Doctors for Knee replacement Treatment

Knee replacement is a surgical procedure that replaces a damaged knee with a plastic or metal implant. It is also known as knee arthroplasty. It is usually recommended for patients who have been suffering from severe arthritis or have a major knee injury.

The knee joints may be impacted by different types of arthritis. Osteoarthritis, rheumatoid arthritis, and traumatic arthritis are a few of the more prevalent types. In osteoarthritis, a degeneration of joints occurs that primarily affects middle-aged or older persons. The condition can weaken the knee joint and cause the cartilage in joints to break down. On the other hand, rheumatoid arthritis causes the synovial membranes in joints to become inflamed and can result in an excessive fluid buildup, which causes stiffness and pain. Lastly, traumatic arthritis can result from a serious knee accident and can seriously harm the knee cartilage, necessitating a joint replacement.

A doctor recommends using conservative methods before recommending knee replacement surgery. In case such methods fail to show effect, surgical treatments are considered. To determine if you are a viable candidate for knee replacement surgery, some physical tests and scans are performed. Moreover, the surgical technique would also depend on multiple factors including your body weight, activity, size and shape of the knee, and overall health.

Listed below are some signs that make you a more likely candidate for surgery:

• Bad arthritis: Arthritis is one of the most common reasons for knee replacement surgery. In most cases, knee replacement surgery is performed to treat conditions like osteoarthritis, the wear and tear type of arthritis, rheumatoid arthritis, an autoimmune condition that causes joint pain and damage, or post-injury arthritis. These conditions are similar, and they all result in loss of cartilage, which leads to pain and loss of motion.
• Extreme pain: If the pain does not respond to other measures, you must consider knee replacement surgery. It helps in improving the condition and quality of your life.
• Swollen knee: Swelling is another sign that the knee is not responding to other treatments. Consistent or recurring knee swelling is a sign of cartilage damage, which can lead to wear and tear. A doctor usually recommends knee replacement surgery to get rid of a swollen knee.
• Deformed knee: In severe cases, arthritis can affect the way you walk, which can also lead to further problems such as a deformed knee. As arthritis progresses, the knee becomes bowed or knocked down. A doctor suggests knee replacement surgery to treat the deformed knee.
• Age: Knee replacement surgery is usually considered in older people over 60 years because younger people’s more active lifestyle may put too much stress on the artificial knee, causing it not to last as long. But it can be performed in people of all ages, depending on your individual case, it's better to discuss with your doctor whether you’re a good candidate.

Listed below are some factors that you must consider before choosing a surgeon for knee replacement surgery:

• Experience of the surgeon: It is one of the major factors that you should consider before choosing a surgeon. Orthopedic surgeons deal with some serious issues that require years of experience to successfully target the condition and plan the treatment accordingly. It is extremely important to consult an experienced surgeon with a good track record of handling sensitive conditions. Moreover, experienced surgeons are more compassionate and are able to empathize with their patients.
• Patient testimonials: The patient’s review are quite helpful in understanding the surgeon’s professionalism, bedside manner, and communication skills. In short, it gives you a rough idea about the quality of care along with the success rate.
• Check the expertise and credentials: Knee replacement surgery requires extreme precision and expertise, therefore, you must consider a surgeon who has already performed successful knee replacement surgery. Moreover, it is extremely important to check the surgeon’s credentials to ensure that he/she is up to date in his/her knowledge and doesn't have any major issues/complications in performing any treatment or surgery. It also gives you an idea about the experience and expertise of the surgeon.
• Consider location and convenience: Rehabilitation is required after knee replacement surgery, so you must consider a surgeon who is at a reasonable driving distance to avoid any complications during the therapy. Apart from quality treatment, it is important that the surgeon is easily accessible or available to maintain quality care.
• Research about the hospital: Apart from choosing the surgeon, it is important to investigate the hospital your surgeon is associated with to have an idea about the medical staff, hygiene, and the quality of care they provide. We suggest checking the patient testimonials along with the recovery outcomes before finalizing the surgeon.

After surgery, you must take the following precautions to avoid any complications and make the artificial knee last long:

• Take prescribed medications: After surgery, there is a risk of developing a blood clot in the first few weeks. It is extremely important to take the anticoagulants that your surgeons suggest. Also, be vigilant if you see any blood clots signs like swelling, redness, excessive pain in the calf, and irritation in the treated area.
• Wound care: Knee replacement is an invasive process. It involves sutures and staples over the wound. Avoid cutting these sutures on your own at home, as it may worsen the wound. It must be removed only by a practiced clinician.
• Limited physical activities: You must be careful not to put your total body weight on the replaced joint right after the surgery. A surgeon usually gives instructions on how much pressure you can put on your knees. It helps in avoiding injury, damage, or dislocation of the joint. Moreover, doctors advise to use crutches, a crane, or a stick to walk around.

