DOCYARD: ORTHOPAEDIC PROBLEMS : TOTAL KNEE REPLACEMENT / TOTAL HIP REPLACEMENT : MYTHS & FACTS
Sunday, 03 June 2018| By Dr. Gaurav Gupta, Sr. Consultant, Department of Orthopaedics | Max Super Speciality Hospital | Dehradun–
Till date the team of specialists at Max Hospital, Dehradun have performed more than 500 cases of TKR. TKR is a surgical procedure whereby the diseased knee joint is replaced with artificial material referred to as prosthesis. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. During the TKR procedure, the end of the thigh bone (femur) and the lower leg bone (tibia) are removed and replaced with a prosthesis which provides mobility to the joint.
Knee replacement not only relieves the patient of chronic pain that he/she has been suffering from a long time it also gives them an improved quality of life. According to the American Academy of Orthopaedic Surgeons, 90 percent of patients undergoing knee replacement experience a dramatic reduction in pain, and a significant improvement in the ability to perform daily activities. Most of these individuals are able to perform daily activities and stay active. In many cases, they’re able to resume activities, such as jogging or playing a sport that they gave up years ago due to the arthritic pain.
Earlier it was common for patients to be in hospital for fifteen to twenty days as the post operative period was painful, the surgical wound was very large and rehabilitation was extremely slow. However with advancement in technology, joint reconstructions have improved in India not just with respect to better surgical techniques, but also higher quality implants with superior surfaces and materials. The current materials have prolonged the life of implants significantly. Max Hospital, Dehradun is equipped with the latest technologies and implants of knee replacement. Even high risk cases requiring complex procedures have been successfully performed at Max Hospital. Being a tertiary care hospital, we provide end to end solutions for the knee replacement needs of the patients- right from appropriate consultation about the kind of implant to post surgery rehabilitation through physiotherapy.
The department of Orthopaedics at Max Super Speciality Hospital Dehradun shares the Myths and facts pertaining to joint replacements:
Myth 1: I am too young for a joint replacement!
Fact: Candidacy of a joint replacement is not based on age , but on the person’s level of pain and immobilization. In fact, as per literature (national center for health states) 38 % of all patients undergoing a knee replacement today are younger than 64 yrs old.
Myth 2: Hip & joint implants are only good for about 10 years
Fact: Used to be true but not today. Advances in new types of knee & hip implants have revolutionized the longevity of their effectiveness. Today, one can expect a new hip or knee replacement to last more than 20 years.
Myth 3: Myth Knee /Hip Replacement should be the last resort to eliminate chronic pain
Fact: Living with chronic pain is not healthy. Gruber and Hunter (Clin Geriatr Med., August, 2010) provide a model for a continuum of de-escalating health in osteoarthritis, postulating that OA leads to limited movement, which begets weight gain, diabetes and other co-morbid conditions, and increased probability of poor clinical outcomes from eventual joint replacement surgery.
Studies have strongly suggested that total joint replacement patients are likely to enjoy improved general health. If pain is affecting life and limiting your mobility –good idea to talk to your doctor for surgical options.
Myth 4: Joint reconstruction is costly
Fact : As per studies joint reconstruction most cost effective in terms of cumulative costs of other treatments .
Myth 5: Replacement takes long time to recover
Fact : It is not true . Patient spends a week in the hospital after Hip and Knee surgery. After that patient takes on an average 4-6 weeks to do most of daily activities.
Myth 6: Can’t really exercise or participate in sports activity after joint replacement surgery
Fact: Not true, being active- what we want after joint replacement surgery. Patient can indulge in low –impact activities such as walking, swimming, and cycling. High impact activities like racket sports, ground sports, jumping etc are not allowed. Some indulge in climbing mountains but these are not the usual norm. Patient must talk to respective doctor about the activities one can do following joint reconstruction.
Myth 7: Technology advances such as robots are making joint replacement surgery better
Fact: Newer modalities to put implants in desired or ideal alignment are available but their actual benefit is not proven as compared to conventional technique. Computer navigation or Patient specific instrumentation can be used in some difficult situations. Robots have been cleared for joint replacement (MAKO, Stryker) especially partial replacement of knees. All these new concepts come with added cost to the patient.
Myth 8 : I should wait as long as possible to undergo replacement surgery
- Many patients who could benefit in realty from a replacement wait too long by delaying Surgery
- According to a study in arthritis and rheumatism waiting too long can result in damage to the back and other Joints as well.
Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult, get it right when one think that disease is affecting life and recreation.
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