Knee is the most vital joint in the human body & having healthy knees is quite necessary to perform most of the routine activities effortlessly. When someone’s knee is sorely damaged whether by any injury or due to arthritis, it may be hard for them to execute simple activities such as walking or climbing stairs. They may even begin to feel discomfort by merely sitting or lying down. If non-surgical treatments like physiotherapy & medications are no longer helpful, patients may consider knee replacement surgery. Knee replacement surgery is a safe & efficient procedure to relieve severe pain, correct deformity of legs & help patients stay active. According to recent studies, 90 percent of patients who have undergone knee replacement surgery have a lot less of pain. In most of the cases, they are however able to resume activities like playing golf & walking which brutal arthritic pain made patients quit years ago.
What is a Knee Replacement Surgery?
Knee joint is made up of lower end of thighbone which is called as femur, upper end of shinbone known called tibia & kneecap which is referred to as patella. Ends of these bones where they touch are enclosed with articular cartilage, a smooth substance that guards these bones & permits them to move freely. C-shaped wedges known as menisci located between femur & tibia act as ‘shock absorbers’ & which provide protection to the knee joint. Ligaments hold tibia & femur to provide stability. Surfaces of knee are covered by a thin lining known as synovial membrane which discharges fluid that lubricates cartilage, minimizing friction to nearly zero in a strong & healthy knee. Knee replacement surgery is a procedure in which infirm knee joint is replaced with an artificial material. Patients suffering from unstable knees & acute pain, in order to gain a pain relief & functional movement require knee replacement surgery as treatment.
Most common cause of severe knee pain & disability is arthritis. Knee pain is mainly caused by the following three types of arthritis.
- Osteoarthritis – Osteoarthritis normally occurs in patients above 50 years of age & it is basically an age-related ‘wear and tear’ type of arthritis. Cartilage that preserves bones of knee weakens & wears away. Bones then rub against one another, resulting in pain & stiffness of knee.
- Rheumatoid Arthritis – Rheumatoid arthritis is a painful condition in which the synovial membrane that encloses & protects the joint becomes thickened. Chronic inflammation can seriously damage the cartilage & eventually cause cartilage loss & inflexibility.
- Post-Traumatic Arthritis – This condition most often follows a knee injury. Fractures of bones or tears of knee ligaments may hurt articular cartilage over a particular span of time, causing knee discomfort & thereby limiting its function.
ALSO READ: Knee Replacement Surgery for Arthritis
Patients may need to perform knee replacement surgery in the enumerated conditions.
- Difficulty in Performing Routine Tasks – Harsh knee pain which limits basic everyday activities of patients, including walking, moving up & down the staircase & getting in & out of chairs.
- Need of Walker – Patients may find it extremely tough to walk more than a few blocks without sharp pain & they need to use a walker or cane for this purpose.
- Non-Effective Medications – Failure to obtain relief from several anti-inflammatory drugs & medications is considered to be one of the strongest indication of trouble in the knee. Medications like ibuprofen & aspirin often are most potent in early stages of arthritis. Their efficiency in controlling knee pain varies from patient to patient & when they become less effective for patients may indicate a severe arthritis condition.
- Constant Knee Pain – Mild or severe & constant knee pain while resting at any given point of time.
- Prolonged Knee Stiffness – When patients cannot easily straighten or bend their knees.
Patients suffering from these conditions may be considered as good candidates for knee replacement surgery. Knee replacement surgery can be performed successfully to obtain relief from severe knee pain for all ages, from a young patient with juvenile arthritis to an older patient with serious degenerative arthritis.
The diagnosis could be done by consulting a skilled orthopedic surgeon. Primary evaluation with an orthopaedic surgeon consists of the following components.
- Medical History – Orthopedic surgeons will gather information about patient’s overall health & ask them about the extent of knee pain & the ability to function freely.
- Physical Examination – This will assess knee motion, strength, stability & overall alignment of legs.
- X-rays – These images can help the surgeon evaluate the intensity of deformity in the patient’s knee.
