In the 21st century, we are enjoying the healthy life with more life expectancy than the previous era. With an increase in longevity, senior citizens are facing more problems related to mobility, And the most common are Arthritis …among all major joints, Knee joint is bearing more weight and hence suffering from comparatively major wear & tear, which leads to painful & altered movements.
Initially, physicians can manage such problems by conservative treatments like medicines, exercise, weight reduction, Steroidal injections(which is not so popular nowadays), Physical therapy etc. but after certain limit these conservative treatments are also not that much beneficial & leads to increased dependency of seniors for movements. Also long administration of painkillers has their own side effects like kidney & liver damage, gastric irritation. In the sixties of such patient now, Medical science gives this golden opportunity of “Knee replacement surgery” to improvise living of such patient.
There are quite a few treatments for early arthritis of knees like weight reduction, anti-inflammatory medications, steroid injections (rarely used nowadays) and physical therapy which can include localized treatments (Hot /Cold fomentation, Massages) and exercises.
When these conservative modalities fail to give pain relief or improve movement and start interfering with the quality of life then Total Knee Replacement could be considered as an option.
Also, if the deformity is such that it starts affecting the other joints, like the same side hip or the opposite side knee, then your doctor could advise a knee replacement surgery for you.
Total Knee Replacement Surgery is a reliable operation to relieve pain and suffering due to disabling arthritis of the knee. However, many patients have reservations due to its prolonged recovery and a need for physiotherapy. Inability to squat and kneel after the operation, which is particularly important to Indian patients also acts as the deterrent.
Techniques that have been developed today, have drastically cut the recovery time down. Many patients after subcastes MI TKR have been able to walk without even holding a walking stick on the third day post surgery. The need for physiotherapy also has become mush less. With the superior quality of joints available, activities such as kneeling and squatting are possible in selected patients. These benefits are enjoyed due to an advanced surgical technique that involves a minimal incision on the front of the knee. This cut is typically less than 4 inches. Former incision lengths were around 9 to 12 inches.
In sub castes MI TKR no cut is made On the underlying thigh muscle called the quadriceps. Instead, the joint is approached from sides of the muscle. This has huge advantages such as not Weakening the thigh muscles at all and this is the reason that the patients are able to walk even without holding on to any walking aids almost immediately after the operation. Mini Subvastus Approach The earlier approach involved cutting the Quadriceps. If the quadriceps are cut, the patients typically need walking aids for 3 to 6 weeks to allow this cut to heal. Moreover, cutting the quadriceps causes more pain and delays the recovery from the operation. The subvastuive approach reduces requirements of pain killers, extensive physiotherapy….so postoperative recovery is much faster as compared to traditional knee replacement…
Mini-Incision The instruments to implant the joint and the surgical techniques Have been suitably modified so that the new knee joint can be implanted accurately through an incision less than 4 inches. This has advantages, as the lesser the cut on the skin, lesser is the pain and earlier the recovery. Incision Less Than 4 Inches Reduced pain during recovery.
The mini TKR through subvastus approach Coupled with advanced postoperative analgesia reduces the pain associated with recovery after the operation. This allows the patients to bend the knee and walk freely early in the post-operative period.Full Bend of the knee The ablity to achieve full bend of the knee requires the joint to be Implanted perfectly.Care is taken intra-operatively to ensure that the joint is bending fully on the operation table. This allows mobilization of the knee to begin immediately after the operation and to eventually achieve full flexion. The high flex and mobile joints that are available help in achieving this aim.