Avoid Knee-Jerk Reaction

Let your knees not give you sleepless nights. Knee replacement is today one of the most successful techniques that has improved the lives of millions of patients
By Dr Aman Dua/Dr Dharmesh Khatri

With development of latest technology, the knee replacement surgeons in India have created a reputation for conducting groundbreaking surgeries. Medical travelers from around the world visit India every year with various knee problems. The quality that sets Indian knee surgeons aside from others is that they are not only good in communicating with the patients but are also good listeners. They provide a beforehand guide about the details and requirements of the procedure, helping the patients to be ready for the surgery both mentally and physically.
Knee replacement surgery is removing a damaged joint and putting in a new one. We usually suggest a knee replacement to improve how you live as replacing a joint can relieve pain and help you move and feel better. Knee replacement may be an option when non-surgical interventions such as medication, physical therapy, and the use of a cane or other walking aids no longer help alleviate the pain.
Other possible signs include aching in the joint, followed by periods of relative relief, pain after extensive use; loss of mobility; joint stiffness after periods of inactivity or rest; and or pain that seems to increase in humid weather. We help to determine which type of knee surgery is most appropriate. We also decide that knee replacement surgery is not appropriate if you have an infection, do not have enough bone, or the bone is not strong enough to support an artificial knee. We generally try to delay total knee replacement for as long as possible in favour of less invasive treatments. With that being said, if you have advanced joint disease, knee replacement may offer the chance for relief from pain and a return to normal activities.
Knee replacement is a routine surgery performed on more than 600,000 people worldwide each year. More than 90% of people who have had total knee replacement experience an improvement in knee pain and function. Deciding whether or not to get knee replacement surgery is difficult. Discussing with patients for their treatment options, it is essential to help the patients to choose whether this is the right option for them.
Top knee surgeons in India are not only highly qualified but also have huge experience of performing thousands of successful knee surgeries. The operations and treatments that knee specialists offer include total and partial knee replacement, arthroscopic knee surgery, and knee ligament reconstruction (including anterior cruciate ligament reconstruction). The knee replacement also gives a new life to patient who come with unbearable pain and are not able to stand on their own feet.
Every replacement is performed in different formats usually known as partial and total replacement, depending on the condition of the patient. After being thoroughly investigated, patients undergo surgery but due to severe Osteoporosis and associated knee deformity, constrained implants are generally used for revision surgery.
In a particular case, rehabilitation protocol was altered for patients. Initial concentration was on the range of movement & strength building of muscles. Nearly after a month, patients started to stand gently with utmost care to stimulate muscle. Nearly 6 weeks to 2 months later, they used walker and gradually due to sheer willpower and good physiotherapy, they regained their strength and in 6 months now they are independently mobile without support. This is different from our usual protocol whereas patient is made to stand within 6 hours after surgery and start walking within 24 hours. Patient is independently mobile without support in an average 6 weeks.
The knee has the responsibility of supporting the entire weight of the body which makes it particularly prone to stress and strain. People world-wide are affected by knee problems. This problem is commonly found among people over 50 years of age and those who are overweight. Other reasons of knee pain can be health issues like bursitis, arthritis, tears in the ligaments, osteoarthritis of the joints, or infections.
Each year, millions of people undergo knee surgery and how quickly they recover depends on many factors such as their age, the severity, location of the injury and preexisting conditions, such as arthritis. Knee surgery typically refers to total knee replacement, or knee arthroplasty. Knee replacement surgery can be performed arthroscopically or in an open fashion. Special techniques and latest implants ensure restoration of natural movements. It covers major surgeries like total and partial knee replacement surgery and less invasive procedures like knee arthroscopy.
The main aim of knee surgery is to increase the mobility and to reduce the pain associated with knee injuries and diseases. Knee replacement is today one of the most successful operations in medicine and has improved the lives of millions of patients. Patients often ask about the correct time to have a knee replacement.
One of the most effective means of treatment is physical therapy. The most effective therapy is called closed-chain quadriceps strengthening. With this therapy, the foot is planted on the floor to strengthen the large thigh muscles. This often improves the way the knee cap moves through the knee joint, decreasing pain and increasing ability to function. Weight loss is also a very effective means of dealing with knee arthritis.
When we speak about weight, we usually speak about the body mass index (BMI), which is a ratio of weight to height that can be calculated using online calculators. People with a body mass index above 30 should consider weight loss to see whether that improves symptoms before embarking on any kind of joint replacement. In simple terms, knee replacement is a surgical procedure most often performed to relieve the pain and disability.

When to go for Knee Replacement

• Your pain persists or recurs over time
• Your knee aches during and after exercise
• You’re no longer as mobile as you’d like to be
• Medication and using a cane aren’t delivering enough relief
• Your knee stiffens up from sitting in a car or a movie theatre
• You feel pain in rainy weather
• The pain prevents you from sleeping
• You feel a decrease in knee motion or the degree to which you’re able to bend your knee
• Your knees are stiff or swollen
• You have difficulty walking or climbing stairs
• You have difficulty getting in and out of chairs and bathtubs
• You experience morning stiffness that typically lasts less than 30 minutes (as opposed to stiffness lasting longer than 45 minutes, a sign of an inflammatory condition called rheumatoid arthritis)
• You feel a “grating” of your joint

(The authors are Senior Consultants, Joint Replacement Unit, Sri Balaji Medical Institute, New Delhi)