In the knee joint there is a layer of smooth cartilage on the lower end of the femur (thighbone), the upper end of the tibia (shinbone) and the undersurface of the patella (kneecap). This cartilage serves as a cushion and allows for smooth motion of the knee. Arthritis is a wearing away of this smooth cartilage. Eventually it wears down to bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
A knee replacement is really a cartilage replacement with an artificial surface. The knee itself is not replaced, as commonly thought, but rather an artificial substitute for the cartilage is inserted on the end of the bones. This is done with a metal alloy on the femur and plastic spacer on the tibia and occasionally the patella (kneecap). This creates a new smooth cushion and a functioning joint that does not hurt.
For the majority of people who have hip replacement surgery, the procedure results in:
Partial and total knee replacement
In some patients, only one part of the knee is damaged, while the remaining parts are completely healthy. In these cases, it is possible to replace only the damaged part of the knee with a metal and plastic implant. This can usually be done through a smaller incision.
There’s no precise formula for determining when you should have a knee replacement. But if you’re having trouble doing your daily activities and require analgesics daily to do this activities. If the deformity is more then one can think of knee replacement.
Before considering a total knee replacement, the doctor may try other methods of treatment, such as exercise, walking aids, and medication. An exercise program can strengthen the muscles around the hip joint. Walking aids such as canes and walkers may alleviate some of the stress from painful, damaged knee and help you to avoid or delay surgery.
All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects.
For knee pain without inflammation, we usually recommend the analgesic medication acetminophen.
For knee pain with inflammation, treatment usually consists of nonsteroidal anti-inflammatory drugs, or NSAIDs. When neither NSAIDs nor analgesics are sufficient to relieve pain, doctors sometimes recommend combining the two. Again, this should be done only under a doctor’s supervision.Warning: NSAIDs can cause stomach irritation or, less often, they can affect kidney function. The longer a person uses NSAIDs, the more likely he or she is to have side effects.
Topical analgesic products may provide additional relief. Some people find that the nutritional supplement combination of glucosamine and chondroitin helps ease pain.
Sometimes, corticosteroids are injected into the hip joint.
If exercise and medication do not relieve pain and improve joint function, the doctor may suggest a less complex corrective surgery before proceeding to knee replacement. One common alternative to knee replacement is an osteotomy. This procedure involves cutting and realigning bone, to shift the weight from a damaged and painful bone surface to a healthier one.Recovery from an osteotomy takes several months. Afterward, the function of the knee joint may continue to worsen and additional treatment may be needed. The length of time before another surgery is needed varies greatly and depends on the condition of the joint before the procedure
We expect most knees to last more than 10–15 years. However, there is no guarantee, and 5–10 percent may not last that long. A second replacement may be necessary.
Most surgeries go well without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are 1 percent or less.
Yes. You should discuss preoperative physical therapy. Exercises should begin as soon as possible.
You may need blood after the surgery. You may donate your own blood, if able, or use the community-blood-bank supply.
Once DR Ramesh Sen has ordered a knee replacement surgery, the patient will need to schedule an appointment with general physician to get medical clearance if require. The patient will need to meet with the anesthesiologist to review their medical history, receive a physical exam and have their blood taken. Patient would be taught pre op exercises by your physiotherapist. Once the anesthesia clearance is done patient would be given date for surgery.
Patient would be admitted a day prior to surgery.
Most knee-replacement patients are hospitalized for five days after surgery. If you need more time for rehabilitation, other options might be available to you. Make arrangements before your surgery to have someone stay with you after you are discharged.
You may have a general anesthetic, which most people call “being put to sleep,” or a spinal anesthetic. The choice is between you and the anesthesiologist.
Yes, but we will keep you comfortable with appropriate medication. Generally most patients are able to stop very strong medication within two days. The day of surgery, most patients control their own medicine with a special pump that delivers the drug directly into their epidural. Our anesthetist will discuss with you what pain control option is best for you.
Yes. Until your muscle strength returns after surgery, you will need a walker, a cane or crutches. Your equipment needs will be determined by the physical therapist.
After hip-replacement surgery, you will need a high toilet seat for about three months. If needed, you will also be taught by the physical therapist to use adaptive equipment to help you with lower body dressing and bathing. You might also benefit from a bath seat or grab bars in the bathroom.
Many patients go directly home when discharged. You can even go to Fortis INN if required.
Yes. In the first several days or weeks after surgery, depending on your progress, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends must be available to help. Preparing ahead of time, before your surgery, can minimize the amount of help required.
Many patients go directly home when discharged. You can even go to Fortis INN if required.
Yes. In the first several days or weeks after surgery, depending on your progress, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends must be available to help. Preparing ahead of time, before your surgery, can minimize the amount of help required.
Yes. Physical therapy will continue after you go home with a therapist in your home or at an outpatient physical-therapy facility. The length of time required for this type of therapy varies with each patient. We will help you with these arrangements before you go home.
We recommend that most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer absence from work.
Ten days after discharge for suture removal. The frequency of follow-up visits will depend on your progress.
