• Dr. Sunil Dachepalli

Knee Replacement

It is a surgical procedure in which the diseased knee joint is replaced by metallic implants.

Indications:

  1. Painful arthritic knee joint.

Types of Knee Replacement

1.Partial Knee Replacement:

Unicondylar Knee Replacement: It is a procedure done in relatively younger patients in which knee joint is replaced partially, usually on the inner side of the knee. The advantage is that it is a bone preserving surgery.

Patients can have smaller wound, get up and walk quicker and also discharge will earlier. Post procedure patient can also participate in lighter sports.

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Patellofemoral Joint Replacement: It is a less invasive surgery that involves resurfacing the back of the kneecap and front of the thighbone. It is a surgical treatment option for individuals with arthritis of the knee that is confined to the patellofemoral compartment anterior aspect of the knee.

patellofemoral-joint1

2.Total Knee Replacement:

The knee joint is completely replaced in this procedure. Usually done in the elderly.

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Anaesthesia:

Knee replacement is carried out underspinal epidural anaesthesia. Rarely general anaesthesia is also used.

Implant Components:



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Cruciate retaining total knee

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High Flex Knee


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Posterior stabilized total knee

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Mobile Bearing

Types of materials used:

Cobalt-Chromium: Cobalt-Chromium is the most widely used alloy in Total knee replacement which suits most of the patients.

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Oxinium: Oxinium is oxidised zirconium that results in less wear than cobalt chromium alloy.

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Gold: It comprises a TiNbN (Titanium niobium nitride alloy) coating with the least wear property. The gold knee is relatively less allergic and has improved longevity.

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Computer Navigation Knee Replacement:

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Here the surgeon will perform cuts based on dynamic computer measurements that will increase precision of the surgery.

Robotic Knee Replacement:

Here the surgeon will perform cuts based on dynamic computer measurements that will increase precision of the surgery.

Robotic-Arm assisted technology enables surgeons to more accurately position a patient’s joint replacement. The result is often a better, and longer-performing joint, as well as faster recovery after surgery including a shorter hospital stay and quicker rehabilitation.

Recovery:

You will be in recovery room for about 3-4 hrs under anaesthetist observation, following this you can be shifted to the room. Majority will be walking within few hours after surgery as we follow FASTTRACK procedure.

The surgeon will instruct you regarding homecare during initial weeks of surgery.

Wound Care:

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The surgeon will apply stitches or staples to close the wound and they will be removed approximately two weeks after surgery. You should avoid getting the wound wet.

Diet:

A balanced diet with calcium and iron supplements is necessary for tissue healing and muscle strength. Make sure you drink lots of fluids. There is no diet restriction unless you are diabetic or have been adviced earlier

Activity:

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Use normal leg while climbing up and operated leg while coming down

Rehabilitation begins immediately after knee replacement. A physiotherapist will teach the important steps which will maintain the motion of the knee joint and ensure you can walk safely.

Your activity program will include a graduated walking program initially in the home and later outside followed by stair climbing. Aim at discharge is to make you independent, so that you can go the washroom on your own and climb few steps if necessary

Revision Total Knee Replacement:

The primary knee replacements that fail due to infection, loosening or fractures, will be replaced with new prosthesis. It involves bigger bone cuts and bigger implants.

This may be done in single stage or multiple stages.

Revision total knee replacement

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