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Joint Replacement Health Feed

Knee Replacement - Knowing The Steps Involved In It!

Knee Replacement - Knowing The Steps Involved In It!

Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritisrheumatoid 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 anaesthesia, an incision of 8-12 inches is made in the front part of the knee. 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 even after 15 years of surgery. Hence, knee problem is no problem at all!

Primary Knee & Hip Replacement - Know More About Them!

Primary Knee & Hip Replacement - Know More About Them!

Total Hip Replacement is also known as Total Hip Arthroplasty, in which the damaged cartilage and bones in the hip area are removed and replaced with prosthetic components. On the other hand, Total Knee Replacement, also known as Total Knee Arthroplasty or resurfacing, involves replacing the bone surface of the knee area.

Causes of Hip and Knee Pain

Arthritis is the most common cause of chronic hip and knee pain or disability. Other causes include:

● Avascular necrosis or Osteonecrosis is a condition where there is an inadequate supply of blood to the femoral head due to a hip injury. The inadequate supply of blood may cause the bone surface to collapse and this can result in arthritis.

Rheumatoid Arthritis is the most common inflammatory Arthritis. In this condition, the synovial membrane surrounding the joint begins to thicken and become inflamed. This results in cartilage loss, stiffness, and pain.

Osteoarthritis is the type of arthritis, usually related to old age but can occur among young people too. The cartilage cushioning the hip and knee bones becomes soft and gradually wears off. The bones eventually start rubbing against each other which causes stiffness and pain in the knee and hip area.

● Post-Traumatic Arthritis can follow a severe hip and knee fracture or injury.

● Some children with hip disease or problem, even after treatment, can develop into arthritis later. This may be caused by uneven or unusual growth of hip which affects the joint surfaces.

Knee Replacement Procedure

● Bone Preparation: The surface of impaired cartilage at the end of the tibia and femur are separated besides a small extent of the underlying bone.

● Locating the Metal Implants: The removed bone and cartilage are substituted by metal implants creating the joint surface. These metal pieces may either be press-fit or cemented into the bone.

● Resurfacing the Patella: The undersurface of the kneecap or Patella is cropped and reformed with a plastic button. This process is variable depending upon the condition.

● Inserting a Spacer: To form a smooth gliding surface, a plastic spacer of medical-grade is positioned between the metal components.

Hip Replacement Procedure

● Metal stem replaces the damaged femoral head and positioned into the femur’s hollow center.

● On the upper portion of the stem, a ceramic or metal ball is planted. This ball acts as a substitute for the damaged/detached femoral head.

● The damaged Acetabulum or cartilage surface of the socket is discarded and supplanted by a metal socket. Cement or screws are used to sustain the socket in place.

● A spacer, either metallic, plastic or ceramic is placed between the socket and the new ball for a smooth gliding surface.

Take Away

Knee and Hip Replacement are taken as the last option for the patient. The surgery and its outcome vary depending upon various factors. One should consult the doctor before undergoing for the Hip and Knee Replacement Surgery.

Golden Knee Replacement - Know More About It!

Golden Knee Replacement - Know More About It!

Artificial replacement parts are made of strong plastic, metal, or ceramic. All knee replacements, partial or total, will have parts made of a few different materials (likely metals and plastic). In most cases, each component is built from titanium, cobalt-chromium alloys, or a titanium and cobalt mixed metal. The chosen materials must be durable, allow for some flexibility with movement and be biocompatible (meaning it will not be rejected, corrode nor react with the body).

1. Cobalt-Chromium Alloys— Chromium alloys are one of the most commonly used materials in implant components. For those with nickel allergies, some particles from this metal can get into the bloodstream and cause a reaction.

2. Titanium and Titanium Cobalt—Titanium cobalt is used as frequently as cobalt-chromium alloys in joint replacement components. Since this metal is softer, it tends to make up the tibial part of the replacement where the plastic inserts lock-in. In the tibial component, the metal choice is less important since there is little traction or rubbing during movement.

