Q.1 Things not to be done after a complete knee replacement surgery?
Even though your activity level is likely to increase, a knee replacement surgery means that high-demand or high-impact activities must be avoided. You should definitely avoid running or jogging, contact sports, jumping sports, and high impact aerobics. You should also try to avoid vigorous walking or hiking, skiing, tennis, repetitive lifting exceeding 50 pounds, and repetitive aerobic stair climbing. The safest aerobic exercise is biking (stationary or traditional) because it places very little stress on the knee joint.
Q.2 Knee or joint problems occur in women after some age, why?
A recent study in The New England Journal of Medicine showed that while women are more likely to suffer from arthritis than men, they are three times less likely to undergo knee replacement to relieve their pain. If you're a woman suffering from chronic knee pain, you may often notice how this pain affects your daily activities such as walking or enjoying family events, and it may even be disrupting your sleep. Yet as a woman, you may often wait to seek treatment due to the uncertainty of the recovery period and how it may impact your life and family. When non-surgical treatments such as exercise or anti-inflammatory medications no longer relieve your pain and your knee dictates what you can and cannot do, it is time to talk to your orthopaedic surgeon about knee replacement surgery.
Q.3 Number of joints in a human body?
There are 360 joints in a human body which include Skull Joints - 86, Throat Joints - 6, Thorax - 66, Spine and Pelvis Joints - 76, Upper Limbs - 64, Lower Limbs - 62.
Q.4 What to do with rheumatoid arthritis?
Unlike osteoarthritis, Rheumatoid knee arthritis involves inflammation of the lining of the joints, known as the synovium. Though less common than osteoarthritis, rheumatoid arthritis is among the most debilitating of the over one hundred forms of arthritis. Rheumatoid arthritis usually develops in middle age, but may occur in the 20s and 30s.
Treatment of rheumatoid arthritis usually involves medications such as NSAIDs, aspirin and analgesics. In severe cases, surgery may be indicated to replace the knee joint with an artificial joint. If you think you may have arthritis of the knee, contact your doctor for a complete evaluation and a discussion of the options available for treatment.
Q.5 Results after a total knee replacement.
You will be discharged when you can get out of bed on your own and walk with a walker or crutches, walk up and down three steps, bend your knee 90 degrees and straighten your knee. At home you should begin ambulation with a cane as tolerated. Keep your incision clean and dry and watch closely for any signs of infection. You'll continue your home exercise program and go to outpatient physical therapy, where you will work on an advanced strengthening program and such programs as stationary cycling, walking, and aquatic therapy. Your long-term rehabilitation goals are a range of motion from 100-120 degrees of knee flexion, mild or no pain with walking or other functional activities, and independence in all activities of daily living.
Q.6 What are the conditions, for which hip replacement is advised?
Hip replacement is advised for many painful hip disorders like fresh or old fractures of either the socket or the ball, failure of previous fixation and arthritis of the hip.
Q.7 For which painful hip disorder, hip replacement can not be done?
If the hip pain is due to ongoing infection in the joint or the bones, hip replacement is contra indicated. But if the infection is burnt out, one may carry out hip replacement in selected case.
Q.8 At what age can joint replacement be done?
Joint replacement is ideally done for patients above the age of 60 years. It may be done between the ages of 40 and 60. It is rarely done between the ages of 20 and 40. It is never done in children. Currently the quality of the artificial joints being very good, young people, even in their 20s & 30s, who suffer from painful arthritis are advised to undergo early surgery to improve the quality of life.
Q.9 What are the types of hip replacements?
There are three types of hip replacements
Hemi replacement :
In which only ball of the femur is replaced.
Total hip replacement :
In which ball is replaced and the socket is resurfaced.
Surface replacement :
Where the surface of the ball is shaved off and is capped and similarly the surface of the socket is scraped off and is resurfaced with metal lining.
Q.10 What is the difference between cemented and non-cemented hips?
The parts of the artificial hip may either be fixed to bone with a substance called Methyl Methacrylate (Bone cement), or they are press fitted to the bone with capacity for the bone to stick to the parts. This non-cemented hip is used mainly for younger individuals.
Q.11 What is the ball and socket made up of?
The ball is made either of stainless steel, cobalt chrome alloy or ceramic.
The socket is made either of polyethylene, stainless steel or ceramic.
Q.12 What is the average time taken for surgery?
The average time taken for joint replacement surgery is 1 hour and 30 minutes.
Q.13 What is the average hospital stay recommended after joint replacement?
The hospital stay is approximately seven days after hip replacement surgery.
Q.14 When does the exercise program start after joint replacement?
Exercises start within a day after joint replacement, while walking starts the day after surgery.
Q.15 Does one need some support of walker or stick after joint replacement?
One may need temporary support of walker or walking stick after joint replacement. Whether one needs permanent support depends on whether other joints are affected.
Q.16 Can a person with diabetes, high blood pressure, heart trouble undergo joint replacement?
Even a person with diabetes, high blood pressure, heart trouble can safely undergo joint replacement surgery under medical supervision.
Q.17 What are the precautions to be taken after joint replacement?
It is advisable to use commode, avoid sitting on floor, jogging, running and fast sports after joint replacement surgery. Moderate speed walking, climbing stairs and swimming are permitted.
Q.18 What are the common complications after joint replacement?
The complications after joint replacement are deep vein thrombosis, pulmonary embolism and infection.
Q.19 What precautions are taken to prevent these complications?
To prevent deep vein thrombosis, a calf compression device can be used, which gently massages the calf, preventing blood flow stagnation. In some patients blood thinners are administered. To prevent infection, surgery is carried out in a specialised operation theatre, at our centre we use space suits during surgery to prevent wound contamination and use antibiotics pre-operatively.
Q.20 Can this operation be done in any Nursing Home or Hospital?
No, this is a specialised surgery which requires a special set up including proper operation theatre, post-operative intensive care unit, trained nurses and technicians and expert physiotherapist to achieve desired results.
Q.21 How much does the surgery cost?
The cost depends on the type of implant, the type of room that you select and your medical condition. Before surgery a budget can be drawn out.
Q.22 Is it covered under Mediclaim?
That will depend on the Mediclaim policy.