KNEE REPLACEMENT - Introduction
All
You Want to Know About Knee Replacement
With increase in longevity.
More number of senior citizens demand a better quality of life.
A painful knee can seriously hamper a person's capacity to walk
freely and make him dependent not only on drugs to relieve pain
but also on others for mobility. The solution to painful arthritic
knee is now easily available in form of Knee Surface Replacement.
Imagine
yourself pushing a fully loaded vehicle which has flat tyres.
You would need considerable force to make it move. Same happens
to an overweight person with an arthritic keen joint. Their
knee joints feel stiff and are deformed and hence the person
needs more physical energy to get up from sitting position,
walk, climb stairs and negotiate slopes. To overcome this, he
or she takes medicine to relieve pain and muscle spasm and may
use a support to walk, but as the age advances, the ability
to overcome pain decreases making the person confined to bed
most of the time. Prolonged use of NSAIDS ( pain relieving medicines)
can even damage the liver and the kidneys of the elderly person
For an individual
aged above 60 years, having painful knee joints which hamper
day to day living, knee surface replacement is an ideal choice.
With current state of progress in every field of medicine, conditions
like diabetes, hypertension, cardiac insufficiency are no more
contraindications for surgery. Even obesity is not a problem.
The surgery
is relatively safe since it is carried out under Epidural Anaesthesia.
This anaesthesia is better tolerated by the elderly. There is
also an added advantage of postoperative analgesia by use of
infusion pump. The infusion pump is used to deliver the calculated
fractional dose suitable for an individual patient. Here the
dose can be controlled by the patient hence it is called Patient
Controlled Epidural Analgesia (PCEA).
The patient
is constantly monitored with the Pulse Oxymeter to measure the
Oxygen concentration of blood and Cardioscope to evaluate cardiac
function during the surgery.
Being a
planned surgery, Auto-transfusion is preferred wherein the patient
is transfused his own blood which is withdrawn preoperatively,
reducing the risk of transfusion related complications.
Unlike hip
joint replacement. Where a large part of the upper end femur
is removed to be replaced by metallic implant, in the Knee Surface
Replacement, only the irregular superficial surface of femoral
and tibal condyles are shaved, which are then resurfaced using
cobalt chrome prosthesis for femur and Ultra Molecular Weight
High Density Polyethylene ( UMWHDP ) implant for tibia and patella,
as this combination of metal and plastic has minimum friction
and is well tolerated by the body.
Even though
the surgery involves bone resurfacing, it mainly consists of
soft tissue realignment and balancing, hence the deformity is
corrected and the patient is ready to be discharged on the 5th
postoperative day in majority of cases. This reduce the cost
as well social inconvenience to the family.
Resurfacing
reduces the friction thereby reducing the pain and hence the
patient starts exercise using Continuous Passive Motion Machine
(CPM) within 48 hours and starts standing and walking in three
to five days, initially requiring support for locomotion. During
the post operative period at home, the patient needs to exercise
regularly, use walking aid and use commode. Sitting on floor
is not permitted. Unlimited stair climbing and walking is permitted.
Knee
replacement surgery is one of the most successful procedures
used for relief of pain, gaining the range of motion and improving
the ability to walk, for a variety of painful knee disorders.
If you are advised knee replacement surgery, it is natural that
you would want to know more about it. This booklet gives you
all the information, which you wish to know, It explains, in
simple words, what to expect before, during and after the surgery.
It is meant to help you understand the intricacies of this complex
surgery. In simple language, you are told , what will be done
for you by the medical and paramedical staff and what you are
required to do to achieve the desired end result. It is recommended
that you go through this booklet before you undergo the surgery.
If you have any questions, our team of doctors will be happy
to answer them.
The schedule
given here is a guideline and individual variations may occur.
The end result varies in different individuals, and in two operated
knees in the same individual , depending on various factors
like age, general condition of the patient, conditions of the
joint, indication for surgery, whether the surgery is on single
knee or both knee joints simultaneously etc.
No guarantee
of any kind can be given for any surgical procedure. According
to world reports, knee replacement surgery is one of the most
successful procedures used for relief of pain, gaining the range
of motion and improving the ability to walk.
Every surgery
carries certain risks. You are required to make yourself familiar
with these risks and the shortcomings.
