Knee Replacement - Is Second Surgery Actually Required?

Of all the joints in the body, the knees probably see the maximum wear and tear. In cases of severe osteoarthritis, or injuries which destroy the knee joint, a total knee replacement surgery may be advised. This procedure involves the replacement of diseased cartilage and bone in the knees with artificial materials.

In cases of osteoarthritis and other such degenerative conditions, this procedure is performed only when the adjacent joints such as the hips are strong and healthy. Before the procedure, you may be advised to discontinue any blood thinning and anti-inflammatory medication. Your doctor will also conduct blood and urine tests to check for signs of anaemia, abnormal metabolism and infections. You may also be asked to lose weight if you are on the heavier side to reduce the pressure on your knees.

A total knee replacement surgery is usually performed under general anaesthesia. The lower end of the femur bone or thigh bone and the upper end of the tibia or calf bone are removed and replaced with a metal shell and plastic piece respectively. In some cases, a plastic ‘button’ may also be placed on the surface of the knee cap. If the posterior cruciate ligament is intact it is left as is or it is replaced by a polyethylene post to stabilize the joint and prevent the calf from slipping backward.

In most cases, a patient is discharged after 3-5 days of hospitalization following the surgery. Post-surgery, it takes about a month for the patient to experience notable improvements. For optimal results, total knee surgery must be followed by physiotherapy and regular exercise. This helps prevent scarring and keeps the muscles strong enough to maintain joint stability. Exercising can also reduce recovery time. However, not all exercises are advisable. Avoid running, jumping, climbing stairs and contact sports which have a high risk of a knee injury. Swimming is highly encouraged as it boosts endurance and muscle strength without putting any pressure on the joint.

In some cases, a second surgery may be required in cases of total knee replacement to fix fractures, loosening or complications of the artificial joint. As with any other surgical procedure, total knee replacement surgery also has risks. Some of these are:

1. Formation of blood clots that can cause shortness of breath, chest pain and shock
2. Urinary tract infection
3. Nausea and vomiting
4. Knee pain and stiffness
5. Nerve damage
6. Internal bleeding in the knee
7. Increased risk of infections

In case you have a concern or query, you can always consult Orthopedic Doctor in Chandigarh & get answers to your questions!