Categories: Orthopaedics

Total Knee Replacement for Knee Osteoarthritis

Osteoarthritis is a condition where the joint gets inflamed, thus eroding the protective cartilage that cushions the ends of involved bones. The ends thus wear down over time. It has become a global burden affecting around 2.4 crore people. Worldwide estimates are that 9.6% of men and 18.0% of women aged over 60 years have symptomatic OA. 2.6 Crore people in India alone are affected by this dreaded devil. A lot of it has to do with lifestyle and age. Women are more prone to osteoarthritis than males, especially around age 50 and above.

Total knee replacement is a surgery wherein deformed bones are replaced making a joint pain free and good as new. Let’s see exactly how they are both associated.

Indications of Total Knee Replacement: There are strictly defined guidelines for surgical candidates:

  • Pain in and around the knee that does not respond to medicines, physiotherapy, etc. Pain at rest.
  • If the scans (Xray, MRI) shows so
  • Restricted range of motion that interferes with daily living activities
  • Deformed knees like bowing outwards, waddling gait.
  • Severe swelling and inflammation

Contraindications of the surgery are:

  • Systemic infections mean affecting the entire body such as high blood pressure, or systemic diseases, such as the flu or an infection in the bloodstream.
  • Muscular or neurological deficit surrounding the surgical site
  • Conditions where anesthesia cannot be administered.
  • Skin infections of the affected area like psoriasis or eczema
  • Uncontrolled diabetes
  • A vascular disease where circulation is inadequate
  • Dental problems like cavities or gingivitis
  • Malnutrition
  • Severe smoking or nicotine usage
  • Brittle bones or osteoporosis
  • Advanced age 80 or above

Surgery vs. Medicine

Numerous studies have reported greater improvements in post replacement surgeries than with a person on non-surgical treatment. Not to rule out the adverse effects caused due to prolonged consumption of NSAIDs and Steroids like liver damage, stomach bleed, stroke, heart attack, and vision-related problems. Enormously expensive pain care supplements have also captured the osteoarthritic market with results extremely questionable.

The success rate of Knee Replacements:

Research has concluded that more than 90% of surgeries result in successful outcomes like

  1. Decreased pain
  2. Upgraded function
  3. Independent ambulation

This is a common but major surgery recommended to all those who cannot be treated by medication and physical therapy.

Effectiveness of replacement surgery:  Factors affecting outcome and patient satisfaction

  • Post-surgical rehabilitation, strengthening, and range of motion exercises
  • Ambulation with the help of an assistive device as long as required

90% of patients rated their post-surgical experience as good to excellent within 6weeks of surgery. Most of them have returned to their normal personal and professional lives with 41% of people being able to perform activities like dancing, golfing, etc.

How Long A Knee Replacement Does Stay?

Approximately 90% of knee replacements last at least 15 years. The average life of a knee replacement is considered 18-20 years. In case the surgery is repeated after 20 years it is called revision knee replacement surgery and is extremely uncommon.

All and all total knee replacement evolves as a safe and proven remedy for knee osteoarthritis, which improves the quality of life and promotes independence in the affected person.

Dr. Rajesh Verma, Director & Senior Consultant – Orthopaedics, Spine Surgery | Dharamshila Narayana Superspeciality Hospital, Delhi & Narayana Superspeciality Hospital, Gurugram

Narayana Health

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