Total Knee Replacement
In the normal knee, the bones are covered with a thin white cushion called cartilage, which prevents the bones rubbing against one another.
Xray of normal knee with space between the bones
Xray of arthritic knee showing bones rubbing against each other
Total Knee Replacement
'Total Knee Replacement' is a misleading term as your whole knee is not replaced! It only involves resurfacing the cartilage on the bones with new surfaces made of metal and polyethylene, which have been used successfully for many years.
Are there different types of Knee Replacement?
Yes, there are hundreds! We have helped design implants (such as the very successful Attune Knee System, from Johnson & Johnson) that are used worldwide. We decide the most suitable one based on a thorough assessment of patient age, weight, activity level, bone quality, deformity, and ligaments. Do let us know if you have a preferred design in mind and are allergic to nickel, chromium or cobalt.
What is Computer and Robot-Assisted Surgery and how is it helpful?
We are foremost in using computer technology for knee surgery (since 2005), we have helped develop software for it, and we were the first in the world to use an iPod for knee replacement. You will have superior results, quicker recovery, less pain, and longer-lasting results due to our extensive research and experience with computer techniques, which also allow us to safely perform knee replacements on both knees at the same time.
How will your 'bespoke' technique benefit me?
Our 'Bespoke' technique helps us to treat your knee in a specific way as your knee differs from that of others. We individualize the technique to suit the condition of your knee and body. Our smaller cut, pain control methods, anesthesia techniques, and fast recovery programme tailored to your specific requirements enable you to recover safely, more quickly and regain full movement. Most of our patients (over 90%) do not need physiotherapy.
How successful is knee replacement?
Success depends on the surgeon and his team's experience, skills and technique in performing it, and the implant design. Very few centres in India and around the world have performed Computer-assisted Total Knee Replacement for as many years and in as many patients as we have. We have treated over 20,000 patients who are very satisfied with their results which last for 15+ years in over 95%.
Is there any age restriction for surgery?
No! We have performed knee surgery in persons upto the age of 95 years provided they have undergone detailed examination, investigations, and assessment by our physicians.
What if I have bent legs? Will my legs become straight again?
Our advanced computer-assisted techniques will make the legs straight again, even if they were severely bowed or knock-kneed. We have developed special techniques (see our 'Publications') to correct extremely deformed knees.
What if I have diabetes, high blood pressure, am overweight, or have a heart problem?
We have successfully operated on patients even if they are overweight (upto 145 kg!), diabetic, and have heart problems - provided they have undergone a complete examination, investigations, and assessment by our physicians. Diabetes and high blood pressure need to be controlled before surgery. Usually after bypass surgery or stenting, we follow the cardiologist's recommendation and delay surgery for 6 months.
What if I have back pain or have had lumbar spine surgery?
If there is also a spinal problem (slipped disc, sciatica, spondylosis, canal stenosis), this will need careful examination and investigations (like MRI scan, EMG). Knee surgery will get rid of knee pain but not cure spine-related pain, numbness, and tingling in the legs, which will require assessment by a neurologist/spinal surgeon. If spinal and knee pain are equally severe, we can help you decide which surgery should be done first. TKR can be done after spinal surgery.
When will I recover from knee replacement surgery?
Most patients can stand and take a few steps the same evening after surgery, and next day will be able to use a chair and commode, walk with a stick/walker, and climb a few steps. If there's an elevator, you can start going out of your house at 2 weeks. After a month, you can climb stairs, drive, swim, take long walks, and travel.
Will I need physiotherapy after surgery?
No! Most of our patients (over 90%) do not need physiotherapy. We will teach you 6 simple exercises which you can easily do yourself. Rarely, if your muscles are very weak, we may suggest a physiotherapist.
When can I start driving?
Most persons can drive 1 month after surgery.
What are the activities to avoid?
Climbing stairs and sitting cross-legged on the floor. These are to be avoided, especially if you are overweight, to prevent excess load on your new knee and ensure that it lasts long.
Can I bend down to pick up something from the floor?
Yes, you will be able to pick things up from the ground and reach low cupboards and drawers.
What recreational activities can I take part in?
Walking, stationery cycling, swimming, yoga (preferably on a bed or sofa), doubles tennis and badminton, dancing, supervised weight training, and using a cross-trainer.
When will I be able to climb up and down stairs normally?
You will be shown how to climb a few steps the day after your surgery. We advise you to avoid climbing floors for 1month. Initially you may go up and down one foot at a time. Soon you will do stairs normally when your muscle strength and balance return.
When will my knee feel normal?
Returning to normal varies from person to person depending on their condition before surgery usually taking 4-6 weeks and upto 6 months. Some stiffness, soreness and aching may last for 9-12 months.