27.04.2020
Common Questions in a patient’s mind about knee replacement.

How long should I wait before I can get knee replacement?

Osteoarthritis is a degenerative disease that continues to damage the surface of knee joint and deform the shape of bones around the knees.Prolonged waiting leads to weakening of the muscles around the knee joint.

Once the pain becomes intolerable,patient does experience difficulty walking, abouthalf a kilometre, climbing and getting down the stairs becomes challenging, immediate consultation with the orthopaedic is warranted.

Do alternative therapies such as acupressure, ozone, massage, oils, laser therapy, magnetic therapy; braces help?

There is no scientifically proven data that alternative therapies may cure the disease.They may alleviate the symptoms to an extent,may also provide temporary relief but do not delay the progression of the disease.

Do medicines prevent the disease progression? How long should I take them?

No. Medicines like pain killers do provide temporary relief and have long term side effects including peptic ulcers and kidney damage. Furthermore, alternative medicines like glucosamine and diacerein act more like placebo.

Medicines for rheumatoid arthritis can provide symptomatic relief and delay progression of disease and prevent deformity to occur.

Does injection knee helps?

There are various kinds of injections. Steroids offer temporary relief from pain but should be avoided as they increase long term wear and tear of the joint. Visco supplementation and plasma rich platelet therapy (PRPP) for the knee have a role in early stages of osteoarthritis as it tends to increase the cartilage producing cells.

What do you mean by knee replacement? Doctor do you put a new knee?

No. It’s is not like other organ transplant. It is a knee resurfacing procedure where by 9 mm of eroded joint surfaces are cut and resurfaced by putting in a cobalt chromium tray and a plastic insert in between.

I weigh 100 kg. Can I get knee replacement done?

Yes. With innovation in science and modern implants available the problem can be tackled with ease. Dr Sumit, has been constantly been using stems in his practice of total knee replacement which leads to weight sharing and easy distribution of the weight of the patient.

What age should I get surgery done?

Indication of surgery remain the same regardless of the age.Age is not a contradiction for surgery .Patients who had undergone knee replacement at age of 89 years and are enjoying the biggest gift of life:-“WALKING”

Should I get Both knees replaced simultaneously or one knee at a time?

Before the age of 70 years it is recommended to get both arthritic painful knees replaced in a single sitting. However, after 70 years it is recommended to replace knees in a staged manner with a gap of 6 months between both surgeries.

I am diabetic hypertensive and have a cardiac stent placed?Can I think of surgery?

Yes. With advent of modern-day anaesthesia and operating facilities it is possible to carry high risk surgery with effortless ease.Cardiac stress test, Echo and stress thallium are such tests conducted in our hospital routinely which screen high risk patients and stratify the risks involved.

Dr Sharma says there is a rising trend in such high-risk cases. Nowadays, its more pragmatic approach to operate these patients early; it not only makes the patient mobile but also a reverse trend is noted in sugar and blood pressure levels.

Do computers and robots have a role in knee surgery?

Dr Sharma recommends computer aided surgery and Mako assisted Total knee gives a road map for planning out difficult deformed knees in my practise. It also aids to position the implant better anatomically thereby minimising surgical error.

Is knee replacement a painful procedure? How long will I have pain after surgery?

Yes, it is. But, with advent of modern-day anaesthesia it has become a painless procedure. Anaesthetist use a wide variety of anaesthesia techniques including epidural anaesthesia and nerve blocks which keep the leg numb while keeping the movements intact. Dr Sharma,has been injecting the popular “RANAWAT COCKTAIL’ a special type of anaesthesia in the knees of the patient which makes them pain free in post-operative period .

After Knee replacement when can I resume my day to day activities?

Usually 3 to 4 weeks post-surgery patient is able to wean walking aids and can climb stairs and start walking normally .Patients can start slow jogging and driving in 6 to 8 weeks post-surgery .The pain free walk which patient achieves is of paramount importance to his health and wellbeing.

How long does the new knee last?

A well done surgery and a well-maintained knee post-operatively usually lasts 15 to 18 years. One should avoid sitting cross leg and using asian toilet seats to maintain longevity of the implant.

Can Knee replacement be done the second time?

Yes. It is seldom required though; It is called revision knee replacement surgery and it too has good longevity.

Doctor
Dr. Sumit Bhushan Sharma
Associate Director
Department of Orthopaedics & Joint Replacement
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