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What are types of knee replacement surgery ?

Knee Replacement Surgery TypesEstimated Recovery DaysHospital Stay DurationAge Group
Total Knee Replacement (TKR)4-8 weeks2-4 daysTypically 50+
Partial Knee Replacement (PKR)2-6 weeks2-4 daysTypically 50+
Minimally Invasive Knee Replacement3-6 weeks1-3 daysTypically 50+
Revision Knee Replacement6-12 weeks3-5 daysTypically 60+
Bilateral Knee Replacement8-12 weeks4-7 daysTypically 60+
Custom Knee Replacement4-8 weeks2-4 daysTypically 50+

What is Knee Replacement?

Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace damaged or worn surfaces of the knee joint with artificial implants. It's typically recommended for individuals with severe knee pain and stiffness, often caused by conditions like osteoarthritis, rheumatoid arthritis, or injury. During the surgery, the damaged parts of the knee joint are removed and replaced with metal or plastic components to restore function and alleviate pain. Knee replacement surgery aims to improve mobility, relieve pain, and enhance the overall quality of life for patients.

The knee is a complex joint that connects the thigh bone (femur) to the shinbone (tibia). It consists of three main components - the femur's lower end, the tibia's upper end, and the kneecap (patella). Articular cartilage covers the ends of the femur, tibia, and back of the patella, allowing smooth movement within the joint. Ligaments, including the anterior and posterior cruciate ligaments and the medial and lateral collateral ligaments, provide stability to the knee. Additionally, the meniscus, two C-shaped pieces of cartilage, acts as a shock absorber between the femur and tibia, cushioning and stabilizing the joint during movement.

In India, knee replacement surgeries have seen a significant rise in recent years due to an aging population, increased prevalence of osteoarthritis, and improved access to healthcare services. According to data from the Indian Orthopaedic Association, over 200,000 knee replacement surgeries are performed annually in India, with numbers steadily increasing. This reflects the growing demand for joint replacement procedures to address the rising cases of musculoskeletal disorders in the country. With advancements in surgical techniques and implant technologies, knee replacement surgeries continue to offer promising outcomes for patients seeking relief from debilitating knee conditions.
 

Overview

know-more-about-Knee Replacement-treatment-in-Nuh
Indications For Knee Replacement
    • Significant pain related to osteoarthritis (especially with weight bearing)
    • Medial pain , with no significant pain in the anterior or lateral knee.
    • Flexion (inability to completely straighten the leg) greater than 120°.
    • Correctable varus deformity (condition that affects the alignment of bones in the legs)
    • Intact ACL and PCL (anterior and posterior cruciate ligaments).
    • X-ray showing predominant narrowing at one side of the joint.
    • No response to non-surgical care
       
Best Knee Replacement Implant Brands
    • Zimmer-Biomet
    • DePuy Synthes – Johnson &
    • Johnson
    • Stryker Corporation
    • Smith &
    • Nephew
    • Arthrex Inc.
       
Knee Replacement Alternatives
    • Weight loss
    • Physiotherapy
    • Hyaluronic acid injections
    • Medication
    • Steroids
    • Acupuncture
    • Cartilage Regeneration
       
Risks/ Complications of Knee Replacement Surgery
    • Blood clots.
    • Infection inside of your knee or at your surgery site.
    • Nerve issues.
    • Blood vessel issues.
    • Problems with the prosthetic implant , including the device wearing down too soon or loosening.
    • Scar tissue inside of your knee.
    • Reduced range of motion and stiffness.
       
Doctor examining patient's knee after knee replacement surgery

Diagnosis and Treatment of Knee Replacement

Diagnosis Before Knee Replacement Surgery

Before undergoing knee replacement surgery, patients typically undergo a thorough diagnostic process to assess the severity of their knee condition and ensure that surgery is the most appropriate course of action. The common diagnostic tests are:

  • Medical History and Physical Examination – The orthopedic surgeon will review the patient’s medical history, including symptoms, previous treatments, and any underlying health conditions. A comprehensive physical examination of the knee joint will also be conducted to evaluate range of motion, stability, strength, and signs of joint damage.
  • Imaging Tests – Various imaging tests may be ordered to assess the extent of knee damage and help in surgical planning. These tests may include X-rays, which can reveal bone abnormalities, joint space narrowing, and alignment issues. MRI (Magnetic Resonance Imaging) scans may also be utilized to provide detailed images of soft tissues, such as cartilage and ligaments, and detect any additional knee problems.
  • Joint Aspiration – In some cases, a procedure called joint aspiration may be performed to remove fluid from the knee joint for analysis. This can help identify any signs of inflammation, infection, or other underlying conditions.
    Functional Assessment – Patients may undergo functional assessments, such as gait analysis, to evaluate their mobility and identify any specific movement limitations or compensatory mechanisms.
  • Based on the results of these diagnostic evaluations, the orthopedic surgeon will determine whether knee replacement surgery is the most suitable treatment option for the patient and develop a personalized treatment plan tailored to their individual needs.