High-impact activities such as contact sports, running, singles tennis and basketball are not recommended. Injury-prone sports are dangerous for your new joint. You will be restricted from crossing your legs. Your surgeon and therapist will discuss further limitations with you following surgery. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, and gardening.
Get your specialist advice on how to beat Knee pain.
These knee exercises are a great starting point if you have difficulty squatting, climbing stairs, or balancing on 1 foot. Practice this routine 1-2 times per day help rebuild the basic strength in your knee. (Please check with your health care provider before beginning any exercise program).
‘Various literature confirms that muscle strengthening & aerobic exercises reduces pain and improves physical functions of Osteoarthritis patients^’2
Place a pillow lengthwise under your knee. Pull your toes back & push your leg down to squash the pillow. Hold for 10 seconds & repeat up to 20 times. You should feel your thigh & gluteus muscles during this exercise. Begin with moderate effort & then increase your effort gradually. This exercise can be done lying flat as shown, sitting in a recliner, or learning against a wall.
Lie on your back with knees bent and toes up. Dig your heels into the ground and pull back without sliding your heels. Hold for 10 seconds and repeat up to 20 times. You should feel the back of your thigh, the hamstrings, during this exercise. As with quad sets, start with a moderate effort and increase your effort and increase your effort gradually.
Tighten your thigh & pull your toes back just as you do for the quad set, then maintain the muscle tightness as you slowly raise your leg 18 inches. Lower slowly, relax your muscles briefly, then tighten your thigh, pull your toes back and repeat 20 times. Note: These first 3 knee exercises are the least stressful on the knee joint as they require little to no movement of the knee itself.
Knees bent & feet flat on the floor with your heels spaced comfortably from your bottom. Fold a bed pillow in half, & place it between your knees. Squeeze the pillow & hold on to it tightly. Raise your bottom upward slowly lifting one vertebra at a time from your exercise mat. Continue lifting your bottom upward until there is a straight line from your shoulders to your knees. Hold this position 5-10 seconds. Repeat 6-8 times. Think of reaching your knees forward over your ankles. Note: if this exercise is uncomfortable, just squeeze the pillow and hold it 10 seconds. This is called an adductor set, as it works the inner thigh muscles. Once you can do this ( and knee exercises #1 and 2) 20 times with a strong effort, try bridging again.
Sit upright in a chair, straighten your leg, tighten your thigh and pull your toes back. Hold for 10 seconds and repeat up to 20 times. The more you tighten your muscles, the better results you’ll get from this exercise. You may feel a stretch behind your knee during the exercise. For a greater challenge, straighten both legs at the same times, or do this exercise with an adjustable ankle weight up to 5 pounds.
If you feel a strong stretch behind your knee during the exercise, pump your ankle (point your toes and flex you foot back) several times instead of just holding your toes back- -this will help improve your flexibility.
DO’s
Cardio exercises strengthen the muscles that support your knee and increase flexibility. Weight training and stretching do, too. For cardio, some good choices include walking, swimming and water aerobics, stationary cycling and elliptical machines.
est, Ice, Compression, and Elevation (RICE) is a good for knee pain caused by a mirror injury or an arthritis flaire. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep you’re your knee elevated.
It can be painful to sit at your desk with your knees folding. Simply rolling back your chair and straightening out your legs can relive leg pain.
For the first 48-72 hours after a knee injury, use a cold pack to ease swelling and numb the pain. A plastic bag of ice or frozen peas works well. Use it for 15 – 20 minutes, three or four times a day. Wrap your ice pack in a towel to be kind to your skin. After that, you can heat things up with a warm bath, or warm towel for 15-20 minutes, three or four times a day.
DONT’s
A Painful or unstable knee can make a fall more likely, which can cause further knee damage. Curb your risk of falling by making sure your home is well lit, using handrails on staircases, and using a sturdy leader or foot stool if you need to reach something from a high shelf.
If you’re overweight, losing weight reduces the stress on your knee. You don’t even need to get to your “ideal” weight. Smaller changes still make a difference.
A crutch or cane can take the stress off your knee. Knee splints and braces can help you stay stable.
Cushioned insoles can reduce stress on your knees. For osteoarthritis, doctors often recommended special insoles that you put in your shoe. To find the appropriate insole, speak with your doctor or a physical therapist.
High-impact exercises can further injure painful knees. Avoid jarring exercises such as running, jumping, and kickboxing. Also avoid doing exercises such as lunges and deep squats that put a lot of stress on your knees. These can worsen pain and, if not done correctly, cause injury.
Too much rest can weaken your muscles, which can worsen joint pain. Find an exercise program that is safe of your knees and stick with it. If you’re not sure which motions are safe or how much you can do, talk with your doctor or a physical therapist.
Sitting on the floor will create unnecessary stress on your knees while getting up. Avoid sitting on the floor while eating your food or doing any kind of home activity.
If your knees pain is new, get a doctor to check it out. It’s best to know what you’re dealing with as soon as possible, so you can prevent any further damage
Max Hospital
Phase 6 Mohali - 160 055
Tel : +91 172 665 2000
Emergency : 091 172 665 2000
Max Hospital
Phase 6 Mohali - 160 055
Timings : MON to THU 10AM to 5PM
Call : +91 172 665 2000