Listed below are some points that will help you in preparation for knee replacement surgery:

• Medical Evaluation: It is important to consult your doctor and undergo a physical examination with your several weeks before the surgery. It helps in ensuring that you are healthy enough to undergo the surgery and complete the recovery process. Many patients with chronic medical conditions, like heart disease, may also need to consult a specialist, such as a cardiologist, before the surgery to ensure they are healthy enough to undergo surgery.
• Cut or decrease medications: You need to stop taking certain medications, such as aspirin, opioid pain medication, steroids, and other medications that suppress the immune system before surgery, to reduce the risk of complications during surgery.
• Quit smoking: Smoking can prevent bones, skin, and tissue from healing and can make it more difficult for the body to fight off infection. You must quit smoking in order to promote healing after surgery.
• Urinary evaluations: People with a history of recent or frequent urinary infections must undergo a urological evaluation before surgery.
• Dental Evaluation: If you have any significant dental condition, then it needs to be resolved before surgery. A dental procedure increases the chances of bacteria entering your bloodstream, causing an infection that could travel to your artificial joint. Ensure to see your dentist well before the day of your joint replacement surgery.

Listed below are some implants that are used during knee replacement surgery:

• Metal on plastic: It is one of the most common types of implant. It has a metal femoral component that rests on a tibial component-attached polyethylene plastic spacer. Nickel, titanium, zirconium, and cobalt-chromium are some of the frequently utilized metals. The least expensive implant kind and the one with the best safety and longevity records is metal-on-plastic. However, a potential issue with plastic implants is an immunological response brought on by minute particles that come off the spacer over time. This may result in bone loss, implant loosening, and implant failure.
• Ceramic on plastic: This type uses a ceramic femoral component instead of metal (or a metal component with a ceramic coating). It also rides on a plastic spacer. It is usually recommended if the patient is sensitive to the nickel used in metal implants. Plastic particles from this type of implant can also lead to an immune reaction.
• Ceramic on ceramic: In this type of implant, the femoral and tibial components are both made of ceramic. Ceramic parts are the least likely to react with the body. However, ceramic joint prosthetics can make a squeaking noise when you walk. In some rare cases, they can shatter under heavy pressure into pieces that must be removed by surgery.
• Metal on metal: In this plant, the femoral and tibial components are made of metal. Metal-on-metal implants have been used much less often in recent years because of concerns over traces of metal leaking into the bloodstream. The metal comes from the chemical breakdown of the implant hardware. All metal implants were originally developed to provide longer-lasting joint replacements for younger people. However, the traces of metal can cause inflammation, pain, and possibly organ damage. Metal-on-metal implants may be considered only for young, active men because they may last longer than other materials. Women of childbearing age can't receive these implants because the effects on a fetus are unknown.

If you are researching knee implant manufacturers, you should check out the following for stable and durable high-quality knee implants:

• Zimmer-Biomet: Zimmer-Biomet dominates a large part of the knee and hip implant market across the world. Currently, around 35% of all the implants used globally are from this company, with around 25% share in the knee implant market. The company makes a wide variety of implants suitable for all types of knee replacement procedures. Some commonly used implant models from Zimmer-Biomet are Zimmer Persona (for total knee replacements), Zimmer Nexgen (for total and revision knee replacement), Gender Solutions (specially designed for all types of knee replacements in men and women based on their gender requirements), Vanguard Individualised Design (different sized implants based on patient’s needs), and Oxford Design (specially designed for partial knee replacements).
• DePuy Synthes – Johnson & Johnson: DePuy Synthes is a subsidiary of Johnson & Johnson. It is the second-largest manufacturer of hip and knee implants in the world. The most common knee implant models from the company are Attune (for total and revision knee replacement), Sigma (for total and partial knee replacements), S-ROM Noiles (for total and revision knee replacement with severe bone deficiency or soft tissue degeneration), and LCS Complete (total and revision knee replacement).
• Stryker Corporation: Stryker Corporation is among the most advanced global knee implant manufacturers. In addition to knee implants, the company also excels in manufacturing robotic arms for robotic knee replacement surgery. The most prominent models of knee implants from Stryker company are Triathlon (for total, partial, and revision knee replacement), Triathlon Tritanium (for cementless total knee replacements), Scorpio (for total and revision knee replacement), Duracon TS (for revision replacement), and Avon Patello-Femoral (for partial knee replacements).
• Smith & Nephew: They are a UK-based knee implant manufacturer that also specializes in implants for robotic knee replacement surgery. They use a special alloy of oxidized zirconium in their implants instead of plastic to reduce implant wear over time. Their most common implant models are Journey I BCS (for a total and partial knee replacement), Journey II (specialized total and partial knee implants for younger and more active people), Genesis II (PCL substituting or retaining implants for a total knee replacement), and Legion (PCL retaining or substituting implants for more stable total or revision knee replacements).
• Arthrex Inc.: Arthrex is a medical manufacturer that produces a variety of products for knee problems. Its flagship product, i.e., the iBalance line, provides advanced total and partial knee replacement results.
• Its most prominent implant models are Arthrex iBalance Total Knee Arthroplasty (for customizable total knee replacements) and Arthrex iBalance Unicondylar Knee Arthroplasty (for better tissue preservation during partial knee replacement).