3. Polyethylene— This is a type of strong plastic found in the tibial patellar (kneecap) component and the plastic spacer. The plastic components allow the metal pieces to glide smoothly throughout the movement. This material is metal-free.

Those with Nickel Allergies-

If you have a history of skin reactions to metal jewelry or are unsure if you may be allergic, it might be worth getting formally tested by an allergist. In general, the femoral component is the only artificial component that those with a nickel allergy need to be conscious of when selecting material and manufacturer. Majority of the femoral parts are made from cobalt-chromium since it is a very tough metal. The tibial component (the other component made of metal) is usually made of softer, titanium alloy, which has very low (almost untraceable) amounts of nickel.

The golden knee replacement surgery is a blessing for the people who have a metal allergy. These knee implants have enhanced surface coating of Titanium Niobium Nitride (TiNiN). This coating gives the implant a golden colored look (hence named golden knee) and improves the longevity and performance of knee replacement surgery. This coating also makes the implant allergy-proof.

The gold knee is one of the best implants available today and the most successful too. It not only increases the life of the implant but also prevents any allergic reactions in the patient. Regular knee implants made of chromium cobalt alloy tend to release metal ions in the body. In patients who have a metal allergy, these metal ions can cause inflammation in the knee area and eventually cause complications like infection, loosening, and persistent knee pain. Golden Knee implants do not induce allergic reaction with human tissue. Its wear and tear are very low. Hence a Golden Knee replacement surgery is generally suggested for such patients. Due to its improved longevity of up to 40 years, this implant is preferred for knee replacements in patients younger than 60 years.

However, any patient can undergo Golden knee Replacement surgery but it is preferably advisable for patients who have a metal allergy and Patients younger than 60 years.

Benefits of Golden Knee Replacement-

  • Allergy-proof

  • Improved longevity of up to 40 years

  • Improved durability of the implant

  • Better Biocompatibility

  • Better surgical results

Total Knee Replacement - Know More About It!

Total Knee Replacement - Know More About It!

Coping with knee pain is never easy. When the wear and tear of the knee joint are so severe that no medication works, it is the surgery that comes to the aid of the patient. Total knee joint replacement surgery improves mobility in the affected individuals.

What is knee joint replacement?

Basically, knee joint replacement means replacement of damaged cartilage rather than changing the whole knee joint

In the damaged surface (cartilage) of the joint is replaced by a smooth metallic surface on both sides between those metallic smooth surface we place highly cross-linked polyethene cushion, this creates a smooth and pain-free movement between the joint bones. So total knee joint replacement is basically a surface replacement only.

Who can go for total knee replacement surgery?

People with damaged knee joints due to severe osteoarthritis, trauma, or degenerative diseases.

When the knee joint pain and stiffness keeps increasing, the daily motion and capacity to conduct activities are restricted to a large extent. Such people can discuss with the doctors about the risks and benefits of the surgery, and go ahead with the same.

When one should go for a total knee joint replacement and can this be done in children also?

Knee joint replacement is usually advised in a patient of age more than 55 or 60 but in some rare situations where the disease is severe, it could be done in the age of 50 also and it should never be done in children.

Can both the joints of a patient replaced simultaneously?

Most of the time joint replacement is done in old patients so it is always safer to go one by one but if the patient is fit medically and the surgeon feels comfortable, both the joints can be replaced simultaneously.

Can it be done in Diabetic and high blood pressure patients also?

Yes, it can be done in hypertensive and diabetic patients also but before surgery, all this should be under control.

Can you continue to take the regular medications that you are taking even before the surgery?

Previous medicines Might be adjusted or discontinued.

When the surgery is planned, the surgeon evaluates the tissues and joints adjacent to the knee for optimal results. Also, the medical history is discussed. In case you are taking blood thinners or aspirin, you might have to discontinue them prior to surgery or they would be adjusted to suit the requirements of the surgery. This is usually done to prevent the risk of excessive bleeding during the surgery.

How long a patient has to stay in the hospital after surgery?

The patient is usually kept in the hospital for about five days after total knee joint replacement and then he can be discharged on oral medications.

What do you say about the results of total knee joint replacement?

