Do I Need A Knee Replacement ?
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 only after supervised physiotherapy trials, have failed.
What Are the different types of knee replacement, and which one do I Need ?
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.
Customized or patient specific Knee Replacement >> is the latest in technology. Helps the surgeon to get the most accurate result, less blood loss, minimizes risk of Embolism for the patient.
If I have pain in both the knees, should I go for surgery of both at the same time ?
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.
When can I resume work after a knee replacement ?
After a unilateral knee replacement, most patients can resume community ambulation within approximately 4 weeks, and start office after 6 – 8 weeks. In a Bilateral Knee replacement, patients attain community ambulation status after an average of 10-12 weeks (approximately 3 months).
In our practice, most of the patients are able to walk without support approximately 3 weeks after surgery.
What are the risks involved in a knee replacement surgery ?
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.
How long do I need to stay in hospital?
Patients normally require hospitalization for 3-4 days in single knee replacement, and up to 7 days in both knee replacement surgery
How much is the surgery duration ?
A single knee replacement takes approximately 90 min- 2 hours. Both knee replacement surgery takes approx 3- 4 hours.
How long do I need to take rest after surgery?
Under normal circumstances, patients are allowed to stand with walker support on next day of surgery. Ambulation with walker starts within 2-3 days, depending upon the medical condition and pain control.
What should I expect during the hospital stay ?
Patients are given epidural anesthesia for surgery, and post op pain relief. They are expected to follow instruction from physiotherapist regarding muscle training.
When do we remove stitches?
Staples / stitches are normally removed 2 weeks after surgery. In case of Diabetic patients with delayed wound healing, staple removal may be delayed by a few days. Absorbable sutures for skin should be avoided due to risk of reaction in some patients.
When can I walk without support ?
Under normal circumstances, patients are able to walk without support after 3 weeks in single knee replacement surgery. In both knee replacement surgery, they take approximately 5-6 weeks.
What activities can I perform after surgery ?
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.
Is there any precaution 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.
What is the approximate cost of Total Knee Replacement Surgery in Gurgaon, India ?
The approximate cost for a single knee replacement surgery starts around 1.5 lac under affordable care hospitals; and 2.0 to 2.50 lac in a corporate hospital.
Cost of surgery package varies according to the 1) Accommodation, 2) Implant Category.
Will the pain go after surgery ?
After a hip replacement, the pain due to arthritis usually subsides in 4-6 weeks. Thereafter, there may be occasional reminders of pain after unaccustomed activity. If however, the pain re-appears after a prolonged pain free period; or the pain tends to worsen progressively, there is a definite cause for concern. This requires an urgent evaluation by the Orthopedic surgeon
How much time do I need to stay in Hospital; and how much time off work ?
As regards hospital stay, the usual duration is 1 week. The timing of going back to previous level of activity depends upon the type of Hip replacement – Cemented/ Un-cemented; and the quality of bone stock. Usually patients may resume office and sedentary work after 4-6 weeks.
What are the chances that I will need a repeat surgery in future ?
The typical longevity of a Hip replacement depends upon- quality of bone/ level of physical activity/ Age/ body weight/ technique of surgery. Most hip replacements survive an average of 15-20 years. However, a large number of variables affecting longevity prevents accurate survival analysis. Individual patient assessment should be done carefully, and the risk- benefit analysis should be explained to the patient before surgery.
What precautions I need to take, and for how long ?
The most important of all, are the precautions to be taken by the patient himself. Dislocation of the new joint is a potential risk. extreme of movements should be avoided under all circumstances. The soft tissue healing takes approximately 6 weeks, however, if the hip joint is structurally unstable, or the soft tissue tension is not adequate, precautions need to be taken for a longer time.
What are the different types of Hip Replacement Surgery ?
Total Hip Replacement Surgery involves a change of both Femoral head & neck, and Acetabular socket. There are several bearing options which are available depending on the patient requirements.
Common Bearing Options include, – Metal on Polyethylene/ Ceramic on Polyethylene/ Ceramic on Ceramic.
Partial hip replacement involves a change of only the femoral head and neck region; acetabular socket is usually preserved. This is preferred in cases of Femoral neck fracture with healthy acetabular cartilage.