- Other Significant Examinations – Occasionally blood tests, or more advanced imaging such as a magnetic resonance imaging scans, may be required to figure out the condition of bone & soft tissues of & around the patient’s knee.
Orthopedic surgeons will review results of primary evaluation with patients & discuss whether undergoing this surgery is the best alternative to resolve their painful knee condition & improve mobility. In addition to this, orthopedic surgeons will also explain the potential risks & complications of knee replacement surgery to patients, including risks related to surgery itself & also those that can occur over time following surgery.
There are mostly two types of knee replacement surgery offered to patients for treating their knee arthritis. Depending on surgeon’s experience & preferences, the following types of knee replacements can be performed.
- Total Knee Replacement Surgery – Also known as total knee arthroplasty, it can prove beneficial to patients with mild to severe knee arthritis who have exhausted conservative treatment options & want to replace their complete knee joint. Total knee replacement surgery involves cutting the arthritically deteriorated ends of shin bone & thighbone & capping them with artificial implants. It is a reliable method of alleviating severe knee pain.
- Partial Knee Replacement Surgery – It is also referred to as unicompartmental knee arthroplasty. It involves replacing only one of the following knee compartments.
- Medial Compartment (Inner Knee)
- Lateral Compartment (Outer Knee)
- Patellofemoral Compartment (Front side of Knee)
Partial knee replacement surgery helps the arthritically affected compartment of knee joint while maintaining other healthy regions of knee. Partial knee replacement surgery is less invasive as compared to total knee replacement surgery & needs less healing time.
Choice of knee implants will ultimately be made by orthopedic surgeons, based upon patient’s physical situation, their lifestyle & age, surgeon’s experience & his/her level of familiarity with a specific piece of equipment. Surgeons will discuss everything clearly with patients prior to their knee replacement surgery. Some of the most common types of knee implants are described below.
- Fixed-Bearing Implants – It is the most commonly used knee replacement implant. Fixed-bearing implant is called as ‘fixed’ because polyethylene guard of tibial component is firmly fixed to metal platform base. Fixed-bearing prostheses offer a good range of motion & are just as durable as other implants for most patients.
- Mobile-Bearing Implants – When patients are active & younger, then doctors may suggest a mobile-bearing knee implant. These reliable implants are specially designed for longer performance with less wear & tear. Mobile-bearing implants & fixed-bearing implants use similar components. However, in a mobile-bearing knee, the polyethylene in the tibial element can rotate short radius inside metal tibial tray. This type of rotation permits patients a few degrees of greater rotation to lateral & medial sides of their knee. Due to such mobility, these implants do need more support from ligaments enclosing the knee.
- Medial Pivot Implants – These implants replicate twisting, rotating, bending & stability of natural knee. Therefore, it feels more comfortable like a normal knee. This implant design is very stable during normal knee movement as opposed to sliding forward marginally.
It is very important for patients to understand the procedure of knee replacement surgery & to have realistic expectations from it. According to reports, 90 percent of patients experience dramatic improvement in the knee after completion of knee replacement surgery. An orthopedic surgeon may take the following steps before performing knee replacement surgery.
- Complete Medical Inspection – Orthopedic surgeons may ask patients to opt for a complete medical check-up several weeks before surgery. It will ensure the health level & aid in the healing process. Patients with chronic health conditions such as heart disease may also be examined by a specialist before undergoing surgery. Certain tests like urine & blood samples may also be taken by doctors.
- Medications – Patients should honestly tell the surgeon about the medications they are taking.
- Dental Exam – Chances of any serious infection after knee replacement surgery are very less still precautions should be taken. To avoid any possibility of infection, dental procedures like extraction of tooth should be finished before knee replacement surgery.
- Urological Evaluation – Patients with a history of urinary infections should perform a urological examination before undergoing knee replacement surgery.
In addition to these steps, patients may arrange someone to assist them for few days after their knee replacement surgery. Patients must properly follow instructions of orthopedic surgeons for the knee to heal faster after surgery.
