Total knee Replacement
Total knee replacement in general is a very good operation for relieving pain. Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it could mean the difference between leading an active life or putting up with a debilitating condition.
Knee joint connects your thigh bone to leg bones. In this joint, movements take place on the smooth surfaces of the bones allowing a painless range of movement of about 130 degrees. This joint can be damaged due to various causes, but it is commonly due to arthritis or wear and tear. Total knee replacement is an operation where the surfaces of the thigh and leg bone are removed and replaced with artificial material with a poly ethylene insert in between them. Under surface of you knee cap can also be resurfaced using a polyethylene button.
Purpose of this operation is pain relief and hence improving your mobility and the level of activity. This operation is one of the most successful operations known and should give you many years of freedom from pain.
Knee replacement is performed for persistent pain arising from knee joint due to variety of reasons most commonly because of arthritis. Arthritis is a general term covering numerous conditions where the joint surface (cartilage) wears out. The joint surface is covered by a smooth layer of a substance known as cartilage that allows pain free movement in the joint. This layer can be damaged in many conditions, leading to bone rubbing on the bone, causing pain. This happens in following conditions
- Osteoarthritis- most common condition. It is seen in old people, exact cause of which is not known.
- Trauma, dislocation, infection etc.
- Growth disorders of the joints and bones
- Rheumatoid arthritis and similar other diseases
- Depending on your medical fitness we may arrange for consultation with a physician, cardiologist or an anaesthetist.
- Stop aspirin or anti-inflammatory medications 7 days prior to surgery as they can cause bleeding.
- Stop smoking as long as possible prior to surgery.
- If you are on blood thinning agents like we may have to stop them or substitute them prior to surgery.
- We will admit you to the hospital a day before the operation.
- You will not take any food or drink (from previous midnight )
- We will instruct you regarding your routine medications. Some of them may have to be taken normally even with empty stomach.
- Don’t take any food, drinks, or tablets without confirming with a nursing staff.
- You will be transferred to operation theatre about 30 min prior to surgery
- First you will enter the anaesthetic and preparation room.
- You will then be taken to operation room and will be positioned on an operating table.
A cut will be made on the front of your knee. Length of the cut will vary depending on the complexity of the case and your body weight. Then we prepare the joint surfaces using specialised instrumentation. We make sure you’re the ligaments of your knee are balanced and the alignment of the artificial knee is perfect. We will measure the size of your knee bones and chose appropriate sizes of the components. Artificial knee components are then fixed to your bones using bone cement. A plastic disc like insert is then placed between to metal components. We will then test the knee to make sure components are functioning well. Then we will stitch different layers of the wound.
- You will be taken to a recovery ward where you may stay for 1-2 hours.
- Once you are in the ward you will be given something light to eat and drink
- Usually you take rest on that day
- From the first day after the operation you start mobilising with the help of physiotherapists
- By about day 3 you will be able to manage most of your personal work and will be ready to go home by day 4-5.
- Remember this is an artificial knee and must be treated with care (not only because it is made of a precious metal!!)
- Avoid squatting and sitting on floors.
- You can take shower once the wound has healed.
- Any problems with the wound, fever, leaky wound etc you should contact us.
Even though this is one of the most successful operations, as with any major surgery there may be some complications. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. Complications may be general associated with anaesthesia and your medications or specific to hip surgery. Specific complications are infection (less than 1%), Blood clots (Deep Venous Thrombosis and pulmonary embolism), stiffness and damage to other structures like nerves and vessels.