10 questions before knee replacement - Dr. Aashish Chaudhry
10 QUESTIONS YOU SHOULD DEFINITELY ASK BEFORE GOING FOR KNEE REPLACEMENT SURGERY
Our orthopaedic hospital in Dwarka has been touted as one of the best knee replacement hospitals in Delhi, where Delhi’s best knee replacement surgeons perform both conventional and robotic knee replacement surgery. We have also begun home physiotherapy in Dwarka owing to COVID-19.
If you are thinking of going in for knee replacement anytime in the future, these important questions are definitely worth asking.
1. WHEN is the time right for a knee replacement?
There really is no exact formula for determining when a knee replacement should happen. The most common reason to have it done is excessive pain, and in case you’ve tried all non-operative treatment such as lifestyle changes, anti-inflammatory medicine, physiotherapy, or even injections for pain; it just may be time to consider surgery.
2. Can surgery be avoided altogether?
Before considering surgery, a doctor will try different non-surgical treatments like: physical therapy, weight loss programmes, anti-inflammatory medication, steroids, alternative treatments like acupuncture.
These solutions have been known to manage knee problems, but in case the symptoms continue or worsen, surgery could be the answer.
If indeed total knee replacement (TKR) is needed, delaying or avoiding surgery for a long period of time can complicate the problem and an even more complex operation with a less favourable outcome may be your final option.
3. What will happen during surgery, and how long will it last?
During surgery, your surgeon will make an incision over the front of the affected knee area to expose the damaged parts, and the incision is about 6-10 inches.
Thereafter, the surgeon will move your kneecap aside and cut out the damaged cartilage and a certain amount of bone. The damaged tissue will then be replaced with new metallic and plastic components.
The components will combine to form a biologically compatible artificial joint which will replicate the movement of a natural knee.
Most knee replacement procedures will take a round 30 to 40 minutes.
4. What is an artificial knee, and how does it stay in place?
Artificial knee implants are made up of metal and medical-grade plastic called polyethylene.
There are two methods for attaching these components to bone. Surgeons use bone cement, which takes about 10 minutes to set in. The other is the cement-free approach, in which the components have a coating that allows the bone to grow out onto itself.
And in some cases, surgeons use both techniques during the same surgery.
5. What about anaesthesia?
Any operation done under the influence of anaesthesia carries risks, but it is extremely rare that severe complications will arise. A team of anaesthetists will decide the most suitable options for you but most knee replacement surgery is done using a combination of spinal or epidural and/or a regional nerve block anaesthesia.
6. How much pain will I have after surgery?
There is most certainly some pain after an operation like this but your surgery team will do everything to keep the pain to an absolute minimum.
You may be given a nerve block before the operation and your surgeon may use a long lasting local anaesthetic to help lower the pain after surgery.
After leaving from hospital, you will be given pain relief medication by your doctor.
After recovering from surgery, your knee will gradually improve and be less painful than before. Following the doctor’s advice after surgery is the best way to deal with pain.
7. What can I expect after surgery?
After general anaesthetic, you may wake up feeling slightly confused and drowsy and your knee will be lifted on support to help with the swelling or may be placed a continuous passive motion (CPM) You may have to wear a compression bandage around your leg to establish proper blood circulation
Many people have complained of an upset stomach after surgery; this does happen and is normal, you will be provided medication for this.
8. How much time before I can go home
Most people are up and about within 24 hours with the help of a walker or crutches.
Following the operation, a physical therapist will help you with bending and straightening your knee, getting out of bed, and ultimately learning to walk with your new knee. This is done on the same day of your operation.
Most people are discharged from the hospital within 2–3 days after surgery.
9. How can I prepare my home for recovery?
If you have a floored house, prepare a bed and space on the ground floor to avoid stairs. Ensure your house is spaced out and free of too many objects, furniture, wires and cables, cords, carpets. Keep focused whenever you walk.
10. Will I need any special equipment?
Some surgeons will recommend using a CPM (continuous passive motion) machine in the hospital as well as at home while you’re in bed as this machine helps increase knee motion during the first few weeks after surgery.
HOD & Senior Consultant, Orthopaedics & Joint Replacement