 

What Happens in Knee Replacement Surgery?

Knee replacement typically involves the following steps:

  • Before the surgery begins, the patient is given general anesthesia to ensure they are comfortable and pain-free throughout the procedure.
  • Once the anesthesia has taken effect, the surgeon makes an incision over the knee joint, typically 6 to 10 inches long, to access the damaged knee components.
  • The type of incision may vary depending on the surgeon’s preference and the patient’s anatomy.
  • The surgeon carefully removes the damaged portions of the knee joint, including the diseased cartilage and bone, using specialized surgical instruments. This step aims to prepare the knee for the placement of artificial implants.
  • The surgeon removes the damaged tissues and proceeds to place the artificial components that will replace the natural structures of the knee joint. This usually involves attaching metal implants to the ends of the femur (thighbone) and tibia (shinbone).
  • In some cases, the undersurface of the patella (kneecap) may be resurfaced with a plastic component to improve joint function and reduce friction.
  • Once the artificial implants are securely in place and the knee joint is realigned, the surgeon closes the incision with sutures or staples. Sterile dressings are applied to the surgical site to promote healing and prevent infection.
  • After the surgery, patients are monitored closely in the recovery room before being transferred to a hospital room or outpatient facility. Physical therapy and rehabilitation play a crucial role in the recovery process, helping patients regain strength, flexibility, and mobility in the operated knee.

 

In Our Doctor's Words

What-Dr. Abhishek Bansal-Say-About-Knee Replacement-Treatment

Dr. Abhishek Bansal

MBBS, MS (Ortho), DNB- Orthopedics, M.R.C.S.

17 Years Experience

"Knee replacement surgery is one of the most delayed surgical procedures. Patients delay it until they can barely walk or bones start cracking. A common sentiment is, "I thought it was Ok, as long as I could walk" or "My friends told me yoga could help". Well, while yoga and other exercises can help prevent certain diseases, an unmonitored strain during an already severed arthritis, does more damage than good. It may severe the pain, and advance complications. This is why I always highlight the importance of timely treatment. Then, you'll able to recover quicker, adjust faster, walk painlessly and experience a very evident change in the quality of life. Also its a myth that the implants only last 5-6 years. No. A good knee replacement surgery will easily last you an average of 15-25 years."

Why choose Pristyn Care?

Best Healthcare Provider for Orthopedic Treatments

01.

Minimally Invasive Knee Replacement Procedure

Minimally invasive knee replacement involves a much smaller incision of 4 to 6 inches, unlike traditional knee replacement, that involves a much longer incision of 8 to 10 inches.

02.

Best Knee Joint Implant or Prosthesis

Our Orthopedic Surgeons use the best prosthesis for joint replacement surgeries, such as Johnson & Johnson, Stryker, Zimmer, Smith & Nephew. Usage of the best quality implants for orthopedic procedures in order to promote longevity and durability.

03.

Physiotherapy Assistance

The patient’s physiotherapy preferably begins after 10-12 days of surgery. For your smooth and precise recovery post knee replacement surgery, we will help you connect with the best Physiotherapist near you.

04.

Post Surgery Care and Support

We offer follow-up consultations with the surgeon and provide instructions for post surgery care including dietary tips and exercises to our patients to ensure they have a smooth recovery.

FAQs About Knee Replacement in Nuh

How long does knee replacement surgery take?

Knee replacement surgery usually takes between 3–4 hours. The time may vary depending on the type of knee replacement you have. For example, a total knee replacement can take 3 hours or more, while a partial knee replacement normally takes a little less than that.

How many years does a knee replacement last?

A knee replacement can last 15–20 years for most people. However, the artificial knee parts may become loose or worn after 15–20 years, which may require another surgery on the same knee.

When can you walk after knee replacement surgery?

After knee replacement surgery, most people can walk independently with sticks after about a week, but this can vary depending on the individual. Patients are usually encouraged to start walking the same day with the help of a walker or other device.

Is physiotherapy necessary after knee replacement surgery?

