Knee Arthroplasty Surgery

When Is the total knee replacement surgery recommended?

Total Knee replacement surgery abroad is usually recommended only if other treatments, such as physiotherapy, exercising, medications or using physical aids like a walking stick are no longer able to help mobility or reduce pain. Some medical treatments for osteoarthritis that may be used prior to arthroplasty include:

• Anti-inflammatory medications
• Pain medications
• Limiting painful activities
• Assistive devices for walking (such as a cane)
• Physical therapy
• Cortisone injections into a knee joint
• Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
• Weight loss (for obese people)
• Glucosamine and chondroitin sulphate
• Exercise and conditioning

People who have arthroplasty generally have substantial improvement in their joint pain, ability to perform activities, and quality of life, so these are important reasons for the procedure as well.

What are the risks of arthroplasty?

As with any surgical procedure, complications can occur. Some possible complications may include:

• Bleeding
• Infection
• Blood clots in the legs or lungs
• Loosening of prosthetic parts
• Nerves or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The joint pain may not be relieved by the surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your health care provider prior to the procedure.

How do I prepare for arthroplasty?

• Your health care provider will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
• You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
• In addition to a complete medical history, your health care provider may perform a complete physical exam to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
• Tell your health care provider if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
• Tell your health care provider of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
• Tell your health care provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
• If you are pregnant or suspect that you are pregnant, you should notify your health care provider.
• You will be asked to fast for 8 hours before the procedure, generally after midnight.
• You may receive a sedative prior to the procedure to help you relax.
• You may meet with a physical therapist prior to your surgery to discuss rehabilitation.
• Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
• Based on your medical condition, your health care provider may request other specific preparation.

What happens during arthroplasty?

Arthroplasty requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices. Arthroplasty may be done while you are asleep under general anaesthesia, or while you are awake under localised anaesthesia. Your anesthesiologist will discuss this with you in advance. Generally, arthroplasty follows this process:

• You will be asked to remove clothing and will be given a gown to wear.
• An intravenous (IV) line may be started in your arm or hand.
• You will be positioned on the operating table in a manner that provides the best access to the joint being operated on.
• A urinary catheter may be inserted.
• If there is excessive hair at the surgical site, it may be shaved off.
• The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
• The skin over the surgical site will be cleansed with an antiseptic solution.
• The doctor will make an incision in the area of the joint.
• The doctor will repair or remove the damaged parts of the joint.
• The incision will be closed with stitches or surgical staples.
• A sterile bandage or dressing will be applied.

How long will I be away for total knee replacement surgery?

You will need 10–15 days holidays which includes your initial assessment, surgery, and post-surgical recovery.