FAQs

Damage to the knee or hip joint can result from various reasons but the most common cause is arthritis. If your knee or hip has been severely damaged by arthritis or injury, simple activities such as walking or getting in and out of a chair may be painful and difficult for you. Going up and down the stairs may become impossible and you may even feel uncomfortable while resting. Medication may control your pain for a short while but long-term use of pain-killers can damage your stomach or kidneys. You may therefore be advised total knee/hip replacement operation. But it is a major operation and your consultants will advise you about the likely benefits of surgery. Before making that decision, you should be sure that your expectations about its outcome are realistic and that you understand the benefits and risks associated with surgery.

Surgery to replace knee or hip joint can have a dramatic effect on the lifestyle of someone suffering from pain and disability. These replacement surgeries can relieve your pain and help you get back to enjoying normal, everyday activities. Advances in joint replacement surgical techniques and technology have greatly improved the results.

Patients with these medical conditions can safely undergo joint replacement operation. These conditions need to be controlled well with medication prior to surgery.

After deciding a date of admission and surgery, we advise some Blood and Urine tests and a medical checkup by Physician. This is to make sure that you are fit for anaesthesia and operation. This will also help us detect if, at all, there is any active or recent infection in your body which can be treated before surgery.

Any active skin, dental or urinary infections are to go ahead for surgery and should be treated and documented in Lab reports! Patient is also required to inform the doctor regarding all the medicines being taken so as to stop certain drugs like blood thinner well ahead of surgery! All these reports can be done without any hassle in our hospital only.

You would be admitted to the hospital on the evening/night before the day of operation and would be examined again to make sure that you are fit and well to undergo operation.

Two types of Anesthesia are commonly used for Knee Replacement Surgery. The First type of anesthesia is Spinal Anesthesia with Epidural Analgesia, which is very commonly used, works by numbing your legs, so you do not feel the operation. This is done by placing numbing medicine around the nerves that would go to your legs using a small catheter in your lower back. You are also given medicine to relax you and you may fall asleep, but you can still breathe on your own.

An actual surgical procedure usually takes approximately 50 minutes to 1 hour. However, preoperative preparation time required by an anesthesiologist to prepare you for the surgery and certain procedures after surgery will make you stay in the operation room for about two-to two-and-half hour.

This will depend on your level of Haemoglobin before surgery. With use of tourniquet, blood loss during surgery is usually minimal. So, during surgery, usually blood transfusion is not needed. But sometimes, we might advise after surgery, considering Haemoglobin level and the drain output coming out of the operative wound.

It is very likely that you will have pain in your knee for first 2 days. This is normal and you should not be surprised or concerned. Most of the pain that you experience right after surgery is from the surgical incision and dissection. You will be given pain medication through your I.V. line and also through the epidural catheter and most of the patients are very comfortable with these pain-relieving measures. With our Fast Track Replacement Technique and a use of the latest analgesia protocols, we have been able to make postoperative period quite Painfree! However, generally any surgery is more or less painful only for first 48 hours and then the patients more likely start getting more and more comfortable.

Both knee replacement operations can be done under one anesthesia. The decision whether to do so depends on medical fitness.

It depends on the complexity of the operation and your recovery. Patient with single knee replacement can go home in 2-3 days while those undergoing one stage bilateral knee replacements can go home in 3 to 5 days.

Generally, you can get out of bed on the day of surgery or the next day. You will be assisted by a Physiotherapist. Mostly knee bending is started immediately after that. As soon as you regain muscle strength, you can take a few steps with support of a walker. Later you can take short walks. If your progress is quick, you can start climbing stairs by third or fourth day.

• You will be sent home on prescribed medications to control pain. Plan to take your pain medication 30 minutes before exercises.
• Continue to walk with walker/stick. Bear weight and walk on the leg as much as is comfortable. Walking is one of the best kinds of physical therapy and for muscle strengthening.
• If excess muscle aching occurs, you should reduce your exercises.
• Keep the incision clean and dry. If you observe sudden increase in swelling and pain, drainage from the incision site, redness around the incision or fever is noticed, report this immediately to the doctor.
• You should not take bath until staples are removed. Generally, the staples are removed in two weeks.
• You should not drive a car until the 4-week follow-up appointment.

An artificial knee is not a normal knee, which the nature has provided. However, the operation will provide pain relief for at least 15 – 20 years. In many patients, their total knee replacement will last their lifetime, but in some it may not last that long. If replacement provides you with pain relief and if you do not have other health problems, you should be able to carry out most of the normal activities of daily living like unlimited standing, sitting, walking etc.

You can do exercises like bicycling, walking and swimming. However, activities that overload the artificial knee like jogging and sports like tennis must be avoided to increase the longevity of the artificial knee. Most of the patients with stiff knees before surgery will have better motion after a total knee replacement.

Almost all modern total knee implants have very similar basic Total Condylar design and have some minor differences in designs. Some of the joints have metallic components fixed to the end of thigh bone (Femur) and Leg bone (Tibia) with bone cement and a plastic insert between the two metallic components (Metal backed Tibial component). It does offer some technical advantages to the surgeon. As against this, some other designs have All-Polyethylene tibial component called allpoly tibia, where the femoral component is metallic and the tibial component consists of only plastic.

All-poly tibial base plates are more cost-effective to the patient. Some of other available knee implants may include gender specific knees particularly for female patients and high flexion knee designs (Hi-flex knees), which are supposed to provide more knee bending. Long term results regarding longevity and patient satisfaction for these relatively recent designs are, however, not available at this stage.

Therefore, the final choice of the implant should be ideally left to the operating surgeon, who would base his decision keeping in mind the requirements of the patient, suitability of a particular implant in the given patient, survivors hip (longevity and track record) of the implant and also his experience and familiarity with the instrumentation and implant practiced.

As the knee arthritis worsens, the stiffness of the arthritic joint also worsens. This can make the replacement surgery technically more demanding. It may also lead to a longer recovery period and more physical therapy. In severe cases, joint flexibility may never return to normal. By waiting too long, you may not get the full benefits of your knee replacement surgery and such a delay could negatively impact the result of the surgery.

Knee replacement surgery can be carried out even in patients who are above the age of 75-80 years provided they are medically fit and are in good general health and their activities of daily living is restricted by painful arthritis of knee joints

According to research, more than 82 percent Trusted Source of total knee replacements are still functioning 25 years later. However, wear and tear can adversely affect its performance and lifespan.

Younger people are more likely to need a revision at some point during their lifetime, mainly due to a more active lifestyle. Consult with a doctor about your particular situation.

Indian customs of cross leg sitting and squatting are avoided after surgery. You need to use a commode or a toilet chair. Activities like swimming, walking are encouraged but running, jumping and other heavy physical activities are discouraged.