Total knee replacement surgery (TKR)
When all the three compartment of the knee are damaged the whole of the knee is replaced by tri or bicomaprtmetal prosthesis this is known as Total Knee Replacement. The candidate for total knee replacement are selected very carefully after proper discussion with the patient. Only the patient with severe pain and grade 4 OA Knee are likely candidate for the surgery.
In this surgery the osteophytes are removed from knee joint, and bone ends are reshaped according to the prosthesis shape. The femur prosthesis and tibia prosthesis is then fitted to bone end with bone cement to both femur and tibia. A highly crosslinked poly also called insert is placed between the two metal prosthesis which act as a cushion and provide a smooth gliding surface so that knee joint can bend easily. Some times patella bone is also resurfaced with the same highly cross linked poly material.
Both Knee joint can be replaced in same sitting or can be done in stages depending on the patient general condition, physical fitness and associated cormorbidities.
Who are the ideal candidate?
The most important criteria is severe pain debilitating patient even to perform his day to day activities. Or those patient who espire to have more active and healthy life, enjoy their outdoor life when pain is restricting their activities, holding them back.
On X-rays grade 4 OA is ideal stage for knee replacement, or those patient whose knee have been completely damaged irrespective of cause like trauma, infecton etc.
Our specialised team of various specialities will assess your condition physically and perform various investigations for fitness for undergoing surgery and to ascertain safe surgery and smoother faster recovery.
Those Patient who are taking blood thinners, are made to stop these medicines 3-5 days before surgery as per the guidance of physician or cardiologist.
Pain Management
In our institution TKR is almost a painless surgery. A special attention is given to keep the pain under control so that the patient can be mobilised early.
During surgery a special mixture of drugs are injected in the tissue surrounding the knee joint for postoperative pain control.
An Epidural infusion is started which delivers drugs continuously to spine keeping the pain under control. Also various pain killer injections and patches can be added in cases having extremes of pain.
Postop protocol
Following Knee replacement surgery patient is mobilised as early as possible.
Patient is made to stand as soon as the effect of anaesthesia weans off or on very next day of knee replacement surgery. Patient is taught exercises for proper pumping of blood in legs, to strengthen muscle and to achieve early and good range of knee movement.
Our highly skilled Physiotherapist team will visit you post operatively and help you in doing proper exercise.
A step by step protocol is properly designed and individually tailor made for better, early and painless recovery.
Following TKR I.V. antibiotics are started to cover any possible risk to infection.
Proper precaution and prophylaxis is started in form of blood thinners and is mobilised as early as possibe to avoid potential complication Like Deep Vein thrombosis (DVT).
Patient responsibility
After successful Knee replacement surgery you need to strictly follow doctors advice and do your exercise regularly. A physiotherapist may help you better in doing your exercise and help you achieve full benefit from your surgery.
You will be put on blood thinners and antibiotics for few days.
Most importantly you have to take care to avoid any fall and any infection anywhere in your body. In case you see symptoms of any infection you must consult your doctor immediately.
What to expect after TKR
Patient is made to stand next day after surgery and made to walk on 2nd day. He is taught to climb stair and is discharged with few sets of exercises from hospital after 3-5 days of surgery.
Stitches will be removed on day 14 after surgery.
Patient is encouraged to do regular exercises with the help of physiotherapist to achieve early strength and good knee movement so that he can start his regular activities as soon as possible. Full recovery may take from 2 months to 4 months after which patient will be able to walk for long distance and climb stair freely. Most patients who are previously able to sit cross leg usually able to sit cross leg post surgery also. Though TKR patients are not advised to sit on ground.
Life of Total Knee Replacement Surgery
Usually your surgery may last anywhere from 15 years to 25 years or may be long.
After successful implantation and with regular physiotherapy you will experience near normal functioning knee and this knee can work lifelong in most individuals.
