Normal Knee Joint and Arthritis
The Knee joint has a smooth, slippery, fibrous connective tissue called articular cartilage which acts as a protective cushion between bones inside the joint.
Arthritis develops as the cartilage begins to deteriorate or is lost because of wear and tear as part of aging or because of disease like Rheumatoid arthritis. As the articular cartilage is lost, joint space between the bones become narrow. This is an early sign of osteoarthritis and is easily seen on X-Rays. The synovium (a membrane that produces a thick fluid to nourish cartilage and keep it slippery) becomes inflamed and thickened. It may produce extra fluid that causes additional swelling. Slowly over time bone ends rub against each other and wear away. This results in the deformity of the joint. The normal activity becomes painful and difficult. Pain can even interfere with simple daily activities.
Common osteoarthritis symptoms include pain, stiffness, some loss of joint motion, swelling, cracking sounds and changes in the shape of affected joints
Common Causes of Arthritis
- Primary osteoarthritis typically affects patients over 50 years of age, but is common in India
- It is more common in persons who are overweight, or suffering from Rheumatoid arthritis. In some patients arthritis tends to run in families.
- Other factors that can contribute to developing knee arthritis include injury to the knee joint.
Treatment Options of Knee arthritis
- Conservative treatments include Anti-inflammatory medications, physical therapy, Weight Control.
- If all these fail to produce satisfactory response, one should consider knee replacement for better quality of life.
What is Knee Replacement Surgery?
An arthritic or damaged cartilage is replaced with a new, artificial joint called a prosthesis. The soft tissues around the knee are carefully balanced to correct the alignment of the joint and optimize the function of the knee.
Benefits of Total Knee Replacement
After the completion of healing, the patient will have improved quality of life due to the ability to return to normal activities.
The benefits of TKR are:
- Reduced joint pain
- Increased movement mobility and stability
- Correction of deformity
Post operative recovery and precautions
Patients are encouraged to start in-bed exercises within 24 hours of the operation. After 24-48 hours, drain from the knee joint is removed and the dressing is reduced in size. Patients are made to sit on bedside with legs supported.
- 2-3 days after the operation, patients are encouraged to stand and walk using a walker and a day or two later, they are able to visit the toilet, with assistance, using a high seat.
- Stitches are removed 2 weeks after the operation.
- 3 weeks after the operation, patients are encouraged to walk with a walking stick.
- 4-6 weeks after the surgery, patients are trained to start climbing stairs.
- The patients are discharged from the hospital 5 days after the surgery with instructions regarding medicines and physiotherapy.
- 12 weeks post operative, one can usually begin driving vehicles, with due precautions.
- One is advised not to squat or sit cross-legged after the operation, particularly on the floor.
- The post operation schedule gets slightly extended in case of surgery being performed on both the knees.