Chronic diseases of the joints are grouped under arthritis. Essentially there is inflammation and destruction of the joint surfaces leading to pain, deformity, limp etc.
There are mainly two types of arthritis. Osteoarthrosis means wear and tear due to aging and joint abuse. The other common type of arthritis is called Rheumatoid arthritis, which has greater degree of inflammation, destruction and disability.
Surgery is not the only method of treatment for arthritis. Conservative methods like anti-inflammatory drugs, anti rheumatoid drugs; weight reduction and muscle developing exercises can give relief in arthritis.
In early stages, arthroscopic surgery on the knee joint can give relief. Synovectomy and joint clearance done arthroscopically can provide relief, when joint cartilage is not badly damaged. High tibial osteotomy can be useful in knee arthritis, where only one compartment of the knee is affected. Knee replacement is undertaken in end stage knee disease.
End stage knee disease is where there is gross destruction of a joint, either due to osteoarthritis, rheumatoid arthritis,after injury, infections in the past, metabolic disorders etc. There is severe pain, deformity and instability. Essentially this is a stage where other forms of salvage surgery are not possible.
Joint replacement is where the old worn out surface of the joint is sawed off and a new synthetic surface put in its place. No, the whole joint is not replaced, but just the surface is changed. The surface, which had lot of friction, is replaced by components, with low friction. Some surgeons call joint replacement as low friction arthroplasty.
Commonly used materials for joint replacements are Stainless, called Cobalt Chrome Alloy and Plastic, called Ultra - high Molecular Weight High Density Polyethylene.
The hospital stay is for seven days after joint replacement.
Exercises on CPM start within a day, after joint replacement, while walking is started 2 - 3 days, after joint replacement.
Even a person with diabetes, high blood pressure, heart trouble can safely undergo joint replacement surgery under medical supervision.
It is advisable to use commode, avoid sitting on floor, jogging, running and fast sports, after joint replacement surgery. Moderate speed walking, climbing stairs and swimming are permitted.
Usually one joint is resurfaced at a time, but if the patient is fit, both knees may be resurfaced in one sitting.
The complications after joint replacement are deep vein thrombosis and infection.
To prevent deep vein thrombosis, early exercises are started and in some patients, specialized medication is administered. To prevent infection, surgery is carried out in specialized operation theatre and antibiotics are given pre-operatively.
This is a specialized surgery, which requires special set up including proper operation theatre, pre-operative intensive care unit, trained nurses and technicians and expert physiotherapist to achieve desired results. Replacement surgery is best performed at a major institution with facilities like total sterility, laminar airflow and the trained Personnel.
The cost depends on the type of implant. The high quality imported implants cost around Rs. 65,000/-. The economy variety of Indian implants could cost less.