smooth movement, a plastic spacer is inserted between the metal components.

Is there no alternative to surgery?

Like mentioned above, there are many alternatives available for those who want to avoid surgery but wish to live a comfortable life. However, if the damage is too great or if it is making one’s life really miserable, then it is better to get the surgery. The final decision is always left to the patient and their family members. However, if you or your loved one who is suffering from knee problems have:
1. Severe pain or stiffness that affects one’s quality of life
2. Moderate to severe knee pain at all times, even at rest.
3. Chronic swelling or inflammation that does not go away with rest and medication.
4. Knee deformity and,
5. When all other treatments have failed.
Then surgery will be the best option for you/them.

Is knee replacement surgery safe for my old parents?

Absolutely! You will be happy to know that complications in cases of knee replacement surgeries are extremely low, with the chances of serious complications at 2 %. Chances of potentially lethal complications are even less. Rapid improvements in surgical methods, techniques and materials have made knee replacements one of the safest and effective procedures out there. So don’t worry, your loved ones are in good hands!

Knee pain is not a walk in the park. Even a minor cut to the knee makes daily life and its movements difficult for us, so one can well understand how debilitating chronic knee pain can be. If you or your loved one is undergoing long term knee issues without any significant relief, then it is time to give TKR a chance to return you to your old happy and mobile self.