Knee replacement surgery

What is done in knee replacement surgery?

During the knee replacement surgery, the orthopaedic surgeon surgically removes the part of the knee that has been damaged and then this portion is replaced by an artificial joint, commonly known as a prosthesis or an implant. The artificial joint or implant is fixed to the bone of the thigh on one end and the shin, and kneecap on the other. These parts are cemented together with special materials like acrylic or cement.

How to choose an ideal prosthetic/implant?

With advancements in medical science, knee replacement surgery can now be performed in a short duration of time and least invasively. The orthopaedic surgeon can choose from a variety of knee designs or implants depending on the patient’s height, weight, and physical activity level.

These implants may be made of metal, ceramic or strong plastic. Each component in majority of cases is built from metals like titanium, alloys of cobalt-chromium or a titanium and cobalt mixed metal. Whatever maybe the material, the implant should have the following characteristics:

• The selected materials must be durable with the potential to last at least 15-20 years
• Allow for flexibility with movement of the knee
• Biocompatible i.e it should not be rejected by the body or should not corrode nor react with the body fluids
• Some implants these days are gender specific, i.e made just for women as they are designed to be compatible with the female anatomy

Is knee replacement good for me? What are the risks and benefits of knee replacement?

The knee replacement surgery is performed to bring about:

• Relief from pain
• Improved mobility
• Increased ability to pursue day-to-day activities like walking, sitting, standing etc

It is usually seen that about 90% patients who undergo knee replacement experience much reduced pain. Majority of them are able to perform routine daily activities and stay active. In many cases, patients are even able to resume activities like playing games (such as golf and walking) which they had earlier given up due to painful condition.

Being a major surgical procedure, knee replacement carries some risks. Most people undergoing knee replacement don’t experience serious complications. However, some of the possible risks are:

• Risks associated with anaesthesia
• Deep vein thrombosis or formation of blood clots in the veins of the leg. Sometimes, these clots may become detached and travel to the lungs, thereby, causing a condition called pulmonary embolism.
• Infections in the site of surgery or within the joint
• Fracture of the bone around the implant
• Dislocation of the knee cap

Damage to the nearby ligaments or nerves etc.

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What factors should be considered while choosing a hospital for knee replacement surgery?

Since knee replacement is a major surgery, it is important to ensure that the hospital has the infrastructure and trained team to support the pre-operative and post-operative needs of the treatment. Some factors that should be considered are:

• The most important consideration while choosing a hospital for knee replacement surgery is the orthopaedic surgeon and his team. The success of surgery depends on the expertise and skills of the surgeon. Specialised training, number of surgeries performed and success rate are indicative of the skill set of your orthopaedic surgeon.
• Advanced operation theatre facilities including provisions to monitor and control infections like High Efficiency Particulate Air (HEPA) Filters, Total Body Exhaust Suit etc, specialized orthopedic equipment is the operation theatre like C-arm, ‘vacuum mixing’ of the cement, pulse lavage etc.
• Post-operative care: Trained team of orthopaedic surgeons, anaesthetist, nursing and paramedical staff to ensure a pain free post-operative recovery and after care for physiotherapy, experienced in joint replacement surgery.
• Round the clock support for diagnostics and pharmacy.

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