MR. SUBHENDU SAHA is 60 years old and practically incapable of physical activity due to pain in his knees.
Last week, after attending his nephew’s wedding, the pain became so unbearable that he became bedridden. He made an appointment with the Orthopaedic consultant at Desun Hospital, who asked him to do the following tests:
MRI
X- Ray &
Joint fluid Analysis
The result showed cartilage loss and narrowing of the space between the bones in his joint. The doctor informed him that he has osteoarthritis and Knee Replacement is the only remedy.
Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, apart from other knee diseases such as rheumatoid arthritis and psoriatic arthritis.
Total knee replacement surgery is considered for patients whose knee joints have been damaged by either progressive arthritis, trauma or other rare destructive diseases of the joint.
Before surgery, the joints adjacent to the diseased knee (hip and ankle) are carefully evaluated. This is important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield significant improvement in function as the nearby joint may become more painful if it is abnormal. Furthermore, all medications that the patient is taking are reviewed. Blood-thinning medications such as warfarin (Coumadin) and anti-inflammatory medications such as aspirin may have to be adjusted or discontinued prior to knee replacement surgery.
Routine blood tests of liver and kidney function and urine tests are evaluated for signs of anemia, infection, or abnormal metabolism. Chest X-ray and EKG are performed to exclude significant heart and lung disease that may preclude surgery or anesthesia. Finally, a knee replacement surgery is less likely to have good long-term outcome if the patient’s weight is greater than 200 pounds. Excess body weight simply puts the replaced knee at an increased risk of loosening and/or dislocation and makes recovery more difficult.
Before surgery, the joints adjacent to the diseased knee (hip and ankle) are carefully evaluated. This is important to ensure optimal outcome and recovery from the surgery. Replacing a knee joint that is adjacent to a severely damaged joint may not yield significant improvement in function as the nearby joint may become more painful if it is abnormal. Furthermore, all medications that the patient is taking are reviewed. Blood-thinning medications such as warfarin (Coumadin) and anti-inflammatory medications such as aspirin may have to be adjusted or discontinued prior to knee replacement surgery
Routine blood tests of liver and kidney function and urine tests are evaluated for signs of anemia, infection, or abnormal metabolism. Chest X-ray and EKG are performed to exclude significant heart and lung disease that may preclude surgery or anesthesia. Finally, a knee replacement surgery is less likely to have good long-term outcome if the patient’s weight is greater than 200 pounds. Excess body weight simply puts the replaced knee at an increased risk of loosening and/or dislocation and makes recovery more difficult.
A total knee replacement generally requires between one-and-a-half to three hours of operative time. Post-surgery, patients are taken to a recovery room, where vital organs are frequently monitored. When stabilized, patients are returned to their hospital room.
Passage of urine can be difficult in the immediate post-operative period, and this condition can be aggravated by pain medications. A catheter inserted into the urethra (a Foley catheter) allows free passage of urine until the patient becomes more mobile.
Physical therapy is an important part of rehabilitation and requires full participation by the patient for optimal outcome. Patients can begin physical therapy 48 hours after surgery. Some degree of pain, discomfort, and stiffness can be expected during the early days. Knee immobilizers are used in order to stabilize the knee while undergoing physical therapy, walking, and sleeping.
A unique device that can help speed recovery is the continuous passive motion (CPM) machine. The CPM machine is first attached to the operated leg. The machine then constantly moves the knee through various degrees of range of motion for hours while the patient relaxes. This can help to improve circulation and minimize risk of scarring and contracture of the tissues around the knee.
Patients will start walking using a walker and crutches, and will eventually learn to walk up and down stairs and grades. Home exercises are given to strengthen thigh and calf muscles.
Desun is the Safest Hospital for Total Knee Replacement.
2 of the major fears of any surgeon are OT infection and cardiac or heart complications during or after the operation. If OT infections occur, even the best surgeon will be unable to help. DESUN is the only hospital in Kolkata that has STEEL OPERATION THEATERS (Steel OTs) that drastically reduces chances of OT infection. After surgery, the patient is under the best care of doctors and nurses in the post-operative phase at DESUN.