What is a knee replacement?

Knee Replacement is a Knee operation performed to resurface its damaged or arthritic parts with it with an artificial joint. This artificial Joint is designed to move like a regular, healthy joint so that you can go back to your everyday activities without pain.

How “bad” does my knee pain have to get before considering joint replacement?

Undergoing a Knee Replacement/ Arthroplasty surgery is a personal decision that only you can make, but an evaluation by your specialist can help determine your pain levels and let your doctor see how your pain affects your daily life. Also, your doctor can evaluate if a certain side of knee arthritis has started to affect the other joints like the other knee, spine, or hips. Experiencing knee pain continuously every day without relief generally will lead to reduced mobility and weakness around the knee, hip, and back muscles, and eventually patients start to confine themselves indoors which stops them from leading an active and fruitful social life. If treatment options like medication and physical therapy can no longer relieve your pain, it may be time to consider a joint replacement surgery.

What is minimally invasive muscle-sparing (mis) knee joint replacement?

During a minimally invasive knee replacement, the surgeon is able to perform major surgery with smaller incisions due to specialized techniques and instrumentation. Mainly this is performed in a Muscle sparing technique wherein the inside quadriceps muscle is not incised. (also known as Quad sparing). Thus, it is considered “minimally invasive” and will cause less surgical trauma to the soft tissues. MIS knee surgery is a “step forward” in regards to total knee replacement, for a number of reasons: with a minimally invasive surgery, your hospital stay will probably be shorter, you’ll recover faster, and also have less scarring as you’ll have smaller incisions.

What are the risks associated with MIS surgery?

Though the MIS knee replacement technique uses smaller incisions and is significantly less invasive than total knee replacement, it is still a major surgery. If performed well with the right specialist, then the risks are no different than a Routine Total Knee Replacement.

What will I need to know about postoperative recovery?

Hospital stays vary depending on individual medical status. You can expect to stay for around 2-3 days. On the first day post-surgery, you will likely start physical therapy in the evening, where there will be very basic exercises, and depending upon the pain and the will of the patient, you may be able to stand and walk a couple of steps. In the next couple of days you are encouraged to start to bend the knee, do some crucial exercises so that you can start walking, walk to the washroom, and climb a small flight of stairs. Within 2-3 days most patients achieve about 80-90° of movement of the knee and then are discharged. Before you leave the hospital, you will need to achieve a set of movements to be deemed safe to return home:
  • Getting in and out of bed on your own
  • Be able to use the bathroom on your own
  • Learn light exercises to do at home
  • Learn how to use your assistive devices (walker/ cane)
Apart from understanding what to do, one would also need to understand what not to do. A good recovery also depends upon how well one has prepared for their homecoming and arranged all the assistance that may be required beforehand. Depending upon the muscle strength, one may need a walker for a few days or can graduate with a cane. Generally, a cane would be recommended for at least 2-3 weeks. Overall recovery tends to take about 3-4 months. With Minimally Invasive surgery where the quadriceps muscle is not incised(cut), the recovery tends to be much faster.

What can I expect after I’m discharged?

You may need to take some painkillers while you heal. It would be recommended to continue physical therapy for at least 3-4 weeks, so as to get the form right and develop the important muscles that one would use on a regular basis.

When will I be able to go back to a normal daily routine?

This can differ from individual to individual and also the type of routine that one may be following. Most patients continue to improve gradually over 3-4 months. Within 2 weeks they are able to go around their building compound, within 3-4 weeks they are able to go to the market etc. Light morning walks can be resumed in a month’s time and can be scaled up gradually. Driving a car can generally be started after 3-4 months. Light sporting activities like golf, swimming, and hiking can generally start after 6 months.

How long does a knee replacement last?

Joint replacements are very successful surgeries that millions of Indians undergo every year. However, over the years the knee prosthetic may suffer from wear and tear and become loose and may require a revision or repeat surgery to be performed. The artificial joint’s longevity depends on both age and activity level. On average most modern-day implants generally last 15-20 years. The orthopedic industry is tirelessly working to improve joint replacement technology and extend the life cycle of artificial joints, especially as the amount of younger and more active people who receive total joint replacement increases.

Will the replaced joint feel artificial?

It is an artificial knee and cannot feel completely natural. Though a Partial Knee replacement feels much more natural compared to a Total Knee Replacement.

What can happen if surgery is avoided?

Most people want to avoid surgery because of the fear of not being able to walk after the surgery and the myth that they will get dependent. The whole idea of surgery is to make the person independent. Two complications are normally seen in patients who opt not to undergo surgery.
  • Physical – Since the weight is not borne by the arthritic joint as much, the load comes on the other knee and the spine and then these gradually start to degenerate (arthritic) and become painful.
  • Mental – Because of the pain these patients gradually start confining themselves within the house and start ignoring going out and socialising. Gradually a sense of loneliness and depression ensues.
Hence, if knee pain because of arthritis starts affecting activities of daily living and regular social activities, and non-surgical methods fail to give adequate pain relief, then one should consider surgery.


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