Total Knee Surgery

Total Knee Replacement can help relieve pain and restore function in severely diseased knee joints. Surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap, and replaces it with an artificial joint (prostheses) made of metal alloys, high-grade plastics and polymers.

Total knee replacement can improve knee problems associated with osteoarthritis, rheumatoid arthritis and other degenerative conditions such as osteonecrosis.

The procedure may help if:

• You have pain that limits activities such as walking, climbing stairs and getting in and out of chairs, or you experience moderate or severe knee pain at rest.
• You have limited function or mobility, such as chronic knee stiffness and swelling that prevent you from bending and straightening the joint.
•You've tried other methods to improve symptoms, for example resting, weight loss, physical therapy, pain medications and surgery, but they've failed.
• You have a knee deformity such as a joint that bows in or out.

How is it done?

During the procedure, your knee is in a bent position so that all surfaces of the joint are fully exposed. After making an incision between 6 and 12 inches in length, surgeon moves aside muscles, kneecap and connective tissues and cuts away the damaged bone and cartilage. He or she takes measurements to ensure a good fit for your new prosthesis and smoothens your bones' rough edges.
The surgeon then inserts the prosthesis. Before closing the incision, he or she bends and rotates your knee, testing and balancing it to ensure that it functions properly.

Recently at Apollo Hospitals, Chennai I started doing the same procedure using computer navigation. Through this we can reduce the cut we make on the skin to 3 to 4 inches. This causes less blood loss and is called as minimally invasive knee replacement surgery.
By using the computer navigation we can reduce the human errors of alignment and fixation of the prosthesis. This in turn will increase the longevity of the knee replacement and range of movement.

Anesthesia: Options and considerations

The Anesthesia doctor places several monitors on your body, to help make sure that your heart rate, blood pressure and blood oxygen levels stay at safe levels throughout the procedure.

These monitors may include a blood pressure cuff on your arm and sticky heart-monitor leads stuck to your chest. Expect the procedure to last about two hours. After surgery, you're wheeled to a recovery room for one to two hours. You're then moved to your hospital room where you typically stay for several days before going home. You may feel some pain, but medications prescribed by your doctor can help control it. During the hospital stay, you're encouraged to move your foot and ankle, which increases blood flow to your leg muscles and helps prevent swelling and blood clots. You may need to receive blood thinners and wear support hose or compression boots to further protect against swelling and clotting.The day after surgery, a physical therapist shows you how to exercise your new knee. To help regain movement, you may use a device called a continuous passive motion machine, which slowly moves your knee while you're in bed.

Day one after the surgery you will be encourage to walk with the help of a walker. We would advise you to use the walker for 3 weeks and then walking stick for another 3 weeks. After 6 weeks you will e allowed to walk independently. During 1st three weeks after the surgery you will be given physiotherapy protocol to build up thigh muscle and knee bending exercises.
About 95 percent of people who have a total knee replacement experience significant pain relief, improved mobility and a better overall quality of life.

Risks

As with any surgery, knee replacement surgery carries risk of potentially life-threatening infection, heart attack and stroke. Blood clots in the leg vein (thrombophlebitis) are a major concern, so blood thinners are commonly used to help prevent them.