Results of total knee joint replacements are wonderful, it is the most appreciated surgery in Orthopaedics in which patient satisfaction rates are very high. Patients usually become almost pain-free and his alignment of both knee and deformity of the knee joint is cured permanently.

What is the recovery period after the total knee replacement surgery?

The recovery period is 6 Months.

Usually after a successful knee joint replacement, the patient can walk on the second day of surgery with the help of a walker. One can return to daily activities within a short span of 6 weeks. For a few, it might take another couple of weeks. But the pain and swelling subside only after 6 months. Also, there are instructions given by the surgeon about things one shouldn’t do during this period. Walking is an exercise that is permitted, while strenuous exercises and other activities are avoided.

Which types of activities could be done safely after total knee joint replacement?

After total knee joint replacement, patients depending on his physical ability can walk as much as he wants, can climb upstairs and downstairs, can do swimming, can do cycling and even can ride bicycles, two-wheelers and can participate in light sports activities.

After a total knee joint replacement, can we do squatting or cross leg sitting?

After total knee, joint replacement patient can do squatting and can sit cross-legged but usually one should avoid these two positions because if a patient uses these two positions repeatedly, the life of the joint is decreased.

How to choose a hospital for total knee joint replacement?

This surgery can be done in any City, all you need is in a hospital which has an experienced Orthopaedic surgeon in joint replacement and a dedicated operation theatre ( that is a modular operation theatre with laminar airflow system), these are the basic and the most important requirement for a hospital to do a joint replacement.

Primary & Revision Total Hip Replacement Surgeries - Is There A Difference?

Primary & Revision Total Hip Replacement Surgeries - Is There A Difference?

Primary Total Hip Replacement Surgery is generally a successful procedure, allowing people to restore their active and painless lifestyle. It involves the replacement of a hip joint with a prosthesis or an implant made of different materials. But, over a period of time, this procedure might fail for a number of reasons. When such a failure happens, revision surgery is employed. The Revision Total Hip Replacement Surgery is hence the second operation that removes parts of the first prosthesis to replace them with a new set.

The ultimate goal of both the procedures, namely Total Hip Replacement Surgery and Revision Total Hip Replacement Surgery is the same that is to improve the quality of life by bettering the functionality and relieving pain. However, these two surgeries are different in their procedure and complexity. Revision Total Hip Replacement Surgery is more complex and takes much longer time. It requires good planning and use of specialized tools and implants for achieving good results. Use of specialized implants compensates for the damage to soft tissue and bone that makes it difficult for the surgeon to use standard Primary Hip Implants.

Revision Total Hip Replacement Surgery can manifest itself into two forms:

  1. There might be the need to remove the entire prosthesis and its replacement. It might also involve rebuilding the bone around the hips with augments or bone graft.

  2. In another case, there is a possibility that only some parts or components of the prosthesis need to be removed and replaced.

When to go for Revision Total Hip Replacement Surgery:

  1. When there is wearing and loosening of Implant, it does not function properly. For proper functioning, the implants can be cemented into place or press- fit allowing the bone to grow onto them. If this does not happen, the components get loose leading to pain. Loosening of implants might be caused by excessive body weight, rigorous physical activity, and wearing of the plastic liner inserted between metal cup and ball. Also, younger patients might also have to go through a Revision Surgery when the implant completes its life expectancy.

  2. If there is a bacterial infection in the Total Hip Replacement, Revision Surgery is employed. This is so because antibiotics cannot alone eliminate bacteria from joints. In such cases, two stages of the operations are required. But sometimes, a single stage operation is also employed. However, it has limited application.

  3. When there is a recurrent hip location in the ball and socket joint, Revision Surgery is opted to properly align the joint and to insert the implant.

  4. In case of a periprosthetic fracture (when bone around the implant breaks), Revision Surgery is required.

  5. When metal used in implant breaks or degrades, it may cause damage to soft surrounding tissue and bone. This would require a corrective Revision Surgery.

