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Anatomy of the Knee Joint

The knee joint is a complex structure where the ends of two bones come together to facilitate painfree mobility. It is formed by the junction of the thigh bone (femur), the shin bone (tibia) and the knee cap (patella), which are held in place by various ligaments. The surfaces of these bones that articulate with each other are covered by a smooth and rubbery structure known as the articular cartilage.

Understanding Osteoarthritis

Osteoarthritis is a common degenerative disorder (just like cataract) that primarily affects the weight-bearing joints in the body, such as the knees and hips, and occasionally smaller joints. In a healthy joint, the articular cartilage allows for smooth gliding motion and acts as a shock absorber during activities like walking. However, when the cartilage becomes damaged, it cannot be repaired by the body's natural healing mechanisms.

Over time, the cartilage thins out, leading to areas of the knee joint where no cartilage remains. This results in the bones rubbing against each other during weight-bearing activities like standing and walking, causing pain and stiffness. Other conditions, such as rheumatoid arthritis, septic arthritis may also cause osteoarthritis at younger age and may lead to pain and disability.

In the early stages of arthritis, pain, stiffness, and disability can often be managed with medications, lifestyle modifications, weight loss, exercises, and intra-articular injections like platelet-rich plasma (PRP) or hyaluronic acid.

However, there may come a point when these measures are no longer effective, and the arthritic changes have progressed to a stage where basic activities become painful and limitations in mobility are experienced. In such cases, a knee replacement surgery may be recommended as the most appropriate treatment option

Understanding Knee Replacement

Knee replacement surgery involves replacing damaged parts of your knee joint with a prosthesis made of metal (such as Titanium, Cobalt, Chrome, or Oxidized Zirconium) and a plastic spacer. There are different types of knee replacement surgeries available:

  1. 1. Unicondylar Knee Replacement / Partial Knee Replacement
  2. 2. Total Knee Replacement
  3. 3. Bicompartment Knee Replacement

Advantages of Knee Replacement

  • Pain relief: Knee replacement surgery effectively alleviates chronic knee pain, improving overall comfort and quality of life.
  • Increased mobility: Patients regain the ability to perform activities such as walking, climbing stairs, and engaging in physical pursuits.
  • Improved quality of life: Knee replacement enhances daily functioning, mental well-being, and independence.
  • Long-lasting results: The durable prosthetic components used in knee replacements ensure lasting relief and functionality.
  • Customization options: Different types of knee replacement surgeries cater to individual needs, optimizing outcomes.
  • Enhanced joint stability: Knee replacements provide improved joint stability, reducing the risk of falls and instability.
  • Reduced medication dependency: Knee replacement reduces reliance on pain medications, leading to fewer side effects and improved well-being.

Meet the Specialist

Dr. M.K. Vetri Kumar

Knee Specialist & Orthopedic Surgeon

Specialization:
  • Knee Preservation and Replacement
  • Day Care Knee Replacement
  • Partial Knee Replacement
Education and Training:
  • M.S. in Orthopaedics from Chettinad University, Chennai (2016)
  • Extensive training in Joint Replacement surgeries across India
  • Fellowship in Arthroscopic and cartilage repair surgeries from an ISAKOS and ICRS accredited center in Milan, Italy, under Prof. Alberto Gobbi (2019)
Achievements:
  • First surgeon in India to perform Day Care Knee Replacement (2018)
  • Published scientific papers on orthobiologics and cartilage repair in international journals
Professional Memberships:
  • International Cartilage Repair and Joint Preservation Society
  • The Indian Orthopaedic Association
  • Asia Pacific Arthroplasty Society
  • American Academy of Orthopaedic Surgeons (AAOS)

Words of Appreciation from Our Patients

Here are some heartfelt Words from our patients who have experienced life-changing results after undergoing surgery at Parvathy Multispeciality Hospital:

Frequently Asked Questions (FAQ)

Unicondylar Knee Replacement / Partial Knee Replacement

A. No. The chances of the rest of your knee getting damaged after surgery are less than 5%. Unlike diseases that can spread to other parts of the body, osteoarthritis progression is primarily due to altered mechanical alignment. Once the limb's alignment is corrected back to its native alignment, the progression is halted.

