Creaking knees and joint pain is commonly perceived as the signs of ageing. People assume that there is no solution to these problems, so they don’t visit the doctor and talk about the problem unless it gets worse. Luckily, advancements in science and technology have offered a lot of options for joint replacement.
Total knee replacement is a surgery to remove and replace the whole damaged knee joint with an artificial joint. Artificial joints are made of either metal alloys, high-grade plastics, or polymers. Based on the condition of the patient, the surgeon may replace a single knee or both the knees at once. If the surgery involves the replacement of both the damaged knee joints at the same time, it is referred to as bilateral total knee replacement.
There is no age or weight restriction for undergoing total knee replacement. People of any age group with severe knee pain and stiffness that limits their daily activities are benefited with a bilateral total knee replacement. People with chronic swelling of the knee that does not improve with adequate rest and regular medicines are good candidates for total knee replacement.
Additionally, individuals with the following conditions are eligible for undergoing total knee replacement:
- Rheumatoid arthritis
- Post-traumatic arthritis
- Bone dysplasias (a condition that causes unusual bone growth)
- Avascular necrosis (bone death caused by lack of blood supply)
- Severe knee injury
- Knee deformity that causes severe pain and loss of cartilage
PREPARATION BEFORE PROCEDURE
The surgical team will review the medical, medication, and social history of the patient. They will also brief you about the procedure, its benefits and risks. A physical examination is done to assess knee motion, stability, and strength. Certain tests, such as complete blood test, urinalysis, X-rays, ECG (electrocardiogram), and magnetic resonance imaging (MRI) are done to determine the overall health condition of the patient for undergoing surgery.
The following instructions may help in having an uneventful total knee replacement surgery:
- Avoid aspirin or any blood-thinning agents at least two weeks before surgery.
- Quit smoking and alcohol consumption temporarily.
- Notify your doctor regarding the use of current medications.
- Inform the surgeon if you have a fever or any infection before the surgery.
- Do not eat or drink anything eight hours before the surgery.
The doctor will administer either general anaesthesia or spinal anaesthesia. Once the anaesthesia sets, the surgeon will make an incision on the front of the knee to expose the kneecap. The surgeon will move the kneecap to reach and remove the damaged knee joint. Now, the surgeon will carefully cut the ends of your thigh bone and shin bone to fit the replacement parts. An appropriately sized artificial joint is replaced and fixed by using either surgical cement or other fixing materials. In the end, the surgeon will repair the muscles and tendons that surround the new bone. The incision is now stitched and covered with a bandage.
Immediately after the procedure, the surgical nurse will monitor your blood pressure, heart rate, and other vital signs in a recovery room. Pain and swelling at the surgical site are common for a few weeks after the surgery. As this is a major surgery, you need to stay in the hospital for a few days. The surgeon will prescribe some medicines to manage pain and inflammation. Your surgeon will advise you to use assistive devices, such as walkers or canes while walking. Before getting discharged, your nurse gives you certain instructions regarding wound care.
Following the instructions given by your doctors may help you in healing quickly:
- Eat a healthy and well-balanced diet
- Do regular exercises as suggested by the doctor
- Take necessary precautions to avoid the risk of falls
- Take the prescribed medicines regularly
- Follow-up with your surgeon as scheduled
- Do not lift heavy objects
- Visit your surgeon immediately on experiencing any signs of infection, such as fever or chills
FACTORS AFFECTING COST
The cost of bilateral total knee replacement depends on the following factors:
- Type of hospital
- Location of the hospital
- Surgery, including operating room cost-per-hour, hospital stay
- Type of anaesthesia
- Surgeon’s fee based on the experience
- Current medications
- Follow-up visits