FAQ's

Your knee joint is the largest joint in your body and also a very complex one. Because it is very important for your daily activities and you use it a lot, it can get injured and damaged.

Your knee joint is made up of:

• 3 bones - Thigh bone (femur), shinbone (tibia) and knee cap (patella).
• Cartilage - Thin covering which keeps the bones apart and provides a smooth, slippery surface for painless, free movement of your knee.
• 4 Ligaments - Thick rubber-bands like structures that holds the two bones together and provide stability.
• 2 Menisci - C - shaped cushions between the femur and tibia which act as shock absorbers.

Normal Knee

Knee Joint Speciality

Your knee can get damaged due to accidental fall, twisting, injury while walking, running, playing sports.
Arthritis - damage and wear of the cartilage can occur due to Osteoarthritis, Rheumatoid Arthritis, Previous Injury, Fracture or Dislocation.

Cartilage damage - Early arthritis, osteonecrosis and injuries may lead to cartilage damage of a limited area leading to pain, stiffness, swelling and difficulty in performing daily activities such as walking, standing, sitting for long, climbing stairs and sitting cross legged.

Meniscal tear - Results from injury, when one excessively bends the knee as in squatting, or due to twisting. Apart from pain, swelling, stiffness and difficulty in walking, there may be 'locking'.

Ligament tears - Sports injuries or accidents may cause ligaments to tear causing instability and 'giving way'. The cruciate and collateral ligaments are commonly damaged.

Joint preservation includes different methods of treatment for knees with mild cartilage damage, meniscal or ligament tears. The key is early diagnosis of the problem and prompt treatment so that it does not worsen and require major surgery in the future!
Joint Preservation includes the following treatment options

• Lifestyle changes
• Exercises
• Arthroscopy
• ACI

Lifestyle plays an important role in joint health. This is especially true in someone who has been diagnosed with early arthritis, ligament or meniscal injury. Keeping your knee muscles strong will help in improving the weight distribution on your knee joint. Maintaining your body weight also reduces the load on your knee and reduces the risk of further deterioration and damage. A well-balanced diet, adequate in calcium and vitamin D, and regular weight-bearing exercises (like walking) will help keep your bone and cartilage healthy. Avoidance of certain activities based on your specific problem may be advisable to prevent further damage.

Early knee arthritis, ligament or meniscal injury can lead to functional limitations due to muscular weakness that prevents one from participating in physical activity. Certain exercises can help in reducing pain, improving function by strengthening muscles and improving gait.

Arthroscopic surgery or "key-hole" surgery allows the surgeon to look inside the joint and perform procedures using special tiny instruments. This usually requires a stay of 24 hours in hospital. Meniscal and ligament tears are treated using arthroscopy as also certain cartilage regeneration procedures.

This is a minimally invasive procedure which involves transplanting your own cartilage cells to an area of Limited cartilage damage. This is done as an open surgical procedure and requires overnight stay in the hospital. The transplanted cartilage cells may help to re-grow and form new normal cartilage at the site of damage, and is useful for loss of small areas of cartilage.

Your knee joint is the largest joint in your body and also a very complex one.Because it is very important for your daily activities and you use it a lot, it can get injured and damaged.

Your knee joint is made up of:

• 3 bones - Thigh bone (femur), shinbone (tibia) and knee cap (patella).
• Cartilage - Thin covering which keeps the bones apart and provides a smooth, slippery surface for painless, free movement of your knee.
• 4 Ligaments - Thick rubber-bands like structures that holds the two bones together and provide stability.
• 2 Menisci - C - shaped cushions between the femur and tibia which act as shock absorbers.

Normal Knee

Knee Joint Speciality

Your knee can get damaged due to accidental fall, twisting, injury while walking, running, and playing sports which may cause meniscal or ligament injuries. Arthritis which damages the cartilage and can be of different types - Osteoarthritis, Rheumatoid Arthritis, and Post-traumatic Arthritis (after previous injury, fracture or dislocation) being the common ones. It causes pain, stiffness, swelling and difficulty in performing your daily activities such as walking, standing for tong, getting up from a chair, climbing stairs and sitting cross-legged.

The cartilage covering the 3 bones where they move against each other is only a few millimetres thick. The cartilage in your knee is said to be present in 3 compartments for sake of simplicity — the medial (or inner), lateral (or outer) and patello-femoral (behind the knee cap) compartments. When the full thickness of cartilage in one or more compartments is worn away due to osteoarthritis, there is no treatment available to make it grow back. Osteoarthritis starts in one compartment (either medial or patellofemoral) and then affects the other compartments. By resurfacing one or two compartments at the right time, the knee joint can be preserved and knee replacement can be avoided or delayed for many years. Only that compartment with worn out cartilage is resurfaced with metal and polyethylene; the remaining joint with its ligaments, meniscus, and cartilage is preserved. The key is to diagnose the problem early and treat it promptly so that it does not worsen and require a knee replacement in the future! Unfortunately, rheumatoid arthritis affects all 3 compartments at once and so resurfacing of one or two compartments alone cannot help.

