Knee replacement in Mumbai is a surgical procedure that decreases pain and improves the quality of life in many patients with severe arthritis of the knees. Typically, patients undergo this surgery after non-operative treatments have failed to provide relief of arthritic symptoms. Non-operative treatments can include activity modification, anti-inflammatory medications, and knee joint injections.
Surgeons have performed knee replacements for over three decades generally with excellent results; most reports have ten-year success rates in excess of 90 percent.
Broadly speaking there are two types of knee replacements:
- Total Knee Replacements and
- Minimally-Invasive Partial Knee replacement.
Both have long “track records” and good clinical results in this country and in Europe.
Total Knee Replacement
Traditional total knee replacement involves a 7-8” incision over the knee, a hospital stay of 3-5 days, and a recovery period (during which the patient walks with a walker or cane) typically lasting from one to three months. The large majority of patients report substantial or complete relief of their arthritic symptoms once they have recovered from a total knee replacement.
Partial Knee Replacement
Partial knee replacements have been around for decades and offer excellent clinical results, just like total knee replacements. Less invasive techniques are available to insert these smaller implants but only a minority of knee replacement patients (about 10%) are good candidates for this procedure.
Ways to help patients waiting for knee replacement surgery.
If you’re on a waiting list for a hip or knee replacement, there are resources and advice to help you stay as fit and healthy as possible.
Working to improve your physical and mental wellbeing before surgery can:
- Help you to stay strong and mobile
- Prevent additional physical and mental health problems
- Help you to cope with surgery and the recovery afterwards
There are many ways to help manage pain,
- PAINKILLERS AND ANTI-INFLAMMATORIES:
Painkillers / anti-inflammatories can help significantly, in terms of helping patients continue to cope with their daily activities. They can also help stop a painful knee from waking them up at night.
Occasional painkillers / anti-inflammatories are fine; however, if a patient is ‘popping pills’ regularly, then there is the risk they might be taking too many and that they should seek the advice of their consultant.
However, for some, pain relief may become less effective over time. This is usually the case if you’ve reached the stage where you and your orthopaedic team are considering joint replacement. This means many people may need a different way to manage pain.
Taking opioids before your operation can also be problematic. This is because it can impact on your recovery and increase the risk that you’ll have to continue to take opioids afterwards.
This means it’s really important to think about whether the pain relief you’re on is still helping. If it’s at all possible, try to slowly reduce the amount you take before the date of your surgery.
- STERIOD INJECTIONS.
Injections into the affected joint can sometimes be used to help relieve the pain from arthritis. This may provide short-term help but it’s not a cure.If injection therapies are used too near to an operation, they lead to a higher risk of infection. However, if it’s going to be a long time until your operation, they may be an option to consider.
Steroid acts as a very powerful anti-inflammatory. It’s not like ‘being on steroids’: the injection does not affect the rest of the body to any significant degree – it’s simply like having a massive dose of Nurofen all in one spot, inside the knee joint, exactly where it’s needed.
The likelihood of a steroid injection working is highly variable, and it depends very much on what is actually damaged in the knee and/or how severe that damage might be. In addition, the effects can vary considerably between individuals. Basically, the more inflamed the joint is (warm, tender and swollen), then the more likely it is that a steroid injection will work. Broadly speaking, a steroid injection might work in maybe 75% or so of people with knee arthritis, although the percentage pain relief varies considerably. The injection may last just a few weeks or could last as long as 6 months; again, However, this is highly variable.
The advantages of steroid injections:
- They are quick,
- They are easy to give,
- They’re very low risk and
- They’re relatively cheap.
The disadvantages of steroid injections into the knee are that:
- The injection might not work,
- Any relief might only be partial,
- The benefits are only ever temporary, and
- There is evidence that in the longer-term they can actually make a joint worse, increasing the likelihood that the individual will actually end up needing knee replacement surgery.
Steroid injections can sometimes be an appropriate option if a patient needs help to get through a particular period or event, such as a family wedding or a big and important family holiday. However, we normally tend to wait at least 3 months after someone has had their knee injected with steroid before then potentially going ahead with any knee replacement surgery, as there is a small fear that steroids may inhibit the immune response and potentially increase the risk of post-operative joint infection if given too close to the time of surgery.
- PHYSIOTHERAPY.
Appropriate physiotherapy prior to surgery (so-called ‘pre-hab’) can improve a patient’s mobility and build strength and fitness levels, helping them to cope better with any subsequent surgery and with the extensive post-op rehab that’s required after knee replacement surgery – and, importantly, this then increases the likelihood of a better long-term outcome from the surgery itself. Therefore, either way, whether a patient is trying avoid or delay surgery, or whether they’re already booked in and waiting for surgery, physiotherapy is an invaluable and essential part of the overall management of knee arthritis. If a patient doesn’t already have a physiotherapist, then their knee surgeon should be able to recommend one nearby.
- CARDIO FITNESS EXERCISE.
If you’re doing ‘proper’ cardio fitness exercise, then your pulse should be racing, you should be out of breath and you should be sweating. If you can hold a conversation whilst you’re ‘exercising’, then you’re not doing proper cardio! Walking is good for you on many levels, including just ‘getting out’, getting fresh air, getting Vitamin D and keeping your joints moving. However, when you’re doing ‘proper’ cardio exercise (pulse racing, short of breath, sweating), then your body is pumping out Endorphins. Endorphins are one of the best anti-depressants known to man, they are addictive (so that the more you do, the more you want to do) and they raise your natural pain threshold, so that you feel less pain. Endorphins don’t actually reverse knee arthritis or make joints physically better, but they do make your knees feel better, and the fitter you are, the longer you’ll be able to keep going and cope before you do eventually end up having to resort to knee replacement surgery. In addition, being fit also reduces one’s risk of heart attack, stroke, hypertension and diabetes, and it even boosts your immune system, and fitter people tend to live longer.
Conditions like arthritis will cause a fluctuation in symptoms. This means the symptoms will sometimes be worse or better than normal.
If you find that your symptoms are getting significantly worse then speak to your knee replacement surgeon in Thane for advice.
