Knee & Joint Replacement Surgeon - About Knee Surgery
The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The fibula, smaller bone that runs alongside the tibia and the kneecap (patella) are the other bones that make-up the knee joint.
Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee:
- The anterior cruciate ligament prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur).
- The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur).
- The medial and lateral collateral ligaments prevent the femur from sliding side to side.
Two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia.
Numerous bursae, fluid-filled sacs, help the knee move smoothly.
Dr.Aditya khemka has a special interest in ACL Reconstruction using anatomy preserving technology and Knee Replacement Surgery using computerized navigation technology. He is one of the best knee replacement surgeon in mumbai.
Frequently Asked Questions
Total knee replacement is often necessary after the cartilage between a patient’s femur and pelvis wears out. Osteoarthritis often results from the lack of cartilage and leaves patients with severe achy pain and immobility. Typically, a knee replacement is not performed unless nonsurgical methods fail to relieve knee pain.
While the patient is under anesthesia, the knee is cut open and the arthritic bone in the socket of the joint is cleaned out. The surgeon also removes arthritic bone from the femur and the tibia, then inserts an artificial prosthesis. The joint is then complete and the surgeon shaves arthritic bone from the knee cap before replacing it and closing the incision.
Real-time Computer Navigation is a relatively new approach to Total Knee Replacement Surgery, which helps the patients improve their clinical outcomes.
It involves the creation of a 3-D model of your knee in real time during surgery. This is done using safe infrared technology and doesn’t, require any CT scan or radiation. The surgeon use temporary pins in the bones and a hand held probe with infrared reflective balls attached to precisely map out the 3-D anatomy of the knee onto a computer. The computer then calculates the optimal alignment. The surgeon is in total control of this process, he can double check the plan and easily make real-time adjustments. Using this technology, it is possible to achieve within half a degree of accuracy, which is more accurate than a human eye can detect.
Studies have shown that poor alignment is detrimental to long-term outcomes of knee replacements. It has long been accepted that just 3 degrees of error in alignment leads to an increased rate of failure.
A comparison I like to use is of navigating when driving a car. The old technology is like using a map and which gets us there safely most of the time. Computer navigation is a bit like a GPS. The surgeon remains in control but the computer allows choosing the optimum route, gives advice, and if it does go off track, the course can be corrected. Reviews have clearly shown that computer navigation improves the alignment of knee replacements compared to the traditional manual technique and would also lead to better outcomes for patients. No other technology is so versatile and hence this in my opinion is the gold standard for knee replacement surgery.
Although patients are sore after surgery, most knee replacement patients report being completely pain-free after 4-6 weeks. Additionally, 95% of knee replacement patients reported having less pain one year after their surgery than before it, according to Total Knee Replacements.
One can sit on the floor now normally six months after the surgery. This clearly depends on how one does the surgery and the use of certain implants.
But it isn’t advisable to do so after a knee replacement keeping in mind the chances of a wear provided in an artificial joint.
Under the care of Dr. Khemka stay for just 2-3 days, and then are back in the comfort of their own home to recover.
Before you are discharged from care, you will need to accomplish several goals, such as:
- Getting in and out of bed by yourself.
- Having acceptable pain control.
- Being able to eat, drink, and use the bathroom.
- Walking with an assistive device (a cane, walker, or crutches) on a level surface and being able to climb up and down two or three stairs.
- Being able to perform the prescribed home exercises.
- Understanding any knee precautions you may have been given to prevent injury and ensure proper healing.
It is recommended that patients take 2-6 weeks off of work depending on their occupation. Patients who have a desk job can typically go back to work sooner than patients who have manual labor jobs or have to be on their feet often.
Patients should be able to move around the house after 4-6 weeks without experiencing pain or using walking aids. After that point, the amount of time that is necessary for a full recovery varies between patients. Some patients recover extremely quickly—within a month or two—while others require a full six months before returning to their pre-surgery levels of activity.
Yes. Physical therapy is an essential part of your total knee replacement recovery process. Physical therapy begins the following day of your surgery and will take place over the course of several weeks. At first, you will do some simple exercises like contracting and relaxing your muscles in order to strengthen your knee. You will also learn new techniques for movements such as sitting, standing, and bending, in order to prevent any possible damage to your knee replacement. Typically patients are in physical therapy for 6-8 weeks and have sessions twice/week.
Some patients may drive as soon as 2 weeks after surgery, while others may need as long as 8 weeks. During this period, simply getting in and out of a car can be challenging, especially if the car’s seats are low to the ground. In order to drive a car safely, patients must meet the following requirements:
- The patient must be off of narcotic pain medication while driving. If the patient takes pain medication at night only and not during the day while driving, that is acceptable.
- The patient must be able to hit the brake quickly.
- The patient must be able to get in and out of the car comfortably and safely.
In addition, reflexes and muscle strength should have returned to their pre-surgical levels
Here is a list of potential post-surgery complications:
- Blood clots
- Need for second knee replacement
Dr. Khemka and your physical therapists will evaluate your risk for complications and provide specific treatments to avoid these risks.
The cost of the surgery is normally divided in two parts. One of which includes the hospital stay, operating room charges, use of consumables, pharmacy, surgeon charges etc and the latter which includes implants depending on what is to be used.
All these costs are normally covered by the insurance company, and we can organise packages with the hospitals where he operates to minimise your burden in the absence of insurance.
Dr. Khemka would be happy to provide all the information to you during consultation