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Selection of a cases for a knee replacement is not based on age but on the person’s level of pain and immobility. The usual age for arthritis to cause disabling pain affecting the quality of life in patients is after the age of sixty. However, it may be needed by some in their 40s depending on tolerance to pain and limitation of mobility. Similarly, patients above the age of 75 years should not be denied this surgery solely because of their age. Their fitness level should be assessed and they can safely undergo the procedure if they do not have other uncontrolled or untreated illness.
The name ‘total knee replacement’ is a misnomer as the joint is never totally replaced. Just about 8 to 10 mm of bone at the damaged ends of the joints are cut and capped by metallic implants. It would be more apt to call it ‘joint resurfacing’.
Top orthopaedic surgeons say “don’t wait”. If everyday activities are causing pain and interfering with your daily life, and you have already tried non-surgical options such as medication and physiotherapy, it is time to discuss the option of joint replacement surgery with your orthopaedic surgeon. If you need to take a pain killer tablet every time you have to travel, it is an indication that a joint replacement would be helpful. Painkiller for prolonged period could damage the liver and kidneys.
Body mass as well as the appropriate surgical technique plays an important role in achieving good knee bending. A patient who has undergone knee replacement can occasionally sit cross legged but definitely not for long periods as this position can wear out the implant earlier and reduce the life of the replaced joint.
The whole purpose of undergoing a Total Knee Replacement is to increased one’s mobility. In fact, patients are encouraged to stand with assistance on the evening of the procedure itself and start walking with the help of a walking aid from the next day. Most patients experienced a dramatic increase in their mobility levels. Knee replacement surgery is found to be one of the procedures with a success rate of almost 98 percent.
The surgery cost anywhere between Rs 1.7 lakh to Rs 2 lakh when done in standardized centers using US FDA approved implants. A significant amount of the expense is because of the implants which are an imported. While indigenous implants are a promising option its long term performance is yet to be assessed.
If you have severe arthritis in both your knees it is definitely prudent to get them operated together provided your medical fitness has been approved by a physician. Operating on both knees together does improve your post-operative mobility much faster than doing them in two separate operations, besides the financial and logistical advantages.
Most of the implants are made of metallic alloys which are highly biocompatible hence they do not cause any reactions. A few patients have nickel allergy (which is rare) and in such cases, studies have recommended the use of Oxinium or at times Gold plated components.
The infection prevention strategies are standardized in Columbia Asia Hospital where strict adherence to protocol is followed. These guidelines specify the operating room environment and infection control practices which help in eliminating infection. There are also surveillance mechanisms in place for infection control across the hospital.