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Knee Replacement

It is of 2 types. Total knee replacement and Partial knee replacement.

What is Total Knee Replacement?

Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with an artificial prosthesis.

Indications for Total Knee Replacement

Total knee replacement surgery is commonly indicated for severe osteoarthritis of the knee. Osteoarthritis is a type of arthritis. It is the most common form of knee arthritis in which the joint cartilage gradually wears away, and often affects the elderly. Your doctor may advise total knee replacement if you have:

  • Severe knee pain that limits your daily activities (such as walking, getting up from a chair or climbing stairs)
  • Moderate-to-severe pain that occurs during rest or awakens you at night
  • Failure to obtain pain relief from medications, injections, physical therapy or other conservative treatments

What to expect during and after TKR?

It is a major decision on the part of the patient to choose total knee replacement surgery and there are many fears and misconceptions around it. Here we will try to address some of those.

  • Fear of painThis is a valid fear. The procedure is extensive and involves removal of diseased bone, cartilage and soft tissue. So some amount of pain is to be expected. However , with modern techniques of surgery and anaesthesia in the intra and post op period, including various blocks, infiltration drug cocktails and post op catheters, the pain can be controlled to a great extent.
  • Duration of hospital stay Usually the patient is admitted a day before the procedure and discharged between 4-5 days post operatively. The exact duration of stay depends upon the general fitness of the patient, pain level and physiotherapy milestones achieved after surgery.
  • Use of blood products If the surgeon or the anesthetist determines that the level of blood loss is high enough to need replacement, blood or blood products may be transfused. Post operatively, the hemoglobin is checked on the day after surgery and this is used to determine if a transfusion is necessary.
  • Duration of dependency on walking aids Every patient wishes that he or she be back to walking unaided as soon as possible after surgery. In reality this agin depends upon the pre op fitness levels of the patient, the post op physical therapy and the quality of the surgery. Generally patients take between 6 weeks to 3 months to be able to walk independently. Patient can expect to experience improvement up to one year after surgery.
  • Ability to squat or use Indian toilets Generally, it is advised post surgery to avoid squatting or using Indian toilets as this tends to put excessive repeated stresses on the bones and implants. A patient may not have the muscle strength and coordination to be stable and may fall causing a fracture.

Partial Knee Replacement

Partial knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement.

The knee can be divided into three compartments: patellofemoral, the compartment in front of the knee between the kneecap and thighbone, the medial compartment, on the inside portion of the knee, and lateral compartment which is the area on the outside portion of the knee joint.

Indications of Partial Knee Replacement

Traditionally, total knee replacement was commonly indicated for severe osteoarthritis of the knee. In total knee replacement, all worn out or damaged surfaces of the knee joint are removed and replaced with new artificial parts. Partial knee replacement is a surgical option if your arthritis is confined to a single compartment of your knee.

Your doctor may also recommend surgery if non-surgical treatment options such as medications, injections, and physical therapy have failed to relieve the symptoms.

Advantages of Partial Knee Replacement

The advantages of partial knee replacement over total knee replacement include:

  • Smaller incision
  • Less blood loss
  • Quick recovery
  • Less postoperative pain
  • Better overall range of motion
  • Feels more like a natural knee