Cartilage Speciality

• UKR: Medial Unicompartmental Resurfacing of the medial compartment
• PFR: Patellofemoral Resurfacing of the patello-femoral compartment
• BKR: Bicompartmental Resurfacing of medial and patello-femoral compartments

Unicompartmental Knee Resurfacing Animation

Unicompartmental Knee Resurfacing

Patellofemoral Knee Resurfacing
 

Bicompartmental Knee Resurfacing
 

Resurfacing is very successful when loss of cartilage in one or two compartments causes knee pain, swelling, stiffness, and affects your daily life, and only when other treatment (lifestyle modification, exercises, medicines and physiotherapy) has failed.

By using the latest techniques of special injections, minimally invasive approach (small cuts) and our fast recovery protocol, you will have very little or no pain, and you will be surprised by the speed of your recovery.

Yes, if all your tests done beforehand show that you are medically fit, resurfacing can be safely done in both knees on the same day.

Success depends on the surgeon and his team's experience in selecting the correct patient for the operation, skill and technique in performing it, and the implant design. We have been pioneers in this operation, are involved in designing resurfacing implants for worldwide use by other surgeons, and have the longest experience. Like most of our patients who are very satisfied with their results, your operation too has an over 90% likelihood of lasting for 10 - 15 years.

Taking the bus or train after Total Knee Resurfacing of both knees

Cycling after Unicompartmental Knee Resurfacing

Your knee will be as similar to your normal knee as possible, will feel normal,and will be as flexible so that you can lead a normal life. By not replacing the knee, we are able to preserve the bone, ligaments, menisci and cartilage in the remaining compartments. Results from around the world show that those who have had resurfacing are more satisfied than those with a knee replacement. It is also very likely that there will be no need for any further operations on your knee. However, should you require knee replacement after many years, it will be an easier operation as the remaining knee had been preserved, and the results will be equally satisfactory and long - lasting.

Your knee joint is the largest joint in your body and also a very complex one.Because it is very important for your daily activities and you use it a lot, it can get injured and damaged.

Your knee joint is made up of:

• 3 bones - Thigh bone (femur), shinbone (tibia) and knee cap (patella).
• Cartilage - Thin covering which keeps the bones apart and provides a smooth, slippery surface for painless, free movement of your knee.
• 4 Ligaments - Thick rubber-bands like structures that holds the two bones together and provide stability.
• 2 Menisci - C - shaped cushions between the femur and tibia which act as shock absorbers.

Normal Knee

Knee Joint Speciality

Arthritis means damage and wear of the cartilage covering the bone ends. It can be of different types - Osteoarthritis, Rheumatoid Arthritis, and Post-traumatic Arthritis (after previous injury, fracture or dislocation) being the common ones. It causes pain, stiffness, swelling and difficulty in performing your daily activities such as walking, standing for long, getting up from a chair, climbing stairs and sitting cross-legged.

'Knee Replacement' is actually misleading as your whole knee is not replaced! It only involves resurfacing the cartilage on the 3 bones where they move against each other. The new surfaces are made of metal and polyethylene and are fixed to your bones with special bone cement. The implants we use are imported, have been well tested, and have been used successfully for many years.

When the cartilage in all 3 compartments of your knee is severely damaged, results in pain, swelling, stiffness and deformity, and affects your daily activity, you should start thinking about knee replacement. It should be considered only after all other standard treatment (lifestyle modifications, medicines, exercises and physiotherapy) has failed to improve your quality of life.

We are pioneers in using computer technology for knee surgery, have helped develop software for it, and were the first in the world to use an iPod for knee replacement. Our extensive research and published papers have shown that you are likely to have superior results, quicker recovery, less pain and tong-lasting results with our CAS techniques which involve the use of reflected infra-red beams to add precision and accuracy to knee surgery.

CAS

CAS (Computer-Assisted Surgery)

Our 'Bespoke' technique of surgery enables us to treat your knee in a customized fashion as your knee is somewhat different from that of others. We use CAS which helps us to individualize our technique to your needs as well as to the specific condition of your knee. Our pain control methods, anesthesia techniques, and fast recovery programme after the operation are also tailored to your specific requirements. This patient-specific approach will enable you to recover more quickly and regain full movement and activity more speedily and without effort.

Bespoke Technique
 

Total Knee Replacement of both knees with severe deformity

Total Knee Replacement of both knees with severe deformity

Climbing a steep ladder after Total Knee Replacement of both knees

Success depends on the surgeon and his team's experience, skills and technique in performing it, and the implant design. We have been pioneers in is operation, are involved in designing implants for worldwide use by other surgeons, and have extensive experience over 20 years. We have treated over 10,000 patients who are very satisfied with their results and which last for 15 years or more in over 95%.

Yes, if your tests done beforehand are normal and both your knees are affected, knee replacement can be safely done in both knees at the same sitting. Your hospital stay (2-3 days) and pain will be the same as when knee replacement is done only for one side. The advantages are that both legs will be of the same length, your knees will recover together, you will walk correctly from the first day, and you will not need to return to hospital for the second knee.

Total Knee Replacement of both knees with severe deformity

Total Knee Replacement of both knees with severe deformity

Climbing a steep ladder after Total Knee Replacement of both knees