Total Knee Replacement

Total Knee Replacement

The knee is the largest joint of the body and the most important to perform everyday activities. It is formed by three bones: femur (thigh bone), tibia (shin bone) and patella (kneecap). The ends of these bones are covered with cartilages that protect them and facilitate easy movement. The menisci located between the joints act as shock absorbers and provide the necessary cushioning. Four different ligaments hold the bones together and provide stability to the joint. The remaining surfaces of the knee are covered by the synovial membrane, which releases a fluid that lubricates the joint.

The most common cause of knee pain is arthritis. These can be of the following 3 types:

  • Osteoarthritis
    This is an age-related wear and tear of the joint that usually affects people above the age of 50 years. The cartilages between the bones wear off causing friction that leads to stiffness and pain.
  • Rheumatoid arthritis
    This is due to inflammation of the synovial membrane surrounding the knee joint, which damages the cartilage leading to pain and stiffness.
  • Post traumatic arthritis
    This occurs following serious knee injury that causes fractures and tears of the knee ligament.

Total Knee Replacement (TKR), also known as knee arthroscopy is a surgery done to resurface the knee joint that is damaged due to arthritis. This surgery is recommended for someone suffering from severe arthritis that affects their daily activities.

Total Knee Replacement surgery is done in four steps:

  • The damaged cartilage surfaces at the ends of the bones are removed along with some part of the bone.
  • Metal and plastic parts components are used to cover these surfaces.
  • The undersurface of the patella is cut and resurfaced.
  • A spacer is inserted in between the newly inserted components to create a smooth movement.

With the right post surgical care and exercises, one can return to an active lifestyle within few weeks of surgery.

Total Knee Replacement surgery should be the last treatment option for arthritis. There are other things that can be done to reduce pain and improve mobility. These include:

  • Losing weight to reduce the stress on the knee joint.
  • Low impact exercises to improve strength and mobility.
  • Anti-inflammatory and pain medications for severe pain.
  • Intra-articular cortisone injections.
  • Autologous chondrocyte implantation (ACI) to replace damaged cartilage.
  • Radiofrequency ablation to control pain.
  • Knee caps, braces or crutches to support the knee joint while walking.

During the first few weeks after Total Knee Replacement (TKR) surgery, it is important to take care of the wound, exercise and avoid falls. Gradually the knee returns to its range of motion before surgery. Most patients are able to fully straighten their knees and also bend them enough to climb stairs. There may be some stiffness and a clicking sound on bending the knees, which is normal.

There is continuous research for finding better options for Total Knee Replacement operation. Consult our orthopaedic surgeons in Indore for a detailed evaluation of your condition. Some of the latest innovations include:

  • Cementless Total Knee Replacement surgery
    where the implant is affixed on the bone without using any cement. This procedure reduces the rate of wear and loosening.
  • Computer navigated surgery
    which helps the surgeon in positioning of instruments and implants during surgery.
  • Robotic assisted surgery
    where the robot helps in positioning the instruments or controls the function of tools to ensure that the bone resection matches the planned operation.
  • 3-D printing and custom implants
    that provide a personalized solution for knee joint construction.
  • High flex prosthesis
    that aims at restoring a near normal range of movement of the knee.