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Knee Arthritis and Knee Replacement – why are we so afraid ?
Let’s first admit that knee arthritis like eye cataract is a disease of old age bound to affect all of us. Blaming our genes or considering familial reasons for this will not be correct. Early arthritis responds nicely to physical therapy, intra articular injections, weight reduction and analgesics. This is the stage when alternative therapies like ayurved or Homeopathic medicines might also work . As the disease progress these modalities become ineffective and require additional treatment modalities. Understanding this simple fact is important as the patients are reluctant to accept these additional treatments indicated in late arthritis.
Late Arthritis if untreated remarkably reduces the physical movement of patient. Due to fear of pain patient gradually restricts his / her activities like daily walk, social interaction and is eventually confined to the house. This results in serious effects on body and lead to worsening of high blood pressure, Diabetes, kidney problems etc. Such patients also suffer from depression and other psychological problems.

Till date , for late arthritis when the joint is almost destroyed, Total knee replacement (TKR)remains the only answer. Knee replacement done in indicated patients have almost 100% success rate.
From patients prospective I think there are some major questions which create a mind block against knee replacement. ..” I am over sixty , can I undergo this surgery safely” .. . Yes of course TKR is a surgery meant for old age. Before this surgery is undertaken a complete medical check up including ECG, ECHO, Renal status etc is done. Besides Orthopedic Surgeon, a Physician (cardiologist if needed) and Anaesthetist are part of team who ensure total well being of patient. Needless to say a good hospital with ICU back up is must. At our centre we have even undertaken surgery in patients who were above 90 years old.
“ How much it will cost ?” Considering the Indian scenario where insurance sector is still in its infancy , majority of patients pay from their savings. In this situation a affordable package and which does not compromise on quality is needed. We have introduced the concept of “NANO Knee Replacement” where in one lakh and twenty five thousand the patient will undergo this surgery at the selected city hospitals.
“ How much bed rest is required ?” . Complete bed rest is required not more than 2-3 days. On 3rd post operative day patient is mobilized with walker and full weight bearing is allowed. Thereafter a physiotherapy regimen is followed and by 3-4 weeks patient shifts to walking stick.
“How long will a joint replacement last? “Longevity of the prosthetic knee varies from patient to patient. It depends on many factors, such as a patient's physical condition, activity level, and weight, as well as the accuracy of implant placement during surgery. Today, total knee replacement has become a common and predictable procedure. Many patients enjoy relief from pain and improved function, compared to their status before surgery. As a result, some patients may have unrealistic expectations about what the prosthetic knee can do and how much activity it can withstand. Activities that place a lot of stress on the joint implants, as may be the case with heavier and more active patients, may reduce the service life of the prosthesis. Some activities need to be avoided like heavy loads , steep stairs, impact sports like jogging or running and kneeling. We now know that about 85 percent of the joint implants will last 20 years. Improvements in surgical technique and artificial joint materials should make these artificial joints last even longer.

Let us not forget the importance of mobility in old age. There is no reason that one should lead a life of pain and agony. Knee replacement offers best treatment option for late arthritis and its safe , affordable and gives the best results .

Dr. Harinder Batth, M.S (PGI)
Consultant Orthopedic Surgeon
INSCOL Hospital, Chandigarh
COSMO Hospital, Mohali

Mob- 9888003333

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