Yes, physiotherapy is suggested after knee replacement surgery. Physical therapy helps improve the physical function of the knee and can help reduce risks after the surgery. Physiotherapy strengthens the muscles surrounding the operated joint and helps in recovery.

What is the best age to have knee replacement surgery?

There is no ‘best’ age for knee replacement surgery. However medical practitioners consider that the optimal age for knee replacement surgery is between 70 to 80 years. According to medical reports available on the internet, most people who undergo knee replacement fall in the age group of 50 to 80 years.

How painful is a knee replacement?

While pain levels vary, knee replacement surgery typically involves significant discomfort during the initial recovery period, managed with medication and physical therapy. However, many patients report significant improvement in pain and mobility in the long term.

Is knee replacement a major surgery?

Yes, knee replacement is a major surgery. It involves anesthesia, incisions, and physiotherapy. The surgery is atypically a pretty complex one and demands stringent care while recovering.

What is rehabilitation after knee replacement surgery?

Rehabilitation after knee replacement surgery involves a structured program of physical therapy and exercises aimed at restoring mobility, strength, and flexibility in the knee joint. This process typically begins shortly after surgery and continues for several weeks to months, focusing on reducing swelling, increasing range of motion, and regaining functional abilities for daily activities. Patient compliance and dedication to rehabilitation play crucial roles in achieving optimal outcomes.

Which doctor to consult for knee replacement surgery in Nuh?

For knee replacement surgery, you should consult an orthopedic surgeon in Nuh. They are medical specialists who are trained to perform knee replacement via different modern approaches.

Types of Knee Replacement Surgery

There are typically 5 types of knee replacement surgeries:

  • Total Knee Replacement – Total knee replacement or TKR involves replacing the entire knee joint with artificial components, including the femoral, tibial, and patellar components. It’s the most common type of knee replacement surgery and is typically recommended for patients with widespread knee arthritis affecting multiple compartments of the knee.
  • Partial Knee Replacement – Partial knee replacement or PKR involves replacing only the damaged portion of the knee joint, preserving the healthy parts. It’s suitable for patients with localized arthritis limited to one compartment of the knee, offering advantages such as smaller incisions, less bone removal, and potentially faster recovery compared to TKR.
  • Revision Knee Replacement – Revision knee replacement or RKR is performed when a previous knee replacement has failed or become worn out over time. Revision knee replacement involves removing the existing implants and replacing them with new ones to restore function and alleviate pain. It’s a more complex surgery than primary knee replacement and may require specialized implants or techniques.
  • Bilateral Knee Replacement – Bilateral knee replacement or BKR involves replacing both knees during a single surgical procedure. This approach is suitable for patients with bilateral knee arthritis who require replacement of both knees and may offer benefits such as reduced overall recovery time and rehabilitation compared to undergoing two separate surgeries.
  • Minimally-invasive Knee Replacement – This approach involves using smaller incisions and specialized surgical instruments to perform the procedure. This approach aims to minimize tissue damage, reduce blood loss, and accelerate recovery compared to traditional open surgery.

     

How to Prepare Before Knee Replacement Surgery?

Before surgery, the patient undergoes a comprehensive medical evaluation, including a review of medical history, physical examination, and possibly additional tests such as blood tests, electrocardiogram (ECG), or imaging studies to assess overall health and identify any underlying medical conditions that may affect the surgery or recovery.

Patients receive detailed information about the knee replacement procedure, including what to expect before, during, and after surgery. This education may cover topics such as anesthesia options, surgical techniques, potential risks and complications, postoperative care instructions, and rehabilitation goals. Preoperative education helps patients feel informed and prepared for their upcoming surgery.

The healthcare team reviews the patient’s current medications and may make adjustments or provide specific instructions regarding which medications to continue or discontinue before surgery. This may include medications to manage chronic conditions, blood thinners, and supplements that could interfere with surgery or anesthesia.

Engaging in preoperative exercises and physical therapy can help strengthen the muscles around the knee joint, improve flexibility, and optimize overall physical fitness before surgery. This conditioning can enhance surgical outcomes, accelerate recovery, and facilitate postoperative rehabilitation.

Proper nutrition plays a crucial role in supporting healing and recovery after surgery. Patients may receive guidance on maintaining a balanced diet rich in nutrients, staying hydrated, and avoiding excessive alcohol and caffeine consumption in the days leading up to surgery.

Patients may need to make arrangements for assistance with daily activities, transportation to and from the hospital, and home modifications to facilitate mobility and accessibility during the recovery period. This may involve setting up assistive devices such as walkers or crutches, arranging for home care services, and ensuring a safe and comfortable recovery environment.