Patients should discuss their doubts related to knee replacement surgery. Patients may take help of the following set of queries to understand the procedure & then confidently decide whether they want to perform it or not.
- What are the possible complications that may occur with my knee replacement surgery?
- Can you tell me the expected recovery period?
- How many days will I be hospitalized?
- How long will I need a support to walk?
- How soon will I be able to walk on my own after my knee replacement surgery?
- How promptly will I be able to climb stairs after my knee replacement surgery?
- How many days will it take to resume my daily activities like job, housework, sports, etc?
- Is sexual intercourse feasible after my knee replacement surgery?
- Which implant will you use for me?
- How long will my knee replacement surgery last?
- What steps can I take in order to keep my knee functioning properly?
Knee replacement surgery procedure can be carried out by a simple operation which is mentioned below.
- Anesthesia – Doctor will examine the health of patient & depending upon that they will make choice of anesthesia. Normally, general anesthesia is used by surgeons.
- Incision – Approximately 7 – 10 inch cut is made in the front side of patient’s knee. Diseased portion of the joint is then eliminated from bone’s surface & these surfaces are then molded to hold an artificial joint. Artificial joint is joined to shin, thigh bone &knee cap respectively, either by using cement or another special material.
- Monitoring – After the completion of knee replacement surgery, patients will be shifted to recovery room, where they have to stay for a few hours while surgeons monitor their recovery from anesthesia. When patients’ wakes up, they will be moved to a general hospital room.
Success of knee replacement surgery will depend upon how well patients follow orthopedic surgeons’ guidelines & instructions at home during initial weeks after knee replacement surgery. Patients will have staples running along the wound or stitches beneath the skin around front side of the knee. Patients should take care & avoid activities which may disturb the healing process. Loss of appetite is very normal for a few days after surgery. Patients should maintain a balanced diet to aid the wound heal & to regain muscle strength. Patients may start light exercises after two weeks & follow-up with the orthopedic surgeon for a speedy recovery.
Potential risks & complications of knee replacement surgery can be described as follows.
- Blood clots
- Increasing pain in calf
- Redness or tenderness around knee
- Shivering chills
- Drainage from knee wound
- High knee pain
- High fever indicating infection
Falls during initial days after knee replacement surgery can, however, damage the new knee of patients and may require further surgery as correction. Patients should, therefore, use a walker or have a caregiver help them until they have achieved adequate muscle strength & flexibility.
Improvement of knee health is the major goal of knee replacement surgery. Most patients can hope to be able to completely straighten the replaced knee & to bend the knee efficiently so as to climb stairs easily. Kneeling can be sometimes uncomfortable, but it is not painful. Patients should take care while performing excessive bending activities. Most patients also feel some clicking of plastic & metal with walking or knee bending which is normal. It will diminish with time & they will experience increased range of motion. Following the guidance of orthopedic surgeon & properly protecting the knee will contribute to the success of knee replacement surgery.
Merits of Medical Tourism in India for Knee Replacement Surgery
Medical tourism in India is a great magnet for attracting global patients for availing best orthopedic surgeries & various other healthcare treatments. Medical facilities & hospitals in India pride themselves on the high standards & availability of latest equipment for performing complicated orthopedic surgical procedures. Popular orthopedic surgeries such as knee replacement surgeries are far more affordable in India, including the cost of accommodation & travel as compared to other developed nations like the Canada & United States. Travcure is a reputable medical tourism company in India which coordinates with best multispecialty hospitals & simplifies every aspect of healthcare for international patients. Travcure team provides the following benefits to their overseas guests.
- Answering every query related to orthopedic surgery in India
- Providing assistance & complete information about associated top-notch hospitals & orthopedic surgeons in India
- Facilitating guidance on accommodation, treatment, travel & stay in India for all types of orthopedic surgeries including knee replacement surgery
One of the biggest advantages of medical tourism in India with Travcure is that global patients can recover in a delightful holiday destination of their choice after undergoing knee replacement surgery.
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