Preparation for the Surgery:

The patient undergoes a thorough physical examination. It is to ensure that undergoing surgery would not be harmful in any possible way. X-Rays, MRIs, and CT scans are employed to fully understand the structure of the joint. Laboratory tests are conducted to ascertain the fitness of the patient to undergo the procedure. It should be noted that post- surgery, the patient is not able to function at all and requires help even to perform petty tasks for himself. Thus, suitable arrangements should be made accordingly in advance for the same.

Post-Operative Care:

Post-operative care involves pain management, preventing infection, physical therapy, wound care, and prevention of blood clot. It ensures healthy recovery.

Knee Replacement - Know Forms Of It!

Knee Replacement - Know Forms Of It!

Knee replacement is a procedure where the weight-carrying surfaces of knee joint are 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 minimize 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 anaesthesia, an incision of 8-12inches is made in the front part of the knee. A 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 the 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 even after 15 years of surgery. Hence, a knee problem is no problem at all!

What is the life of knee replacement? Is there any other device for replacement other than manual knee surgery? Which device is easily available in India?

What is the life of knee replacement? Is there any other device for replacement other than manual knee
surgery? Which...
Before replacements, you should try physiotherapy for 4-6 months. because you will have always some issue for knee after replacement also otherwise today in market available life long implant wth good quality. Choice depends on years' cost. Consult with implant representative in urs area.
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Knee Replacement Surgery - What To Expect?

Knee Replacement Surgery - What To Expect?

When performing simple daily activities like climbing stairs, getting out of a chair, or walking tend to become a rather painful experience, knee replacement surgery seems to be the only suitable solution. Referred to as arthroplasty, it is a common surgery nowadays and ideal when several other therapies and injections fail to bring back the knees into the normal functioning order. Below are some the things that one can expect from a knee replacement surgery.

  1. Medications: It is quite natural to receive lots of prescribed medicines right after the completion of the surgery. From antibiotics to painkillers, one needs to be ready to have various medicines which are meant to relieve the pain of the surgery as well as to prevent blood clots. However, the drug dosages continue to get lesser, after each passing day, depending on how well the knees are performing.
  2. CPMTaking the help of CPM or continuous passive motion becomes necessary for many people after having the knee replacement surgery. Depending on the condition of one’s knee, one might need to spend time in a CPM system, which helps in keeping the knee flexible. There’s a cradle in the machine for the legs, and the machine is fitted with the joint position and leg length. One can adjust the level up to which the machine can bend the knees, depending on their comfort level.
  3. Walking: The majority of the people who undergo knee replacement surgery can walk the very day of the surgery or the next day. Most of the people become able to bear the weight of the replaced knee with the help of crutches or walkers. However, one can expect a bit of pain when starting to walk for the first time after surgery.
  4. Rehabilitation: The primary purpose of rehabilitation after a knee replacement surgery is to make one capable of bending his or her knees at least 90 degrees which is essential for performing the daily activities easily. Several therapies can make the rehabilitation process a success and make the knees bendable more than 90 degrees in most of the cases.
  5. Exercise: Most people go home within a few days after a knee replacement surgery and is essential to take care post-surgery. The best way to maintain the good health of the knees is by performing the exercise program regularly, which is suggested by the doctors. Following the exercise program regularly and performing regular short walks, can make the knees flexible like before while regaining their strength as well as the motion range more quickly.

It's best to visit one's doctor from time to time, even months after the knee replacement surgery is done to not only monitor his or her knee replacement; but also to ensure that there are no risks of any complications.
 

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Joint Replacements - What Should You Know?

Joint Replacements - What Should You Know?

When your daily activities are limited due to severe pain or joint damage, it is when a joint replacement may be the best option. Joint replacements are done to restore movement and reduce pain. The most commonly replaced joints are the hips and knees. With advances in medical technology and operational expertise, these procedures have undergone major changes in the way they are done. The success rates have also proportionately gone up.

Hip replacement: The hip is a bone and socket joint, wherein the hip joint sits in the femur, which is the thigh bone. This could require replacement either due to a severe injury or due to regular wear and tear with aging. Replacement is considered when non-medical therapies like exercise and painkillers fail to improve the quality of life. In advanced joint replacement, both the ball and socket portions are completely replaced with artificial components (could be metal, plastic, or ceramic).