Generally, knee implants are made up of 3 components - metal alloys, ceramic materials, and strong plastics. While designing a knee implant, metal components are articulated with plastic components to allow smoother joint movement and prevent rapid wear and tear damage to the implant.

These 3 components comprise the articular surfaces necessary for the proper function of the knee joint, as described below:

• Tibial component: This component articulates with the top surface of the tibia, i.e., the shin bone. It is generally made of a polyethylene cushion with or without a flat metal platform. In some cases, if needed, the metal portion can be embedded in the tibia for additional stability.
• Femoral component: It interacts with the lower end of the femoral bone (thigh bone). Its design is often modified with grooves so the knee cap can move smoothly and help perform bending and straightening motions.
• Patellar component: It takes the place of a normal patellar bone. It is normally made of plastic, and its back portion is dome-shaped to allow for typical knee joint hinge movements.

The implant is fixed to the surrounding bone and tissues during knee replacement surgery so that it can mimic knee movements. A surgeon carefully evaluates the case and determines the best method. There are 3 ways of fixing knee implants:

• Cemented Fixation: In this type of fixation, the implant is fixed to its articulating bones using a fast-curing bone cement like PMMA – polymethylmethacrylate.
• Cementless Fixation: It involves press-fitting, i.e., instead of relying on cement, the implant is made of a material that attracts bone-forming cells to form new bone around it. To improve bone growth, the implant surface can be textured or coated with osteopoietic material.
• Hybrid Fixation: In this method of fixation, a mixture of cemented and cementless fixation is used.

Here is a list of questions that you must ask your surgeon before surgery to understand the procedure and the risks and complications associated with it:

• What is the success rate of knee replacement surgery?
• What are the chances of infection after knee replacement surgery?
• Is there something I can do to ensure the success of the surgery?
• Do I need to do any exercises before the surgery to make my muscles stronger?
• Do I need crutches after the surgery?
• How can I get my house ready for when I am discharged from the hospital?
• What medications do I need to stop taking before surgery?
• Do I need to lose some weight before the surgery?
• Do I need to quit smoking and alcohol before the surgery?
• What is the cost of knee replacement surgery?
• Does my insurance cover the cost of surgery?
• For how long do I need to stay in the hospital after surgery?
• Is knee replacement surgery the best option for me?
• Does my age affect the rate of success of the surgery?
• What are the consequences of delaying the surgery?
• Which knee replacement surgery is best for me?
• How is a minimally invasive knee replacement surgery performed?
• What are the potential risks associated with the surgery?
• Is there anything I can do to reduce the chance of complications?
• Does any pre-existing health condition like diabetes, high blood pressure, heart disease, etc., affect the chances of successful surgery?
• How long is the rehabilitation period after the surgery?

Most insurance companies in India cover the expense of knee replacement surgery. Furthermore, insurance companies usually have specific criteria for determining who is eligible for knee replacement surgery. For instance, they may require that the patient has tried non-surgical treatments for a certain amount of time before surgery is considered or that the patient meets certain age or weight requirements.

Even though knee replacement surgery is covered under insurance by most insurance providers, each insurance policy may have different criteria and requirements for coverage, so it’s important to contact your specific insurance provider to understand what is covered in your plan.

To know more about knee replacement surgery procedures, cost, and insurance coverage, book your consultation with our orthopedic doctor near you.