Why Knee Replacement is needed ?
There are 20 joints in the human body and knee joint is one of them. With advancing age, the knee joint gets damaged. Obesity and arthritis are two of the most common causes for damage of the knee joint. Indians are getting fatter by the day. The problem of pain in the knee joint is being felt by most of the people around the age of 50 years. Due to overweight and arthritis the cartilage in the knee joint wears away. In the early stages, orthopaedic doctors may suggest a gel injection in the knee. This kind of injection can alleviate the knee pain for 6-8 months and then the pain returns. The injection is sold in the market with the brand name of Synvisc. This injection would cost you Rs. 18-20 thousand for each knee and helps in alleviating the knee pain for some time.
Initially the pain is felt during activity like walking or climbing stairs. However in some time the pain is felt even while sitting or lying down. This is the time when you become a candidate for Knee Replacement Surgery.
Candidate for Knee Replacement
Arthritis Type – The knee joint arthritis is classified into 5 grades and the best time to get this surgery is when the disease is around grade 3. You should get the surgery done while you are mobile and not bedridden. Therefore you should not postpone the surgery for long. With age other problems like Diabetes, Heart Disease etc would reduce your chances of getting the surgery done.
Knee Implants – In this surgery the worn out joint is replaced with an artificial one. This artificial joint is also known as Knee implant or Knee Prosthesis. The best knee implants are made by Zimmer, Smith & Nephew, Biomet, Stryker, Johnson & Johnson & DePuy. Most of the orthopaedic surgeons in India are using US FDA approved imported implants. Some Indian implants are also available but are not used very often.
Best Age – If you are in the age bracket of 50-70 years and are otherwise healthy then you are the ideal candidate for this surgery. When you come to see our orthopaedic surgeon we will get X-rays done for your knee joints. The diagnosis for surgery is made on the basis of plain x-rays and advanced tests like MRI are not required. Once you decide to get the surgery done then our physiotherapy team will devise an exercise programme for you. You should start doing these exercises atleast 10 days before the surgery.
Hospital Stay – You will get admitted to the hospital one day before the surgery. The surgery takes around 1 hour for each knee. After the surgery you are shifted to the post operative ward where you stay for 5-6 hours. After this you are shifted to the room. You will be on your feet within 24 hours of the surgery with the help of a walker. From the second day of the surgery you are going to the toilet on a walker. Your stay in the hospital will be for 4-5 days during which the physiotherapy team will put you through several exercises.
Types of Knee Replacement Surgeries
Partial Knee Replacement – A Partial Knee Replacement is a surgical procedure whereby only the most damaged areas of cartilage from the knee joint is replaced with artificial material and healthy parts of the joint are left for continued use. In partial knee replacement the implant is placed between the end of the thigh bone and the top of the shin bone. Partial knee replacement can also replace the part of the joint under the kneecap known as patellofemoral replacement.
Total Knee Replacement – During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell and the end of the lower leg bone (tibia) is also removed and replaced with a plastic piece with a metal stem. Total knee replacement surgery is considered for patients whose knee joints have been damaged by either progressive arthritis, trauma, or any other rare destructive diseases of the knee joint.
Revision TKR – Revision Knee Replacement Surgery is now becoming quite common. The patients who undergo Total Knee Replacement at the age of 50-55 years typically require Revision Knee Replacement after 15-20 years. Not many surgeons are adept at doing Revision Knee Surgery. Due to the changes in the bony structure with the advancing age the screws which bind the knee joint with the bones become loose and this necessitates revision surgery. In this surgery the older knee implant is removed and a new implant is placed.
Computer Navigated Knee Replacement – While doing Knee Replacement Surgery, the surgeon has to align the artificial knee joint with the hip joint. This is done by using a metallic caliper by most of the surgeons. These days you get the wheel alignment of your car with the use of a computer so doing Knee alignment with a caliper is old technique. Newer surgeons are using computer navigation to align the knee joint with the hip joint which eliminates any chances of misaligned knee joint.
Robotic Knee Replacement Surgery – This is not very common as the price of a surgical robot is in excess of USD 1 million. There are few hospitals in India who have procured Orthopaedic Robot. Vardhman Hospital at Muzaffarnagar and Amandeep Hospital at Amritsar are two of them. In Robotic Knee Replacement Surgery, the cutting of the knee joint is not done by the surgeon but is done by the robot. This makes the cutting absolutely precise both in terms of length and depth. Precision cutting makes the job of the surgeon very easy as the implant fits nicely into the bone and the surgeon does not have to make any adjustments. In this surgery there is very little blood loss and the recovery is much faster. However the cost of the surgery increases by USD 1000 for each knee if robot is used in the surgery.
Best Doctors and Cost
Our Knee Replacement Surgeons have trained at some of the best centres in India, USA and Germany for doing Knee Replacement Surgery. Only 20% patients who are in advanced stage of osteoarthritis have to undergo surgery and others can benefit by physiotherapy and medications. Even though the surgery takes only 2-3 hours for both the knees the entire process is about 2 months long. Post Surgery a comprehensive rehab programme is designed and the patient is put under the care of the physiotherapy team.
The cost of Partial Knee Replacement Surgery is USD 3000 for each knee. The cost of Total Knee Replacement Surgery is USD 3500 for each knee. The cost of Computer Navigated TKR is USD 4000 while the cost of Robotic TKR is USD 4500 for each knee. These are the costs when FDA approved imported knee implants are used. If Indian implants are used then the cost is USD 500 less in each of the category.
You would get some of the finest knee replacement surgeons in India. Dr. Subhash Jangid, Dr Anubhav Jain and Dr Avtar Singh are legends in the field of Knee Replacement Surgery. They are doing both the Computer Navigation and Robotic Knee Replacement surgeries.
The role of physiotherapy is very important after total knee replacement surgery. Getting your mobility back is the primary reason for this surgery. After discharge from the hospital, our physiotherapy team will take care of the rehabilitation for the next 45 days. If you are coming from a different city or country then you can go back to your home within 2 weeks from the date of discharge. The remaining rehabilitation can continue in your hometown under the supervision of our physiotherapy team.