A. Unlike total knee replacement, where only a few patients can achieve a full range of motion, most patients who undergo Unicondylar Knee Replacement can enjoy the convenience of squatting and sitting on the floor. However, we do not recommend to do squatting and sitting on the floor on a day to day basis.

A. Unicondylar Knee Replacement is a minimally invasive surgery with a small incision (about 4 inches), resulting in minimal tissue damage, blood loss, and bone resection. This allows for quicker recovery and a faster return to normal activities.

A. You will be encouraged to walk on the same day of the procedure, typically with the assistance of a cane or walker during the initial phase of recovery. Most patients are able to walk without assistance within one to two weeks.

A. You can start performing your activities, such as taking care of your hygiene, from the same day or the next day after surgery. You don't have to fear being dependent on others for basic needs during the recovery period. You can move around inside the house, eat, and enjoy leisure activities like watching TV from the next day of the surgery. Cooking and household chores may require a minimum of four weeks.

A. There is no age criteria for Unicondylar Knee Replacement. The decision is based on your history, examination, radiological parameters, and treatment expectations. Unicondylar Knee Replacement will be advised if you meet the specific criteria. Additionally, our surgeons are passionate about preserving your knee joint and may also suggest other joint preservation procedures.

A. There is no age criteria for the procedure, and it is based on the stage of your osteoarthritis. By following our radiological protocol, we can guide you on whether you need Unicondylar Knee Replacement or Total Knee Replacement.

A. Unicondylar Knee Replacement has been performed worldwide since the 1970s. However, its adoption has been slower compared to total knee replacement due to its complexity and limited understanding of indications. Nevertheless, four decades of dedication, particularly by the Oxford group, have led to the success of this procedure and helped knee surgeons master it.
Total Knee Replacement / Bicompartment Knee Replacement

A. Unfortunately, any major procedure can be painful. However, we have advanced techniques in post-operative pain management, such as ultrasound-guided nerve blocks, to help you manage your pain effectively during the recovery period. On average, our patients experience pain ranging from 2 to 5 on a scale of 10 for the first three weeks. The pain gradually decreases after the initial three weeks.

A. You can start traveling by car, train, or flight by the 4th week after the surgery. It is important to consult with us before planning your travel so that we can provide you with important tips to ensure a smoother journey.

A. The procedure itself takes approximately 60 to 90 minutes. However, when factoring in preparation, anesthesia, and post-operative observations, the overall time spent in the operating room is around 3-4 hours.

A. If your surgeon has advised you to undergo a partial knee replacement, then sitting on the floor is possible. For other types of knee replacements, it may vary depending on your individual circumstances, choice of implant, and compliance with your rehabilitation therapist.

A. No. Just like the lenses used for your cataract, these metallic prostheses become part of your body and function as a normal knee.

A. With our rapid recovery program, we encourage patients to start walking on the same day of the surgery. Initially, some patients may require walker support for a maximum of 2-3 weeks. After that, they can gradually transition to walking independently.

A. During the initial week after the surgery, you may need some assistance, but you will gradually become more self-sufficient. By the end of 4 weeks, you can expect to socialize and walk without pain.

A. Osteoarthritis can sometimes run in families. To help prevent it in the next generation, individuals between their 20s and 40s should maintain a BMI below 25 and engage in regular cardiovascular activities, preferably swimming, as well as leg-strengthening exercises. If anyone in the family is over 40 and experiencing joint pain, it is important to consult with joint-preservation experts to explore non-operative and operative modalities that can help them avoid a knee replacement.

A. There is no limit to walking after a successful knee replacement. In fact, during our Annual Walkathon Event, joint-replaced and geriatric participants walk for 1, 2, and 5 kilometers with great enthusiasm and pride.

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