Knee Arthritis & Joint Replacement

June 6, 2011 - PRLog -- Osteoarthritis is the wearing out of the cartilage (cushion) which is usually the result of natural degeneration. It may also be a sequel to past infection, injury, or a consequence of a metabolic disease process. Arthritis can affect any joint. In Indians, arthritis most commonly affects the knees and women are more predisposed than men. Arthritis due to natural degeneration and metabolic disease process usually affects joints bilaterally where as a past infection or injury would affect only one joint.

Knee joint involves three bones; the lower end of femur, upper end of tibia and patella (knee cap) held together by capsule, muscles, tendons and ligaments and are lined by cartilage which makes the knee move painlessly in all directions. When this cartilage starts wearing out, it causes pain. The pain is the most severe, when the cartilage is totally worn out and consequently when bone rubs against the bone. The severity may range from arthritis affecting only the femur and the tibia, or femur and the patella or all the three joint surfaces being affected together.

In the initial stages conservative treatment with medication, dietary supplements, lifestyle modification, injections and physiotherapy may help. Arthroscopy & Osteotomies may be of benefit in the beginning. But once the disease process is advanced, the above management fails. In such situation a joint replacement surgery remains the only successful option.

Joint replacement surgery is of many types. It may be limited to replacement of only one compartment of the knee (the compartment which is symptomatic) termed Unicompartmental Knee Replacement, or it may involve replacement of the knee cap region (Patellofemoral Joint Replacement) or a total joint replacement where the whole joint is replaced.
Majority of the patients of knee arthritis have involvement of two or more areas making them candidates for a total joint replacement. The choice of the surgical procedure depends on the symptoms, X-ray appearance and the careful assessment done by the surgeon.

In most cases the disease process is bilateral. It is absolutely safe to undergo bilateral knee replacement at one sitting. The indication of doing a bilateral surgery is stronger if the deformity is severe in both the knees and cost is a constraint, as doing two knees at the same sitting works out to be cheaper for the patient. With advancements in technology, increasing success of joint replacements, this surgery is being increasingly accepted by more and more young symptomatic patients.

Knee replacement surgery is as safe as a flight with the complication rate close to or less than 1%. The average duration of hospitalization is approximately one week. The patient gets admitted a day before surgery and stays for five days post surgery. During these five days, the physiotherapist makes the patient walk and exercise. Removal of stitches is around the 14th day. Recently PSI (Patient Specific Implants) technology has been introduced which provide customized implant to every patient. This surgery involves lesser blood loss with more accurate placement of components.