Dr.Jitendra Chowdhary
D.Ortho,DNB (Ortho),MNAMS. Fellow in Joint Replacement USA
+91 99740 87245
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Joint Replacement
 Total Knee Replacement
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Total Knee Replacement...
 
 
 
KNEE ARTHIRITIS & OPTIONS
  The knee problems are found commonly in all sections and age groups of people, this is more so often in females after the age 50 years. about 15% of the populations is suffering from one or the other type of joint problem viz. arthritis. "Arthritis" is a general term describing the disease of any joint knee, hip etc. where the joint is damaged or destroyed by a disease or injury. The most common type of arthritis is called 'Osteoarthritis', which is degenerative in nature.It usually results from constant knees stress e.g. due to overweight. Heredity sometime also contributes. The second commonest type of arthritis is called 'Rheumatoid arthritis in Knee Joint Replacement.This disease usually affects multiple joint of the body like hand, elbows, shoulders, knees, hips and feet in Knee Joint. The cause of it is not well known. However, there is evidence to suggest that it is an 'autoimmune' disease, where some tissues in the body (under the influence of some triggering agent) produce chemicals which attack the lining (synovium) of the Knee Joint Replacement irreparably.
 
TREATMENT OPTION
 As an initial treatment of arthritis, conservative treatment in form of medicines, Physiotherapy is used Knee Joint Replacement.Even though modern medicines offer symptomatic relief from the agonizing pain and inflammation of the knee joint, their efficiency is limited and the symptoms reappear with withdrawal of medication. In early stages of resistant arthritis, keyhole surgery (Arthroscopy) is useful.

  As the disease progress and tolerance to medicines develop, the patients become knee crippled and are unable to lead a normal life. Moreover, these painkillers are sometime harmful as they may cause gastric ulcers, kidney and liver damage. Repeated, progressive attacks of arthritis could lead to permanent damage and deformity of the Knee Joint Replacement. Knee Joint Replacement (T.K.R.) is a highly successful treatment option available in this stage.
 
 
ARTIFICIAL JOINT
  like a hinge of a door or window and can only move in one direction. It is formed by the articulation between 3 bones viz. femur (thigh bone), tibia (leg bone) and patella (knee cap). The artificial joints are made of a metal and plastic combination. The metals used commonly are Vitallium, Titanium and Stainless Steel.
  The plastic used is Ultra High Density Polyethylene (UHDPE). Artificial joint is technically called a 'prosthesis'. A prosthesis is designed to look and function in exactly the same manner as the natural Knee Joint Replacement.A prosthesis is made from a strong material capable of taking stress and is biocompatible i.e. nontoxic and non allergic. Although, a prosthesis is designed to last for a lifetime but like our very own joints, some time it loosens or wears out, after 10-15 years of the operation in Knee Joint Replacement.This problem can also be tackled satisfactorily through a 'revision surgery (re-operation)'.
PROCEDURE
  The procedure of TKR involves shaving off the damaged/diseased ends of the bone and fixing of a new artificial joint on the existing healthy bone either by bone cement (polymethyl methacrylate) or bone screws. One cut (incision) is required on the front of the knee to expose the joint & to do the operation.
  If there is any infection in the body then a doctor should be consulted immediately and proper antibiotic cover should be taken, to avoid secondary infection in the artificial Knee Joint Replacement.
 
OUTCOME
  TKR not only offers pain relief but corrects the existing deformity and restores the stability of the damaged joint. It also helps in achieving the functional range of motion and thus improves the gait and mobility of the patients. Overall, the patients have a better quality of life and independence, which is so vital in elderly age.
 
FUTURE
  The future of join replacement surgery is bright in India. TKR surgery has come here to stay forever, as it has proved worldwide over in the last 2 decades, through excellent result. A great amount of research is being carried out the further improve both the material used in the replacement parts and in their design to make them function smoothly and as 'normally' as possible. With more trained personal available in time to come and lower cost of prosthesis would certainly help in making the TKR to become extremely popular treatment For Knee Joint Replacement.
 
ABOUT THE SURGERY
  Knee Joint is done under general or spinal/epidural anaesthesia. It is a major surgery which lasts for one two hours. The average blood loss during and after the operation is about 500 to 700 mls., and this loss is compensated by a blood transfusion. Before the surgery, a through physician and pre-anaesthetic check up is done. It is very important to exclude any active or hidden infection in the body at the time of doing T.K.R.
 
BEFORE THE SURGERY
  Patients are advised to do certain exercises for few days or weeks before the surgery. So that good results can be achieved.
 
AFTER THE SURGERY
  In Knee Joint Replacement Rest is given to the patients for 24-28 hours after the surgery. The patients are allowed to stand and walk with support. The knee bending is also started after 2 days, under the supervision of a physiotherapist. The sutures/clips are removed between 10-14 days. The patients are discharged home between 7-10 days. Follow-up visits are done 1, 4 & 12 months of the operation and thereafter once every year.
 
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