Arthritis is a major concern for the elderly people all over the world and is more common in women. The temporary treatment often involves medicines, physiotherapy, Intra joint injection of a lubricating agent, Arthroscopy and Osteotomy.
Knee Replacement is the only permanent solution of Osteoarthritis. The surgery aims to relieve the pain and bring back the motion of the knee joint. Knee replacement actually is a misnomer as only the parts of the bones contributing to the joint are “resurfaced” and the whole knee is not removed.
A knee replacement surgery basically is done to remove the damaged parts of the bone and cartilage from within the joint and replace it with new Implants/Prosthesis which are fixed onto the bone thus regaining the smoothness of the joint and relieving pain and regaining function.
Knee joint arthritis is a common condition affecting people above the age of 40 to 50 years.
It is known that women suffer from Knee joint arthritis more than men in the ratio of 4:1. As the age advances one would like to stay mobile & walking without pain to remain physically, mentally and socially active. Painful arthritis of the knee could sometimes hamper all these activities. That in turn deteriorates patient’s overall health. Total or Partial Knee replacement is a final permanent answer to all these problems.
Unlike Hip replacement surgery, Knee replacement is actually a true Surface Replacement. During arthritis of the Knee, the joint surface which is normally extremely smooth becomes rough and is worn out. Walking, standing, stair climbing etc. activity causes friction between these worn out parts of the joint and bones in the knee joint start rubbing against each other. This causes pain and stiffness of the surrounding support structures of the joint namely muscles, Ligaments and joint capsule.
The operation is generally carried out under spinal or epidural anaesthesia. In the Knee replacement surgery the knee which is bent due to Osteoarthritis is first made straighter by correcting the soft tissues. With the help of highly specialized instruments and equipments the preparations are made on the arthritic bone to receive the artificial Knee joint. This is a skillful job which is done by the Knee Surgeon.
You shall be taken to the Operation theatre nearly 30-45 minutes before the surgery for Preparation and anaesthesia.
The anaesthesia given can be General (puts you asleep throughout) or Epidural (allows one to be aware but anaesthetizes the lower half of the body). Epidural or Spinal anaesthesia is more common now and has the advantage of having a quick recovery and allows anaesthesia in patients with High Blood Pressure and Heart problems.
The surgery begins once all the preparation is completed. It is performed with all the state of the art technology to achieve the best results and reduce any complications which may occur after the surgery.
Your surgeon shall open your knee joint and take out all the damaged Bone components from the Femur and Tibia along with the damaged cartilage. Then cutting blocks (jigs) are used, these jigs allow the bone cut to be very accurate so that your new prosthesis fits perfectly. The undersurface of the patella is removed. Accurate bone cuts are taken and a trial prosthesis is fitted to confirm the alignment of the joint and leg to maintain precision. Then, the trial implants are taken out and your new knee is fixed onto the bone. Special Bone cement is used to fix the implants onto your bone and ensure a steady fix. The alignment is checked once again before washing the joint and injecting painkillers to reduce the post operative pain.
It consists of 3 parts :
- Femoral: It replaces the lower surface of the Femur/Thigh bone and is made of a strong metal/ceramic.
- Tibial: It has two parts which sit on the upper end of the Tibia/shin bone. It has a metal tray on which a plastic component is placed to provide a good and easy movement capability of the joint components.
- Patellar: It replaces the part of the patella in contact with the knee joint.
What to expect after Surgery
Knee replacement surgeries are one of the most common and most successful surgeries performed in the world.
After the surgery and rehabilitation is completed, your knee should have a range of motion of 100 to 120 degrees. This is adequate for our daily activities.
With your new and replaced knee you shall be able to resume the activities which you were unable to do before surgery, with minimal or no pain. Most people after the surgery can complete their daily activities without any problems.
You can resume your job once you are fit. Most people can enjoy recreational walking, swimming, driving, light dancing and stair climbing.
You can also travel overseas easily without any difficulty.
Complete recovery takes nearly 3-6 months.
Total or Partial Knee Replacement surgery is a surgery which improves the Quality of Life of all the patients suffering and thus is one which should not be avoided in case you are suffering from Arthritis.