1. Total Knee Replacement (TKR) – A Current Treatment Modality For Knee Pain.
FAQ about Total Knee Replacement.
What is TKR?
It is the replacement of normal knee joint by artificial joint made up of stainless steel alloy called cobalt chrome alloy and plastic called ultra high molecular weight high density polyethylene. Steel part covers the bone ends of joint and polyethylene insert remains in between the two steel ends.
When it is necessary?
Most common indication of TKR is pain which is not relieved with non operative methods like medicine, intra- articular injections, braces, physiotherapy etc
At what age can joint replacement be done? Can it be done for children?
Joint replacement is commonly done for patients above the age of 60 years. It may be done between ages of 40 and 60. It is occasionally done between ages of 20 and 40. It is never done in children.
What is that condition which leads to TKR?
Most common is age related degeneration of knee joint i.e. osteoarthritis, rheumatoid arthritis, tumor related joint disease etc
How these diseases affect the joint?
Every disease has its own way to destroy the joint by destroying the cartilage i.e. tissue layer which smoothens the bone ends to make joint frictionless , decreasing the joint lubrication by decreasing the synovial fluid, decrease in joint space, inflammation & swelling, extra bone formation, muscle weakness, decrease in range of motion, deformity of knee, and leading to painful gait, limp, life confined to bed.
How one can avoid destruction of joint?
Age related degeneration comes with growing age as other diseases like cataract, graying of hair, tooth decaying etc. but one can keep the joint healthy by doing regular exercises for knee, avoiding squatting and overweight.
Other conditions with specific pathology should be treated accordingly by doctors.
Is there any alternative to TKR?
Yes, before going for the TKR one can try medicines like analgesics to decrease pain, chondroprotective drugs for regeneration of cartilage which is the important tissue of joint, steroid intra- articular injections to reduce inflammation, injections to increase lubrication of joint, braces etc. All these measures can delay the TKR, but ultimately TKR is the choice.
Is there any operation which can replace the TKR?
No, there is no alternative operation to TKR till date but there is a variant of this known as unicondylar knee replacement i.e. half knee replacement, is being done in some selected conditions.
One procedure is there known as high tibial osteotomy, which is advised in early stages of osteoarthritis to correct the alignment of knee. With this operation knee load distribution becomes equal and leads to pain free knee movement. This is recommended in selected cases, but ultimately lands with TKR.
What is the average time taken for joint replacement surgery?
The average time taken for joint replacement surgery is 1-1.1/2 hrs.
How much is the hospital stay after TKR?
It varies with the condition of the patient, normally it is 7-14 days.
What is the role of physiotherapy and exercises after joint replacement?
Physiotherapy exercises called CPM - Continuous Passive Motion machine start within 1-2 days after joint replacement, while walking is started 2-3 days after joint replacement with full weight bearing, as tolerated.
How many days patient takes to get out of bed and walk?
Usually after 3 days patient starts walking with walker but it depends on the condition of patient./
For how many years it works?
About 20 years is the life of TKR.
Can a person with diabetes, high blood pressure, or heart trouble undergo joint replacement?
Even a person with diabetes, high blood pressure, cardiac disorders can undergo joint replacement surgery under medical supervision. The diabetes or BP must be under control.
Is there any risk to life during this operation?
TKR is like other operation so no added risk is involved in this operation. But generally this is done in elderly age group those are having other diseases like diabetes, heart disease, hypertension, asthma etc. so one should be confident that his hospital is fully equipped to tackle these added risks.
After the knee replacement will the patient be able to squat?
It is difficulty to do the traditional squatting. However, one can sit cross legged for a special occasions and can also sit in the sideways sitting position of the ground avoiding full bending at knee using support below knee.
What are the precautions to be used after joint replacement?
It is advisable to use a bedside commode for 3 to 4 weeks and a English toilet after that, Avoid sitting on floor, jogging, running and fast sports after joint replacement surgery. Moderate speed walking, climbing stairs and swimming are permitted
Does one need plaster of Paris cast after surgery?
No, your knee is free, a brace is used for few days for comfort and support and, usually hinged knee cap is used for walking for a few weeks
How far can one walk after a Joint Replacement?
One can walk as many kilometers as general health will allow. Some patients can walk even 8 K.M at one stretch. But generally one can walk for 2-5 K.M without any problem
So go for new treatment modalities and live with pain free knee.
For further queries contact ORTHOMAX, bone & joint center.