 

When is Knee Replacement Surgery Needed?

Knee replacement surgery is typically recommended for individuals with severe knee pain, stiffness, and functional limitations who have not responded adequately to conservative treatments such as medication, physical therapy, and lifestyle modifications. Some common indications for knee replacement surgery include:

  • Osteoarthritis – The most common reason for knee replacement surgery, osteoarthritis is a degenerative joint condition characterized by the breakdown of cartilage in the knee joint, leading to pain, swelling, and stiffness.
  • Rheumatoid Arthritis – Inflammatory arthritis conditions like rheumatoid arthritis can cause chronic inflammation and damage to the knee joint, resulting in pain, deformity, and loss of function.
  • Post-Traumatic Arthritis – Severe knee injuries or fractures can disrupt the normal structure of the knee joint and lead to the development of arthritis over time, necessitating knee replacement surgery to restore function and relieve pain.
  • Other Forms of Arthritis – Less common forms of arthritis, such as psoriatic arthritis or ankylosing spondylitis, may also cause progressive joint damage and pain that may require surgical intervention.
  • Severe Knee Deformity – Individuals with significant knee deformities, such as bowed legs (varus deformity) or knock knees (valgus deformity), that cannot be adequately corrected with conservative measures may benefit from knee replacement surgery to improve alignment and function.
  • Failed Conservative Treatments – When conservative treatments such as medication, physical therapy, corticosteroid injections, and joint supplements fail to provide sufficient relief from symptoms or improve knee function, surgery may be considered as a next step.

     

The decision to undergo knee replacement surgery is made on a case-by-case basis, taking into account factors such as the severity of symptoms, the impact on daily activities and quality of life, overall health, and individual treatment goals. Orthopedic surgeons carefully evaluate each patient’s condition and medical history to determine whether knee replacement surgery is the most appropriate treatment option to address their specific needs and improve their overall knee function and quality of life.

 

Recovery After Knee Replacement Surgery

 

The recovery phase after knee replacement aims at restoring mobility, reducing pain, and regaining strength and function in the operated knee.

After surgery, patients typically spend a few days in the hospital for monitoring and initial postoperative care. During this time, pain management, wound care, and physical therapy begin.

Pain management strategies may include medications prescribed by the healthcare team, such as opioids for acute pain and nonsteroidal anti-inflammatory drugs (NSAIDs) for inflammation. As recovery progresses, pain management may transition to over-the-counter medications and other non-pharmacological interventions.

Physical therapy plays a crucial role in the recovery process, starting soon after surgery. Physical therapists work with patients to restore range of motion, strength, and flexibility in the operated knee through targeted exercises, stretching, and mobility drills. The frequency and intensity of physical therapy sessions may vary depending on individual progress and goals.

Patients are encouraged to begin walking and weight-bearing on the operated leg with the assistance of crutches, a walker, or other mobility aids as directed by the healthcare team. Gradually increasing activity levels and gradually weaning off assistive devices help promote healing and prevent complications.

After discharge from the hospital, patients continue their recovery at home with guidance from the healthcare team. This may involve following a prescribed exercise program, adhering to postoperative precautions (such as avoiding certain movements or positions), and attending outpatient physical therapy sessions as needed.

As recovery progresses and the knee strengthens, patients gradually resume activities of daily living and may eventually return to more demanding activities such as walking, climbing stairs, and recreational sports. The timeline for returning to specific activities varies depending on individual factors such as age, overall health, and the extent of preoperative impairment.

Different kinds of knee implants

Generally, a knee implant is made of four components, i.e., a tibial component, a femoral component, a patellar component, and a plastic spacer. Based on their components, knee implants can be categorized as:

  • Metal on plastic – In this type of implant, a metal femoral component is attached to a plastic tibial component. It is the most common, least expensive kind of implant. However, these implants are not preferred as much now because the particles released due to the wearing away of the plastic component can trigger an immune response in the future.;
  • Ceramic on plastic – These implants feature a ceramic femoral component on a plastic tibial component. It is used in people who might have an allergy to metal implants. However, they are not preferred for the same reason as the metal on plastic implants.;
  • Ceramic on ceramic – In these implants, both components are made of ceramic. They are least likely to trigger an immune response. However, they are not preferred as much because they make a squeaking noise when the patient is walking. Also, they can easily shatter when subjected to very heavy loads.;
  • Metal on metal – In these implants, both components are made of metal. These are not widely in use as they release small amounts of metal in the bloodstream as they erode, which can cause inflammation, pain, and even permanent organ damage in the long term.
     
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