Dr. Sujit Jain

Knee replacement is a procedure where the weight carrying surface of knee joint is replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50.

Surgery Types

Knee replacement is mainly of two main types:

1. Total knee replacement where both the sides of knee joints are replaced
2. Partial knee replacement where only single side of the joint is replaced

Procedure

In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage, and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less.

In total knee replacement, four steps are performed:

1. Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone.
2. Replacement with metal components, which help as a recreated surface of the joint
3. Incision of knee cap with a resurface made of a plastic button, which is optional based on the case
4. Insertion of a medical-grade plastic spacer amid the metal components. This creates an effortless gliding surface.

After general or spinal anesthesia, an incision of 8-12inches is made in the front part of the knee. The joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin, as well as knee cap, is attached to the artificial joint with either cement or a special material.

After Effects of the Procedure

After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery.

There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping.

Presently, over 90% of total knee replacements function well for 20 to 22 years of surgery. Hence, knee problem is no problem at all!

The Rehabilitation After Total Knee Replacement: 

1. Full weight-bearing walking, knee bending, exercise next day after surgery 
2. Commode use, sitting on chair 2nd day 
3. 3rd day: Stair climbing, start cross leg sitting 
4. 2 weeks: Suture removal and walking to outdoors

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. The post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, the patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, the patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping. If you wish to discuss about any specific problem, you can consult a Orthopedist.