Enabling Lives With Total Knee Replacement

Mobility is life and this surgery assures that our geriatric population remains mobile, self-dependent and enjoys an independent lifestyle. With a population of 137 crores, out of which about 10% is elderly and is further growing rapidly to an estimated 30% by 2050, India has a huge number of patients with knee problems.

Taking a glance at statistics, more than 15 crore Indians suffer from knee problems, out of which about 4 crore patients need Total Knee Replacement (TKR), imposing a huge health burden on the country. In contrast, in China, about 6.5 crore people suffer from knee problems — less than half the number in India. The incidence of knee arthritis among Indians is 15 times higher than that in Western countries; this is because of the genetic predisposition of Indians towards knee arthritis and a lifestyle that results in overuse of the knee joints.

USA, with a population of 30 crores, sees about 7 lakh total knee replacement surgeries every year. In India, this figure is only 150,000, while this is a huge jump from a mere 350 knee surgeries that were performed in India in 1994. The unmet demand in the country would be a staggering one crore knee replacements each year, compared to this, India will be seeing just about one million knee replacements every year by 2022.

Amongst many causes of chronic joint pain, degenerative osteoarthritis is the leading cause in India and leads to a majority of morbidity. Other reasons are inflammatory causes like gouty arthritis, psoriatic arthritis, rheumatoid arthritis, or can be secondary to trauma.

Total Knee Replacement is one of the most successful surgeries of orthopedics and with technical augmentation and skilled surgeons; this surgery has been totally revolutionized by Shalby Hospitals, India.

An avalanche of questions arise as soon as a patient is advised TKR surgery and even more are the myths about this procedure which patients and their relatives are flooded by hearsay.

FAQs and Myths about TKR

Myth 1: Knee replacement is a surgery for old people. I’m too young for a knee replacement.

Fact: Candidacy for a knee replacement is not based on age but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor.

Myth 2: I should wait as long as possible, to undergo knee replacement surgery.

Fact: You don’t need to suffer by waiving until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgeries and return to activity more difficult.

Myth 3: I should continue with medications as long as possible.

Fact: Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration etc.

Myth 4: Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy, and braces will cure my advanced arthritis and knee pain.

Fact: To date there is NO cure for advanced knee arthritis and these alternative therapies are not backed by any established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative.

Myth 5: After a knee replacement, it takes months to recover.

Fact: Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. One becomes independent for self before discharge from the hospital.

Myth 6: After knee replacement, I’ll have to give up some activities and sports.

Fact: You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. Squatting and sitting cross-legged though possible, should be kept to minimal for the best long-term results.

Myth 7: Knee replacement is a very painful surgery. There is lots of pain in post-operative period.

Fact: With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post-operative period and has a smooth recovery.

Myth 8: Knee replacement can be done one at a time, only.

Fact: Both the knees can be operated at the same time if the patient does not have significant co-morbidities and is deemed fit to undergo the procedure by the doctor.

Myth 9: The new knee lasts for 5-6 years only.

Fact: With modern day precision and advancement in biomaterials, the longevity of the implant has increased considerably. Today’s joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth 10: Knee replacement cannot be done a second time.

Fact: Knee replacement can be done multiple times and it is known as revision joint replacement surgery with good survivorship.

Myth 11: I am obese; I cannot undergo Knee replacement surgery.

Fact: Knee replacement can be successfully done in an obese patient. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth 12: I have diabetes, hypertension or heart ailment, so I cannot undergo Knee replacement surgery.

Fact: There is no such restriction. In fact better mobility after TKR enables to control above diseases better.

TKR is surgery of choice; hence the patient decides when he/she wants to undergo surgery. All the patients are extensively managed by a team of super-specialists to be fit for surgery. Each patient is different and planned accordingly. Strict protocols are followed by pre-intra and post-op. The Success Mantra is: Precise and Fast surgery by a highly trained team.

The patients return to their daily activities within 6-8 weeks which include home chores, driving, recreational activities, and sports like swimming, walking, and gardening with new confidence to take on life and define new horizons for themselves.

Dr. Deepak Saini, Senior Joint Replacement Surgeon,
Shalby Hospitals Jaipur