Knee joint replacement: The knee is a modified hinge joint formed between three bones – the patella (knee cap), the femur (thigh bone), and the tibia (shin bone). The knee can be affected either due to regular wear and tear or as a part of the trauma. When the knee joint is affected, the patient’s ability to move is greatly diminished, and thus requires treatment. If nonsurgical measures fail, then surgical correction is required.

What happens during the joint replacement?

  • These are major operations and are done in the hospital setting, with 1 to 2 days of hospitalization
  • The operation takes about 4 to 5 hours
  • The damaged cartilage or bone is removed and the part is prepared to receive the prosthesis
  • Titanium alloy is often used as it has the unique ability to fuse to the bone
  • Sometimes, plastic or ceramic is also used
  • These simulate the movement that was previously produced by the natural joint
  • Post operation, infection control is extremely important
  • Pain control initially could be through injection, and then gradually move to ad-hoc basis
  • With the pain and limitation on movement gotten rid of, the new joint should be gradually accustomed to movement. The surrounding tissue also requires time to heal and support the normal movement.
  • Return to movement should be gradual and under a physiotherapist’s guidance. Advance exercise as directed.
  • Diet should be modified to ensure the required nutrition is provided for proper healing
  • Other equipment like a walking stick, shower bench, handrail, or a walker may be required.
  • The first few weeks could require extensive help to move around and get back to normal activities.

Whatever the part replaced, with total joint replacement, these precautions should be adhered to, to ensure complete recovery and successful return to a stage of pre-operative movement.

Also Read: Benefits of Pure Nutrition Endojoint Capsules in decreasing oxidative stress and maintaining health of joints.

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Knee Replacement - Know All About It!

Knee Replacement - Know All About It!

Knee replacement surgery- which is also known as knee arthroplasty, helps to relieve the pain in the knee thereby restoring the knee function. During this procedure, a surgeon cuts the damaged cartilage and bone from the kneecap, thighbone, and shinbone and replaces the same with an artificial joint comprising of high-grade plastics, alloys, and polymers. A patient/surgeon has the liberty to choose the type of knee joint he/she prefers based on factors such as weight, age, overall health etc. 

Signs that might indicate a knee replacement surgery -

  1. The pain in the knee keeps coming back all the time. 
  2. The knee aches after a brisk walk or during an ongoing exercise session. 
  3. The mobility of a person has gradually decreased over time as compared to last few years. 
  4. A supporting cane or medication isn’t delivering the desired support or pain relief. 
  5. The knee tends to stiffen when a person sits for a long time. Example- witting through a movie or sitting in the car for too long proves to be a major hurdle. 
  6. The pain proves to be a major problem that intervenes with sleep. 
  7. The knee motion significantly decreases once a person tries to bend the knee. 
  8. Climbing stairs turns out to be a major hurdle. 
  9. Getting out of bathtubs becomes a major challenge. 
  10. The knee becomes and stays stiff or at least half an hour after getting up from bed in the morning. If the stiffness lasts for more than 60 minutes, it is a sign of inflammatory disease. 

How is a knee replacement surgery performed? 

  1. Knee replacement surgery requires overnight stay in the hospital. 
  2. It involves a general or spinal anesthesia
  3. Once the skin over the surgical site is cleansed with an antiseptic, the doctor makes an incision and takes out the damaged surface of the knee joint. 
  4. The knee joint is then resurfaced with a prosthesis made up of plastic and metal. 

A cemented prosthesis is most commonly used during these days. The prosthesis contains 3 components: 

  1. Tibial component 
  2. Femoral component 
  3. Patellar component 

What are the advantages of knee replacement surgery? 

  1. The biggest advantage of this surgery is the freedom from constant and throbbing pain. 
  2. The fact that surgery can increase the mobility also proves to be a blessing for the general condition of the patient.
  3. Knee replacement also helps a patient to get rid of supporting device such as a cane, wheelchair, pain medications etc. 
  4. The feeling of stiffness also goes away after the surgery.
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