The Knee Replacement Unit at Nanavati Super Speciality Hospital offers most comprehensive care to a full spectrum of musculoskeletal conditions related to knee. Our team of well-trained knee replacement surgeons provides comprehensive care to address the most common to the rarest complications while evaluating all types of knee conditions and treating chronic knee pain.
We follow a patient-centric multidisciplinary approach to treat a wide range of knee conditions using the latest technology and state-of-the-art procedures like minimally invasive surgery or computer-assisted navigation for orthopaedic surgery. Thereby, providing better outcomes and, in some cases, faster recovery time for our patients. Our team of extremely experienced surgeons focuses on providing every patient with high-quality care and advanced treatment modalities, which are at par with industrial excellence.
What is a Knee Joint?
A knee in a human body is a complicated joint that connects the thigh bone (femur) to the leg bone (tibia) and the kneecap (patella) is articulated with the femur. Normally, joint surfaces of bones are lined with a layer of cushion called articular cartilage, which ensures movement with minimum friction. Other specialised structures inside a knee like meniscus help in the motion of a knee and act as shock absorber.
What causes Knee Pain?
During the incidences when knee cartilage gets worn out, it results in painful movements and makes the surface of the joints rough. However, as a person ages, joint cartilage usually wears leading to os-teoarthritis and some other types of arthritis, such as rheumatoid arthritis, post-injury arthritis, etc
When the cartilage covering bone articulation is lost it is called Arthritis. Most common types of arthritis are;
The early-stage treatment of knee arthritis involves management of pain with mild medication, weight reduction, and physiotherapy.
However, for end-stage or chronic arthritis which involves a severe decrease in joint space and a consequently significant amount of pain, a surgeon replaces the worn articular cartilage with artificial long-lasting bearing surfaces called modern knee replacement.
Knee replacement or knee resurfacing is a procedure that involves the replacement of worn-out carti-lage (along with a bit of bone) with an implant made up of metallic on one side and special plastic on the other end. A surgeon uses special tools (jigs), to create a shape for properly fixing the implants using special bone types of cement.
These implants offer immediate bone fixation and permit a patient to perform daily activities like walk-ing, load-bearing, etc. with ease and offer very low friction to the joint.
Knee replacement surgery is a very common surgery in India and is considered the most effective and successful treatment in dealing with osteoarthritis. Modern knee implants can withstand wear and last for up to 25 years.
Joint pain and weakening of joints can hit anyone at any age and is not merely associated with the process of ageing. Many young people suffer from arthritis at a young age. The major types of arthritis which people might experience include:
Osteoarthritis: It is one of the most common forms of chronic arthritis that generally affects people of old age. The major reason behind its cause is breakage of the cartilage (a protective tissue that covers the two bones in the knee, making it a joint) in the knee that leads to stiffness while moving and pain in the joints. Thereby, adding discomfort for a person suffering from osteoarthritis and abstainment from physical activities.
Osteoarthritis is a progressive disease, once the cartilage is lost the underlying bone starts wearing out resulting in bow knee deformity. Usually, it affects bilaterally, and at times a patient can experience severe pain on one side of the knee. A doctor may advise knee replacement surgery only in the following conditions:
Considered as one the most advanced form of surgery, knee replacement surgery offers the best treatment solution for people suffering from osteoarthritis. However, a patient must strictly follow the before and after surgery precautions which include:
Before the surgery
During the surgery
After the surgery
Short- Term Precautions
Long Term Precautions
Surgical procedures of any kind carry some of the other risk factors, particularly if a patient is suffering from other medical problems such as obesity, hypertension, etc. Our team has been trained to make sure such risks are minimised and the treatment is carried out safely. However, some immediate com-plications that a patient might experience include:
Infection: Sometimes despite strict precautions, infection can occur. Superficial infection may occur at the wound site. If a deep infection develops most of the times THR implants need to be removed with subsequent revision surgery after healing of infection.
At Nanavati Super Speciality Hospital we have
Deep Vein Thrombosis (DVT): Despite taking precautions to prevent blood clot (thrombosis) formation in the veins of the leg post-surgery remains a common risk after knee replacement surgery. Rarely, these clots can dislodge and travel through the heart to the lungs. This is known as pulmonary embolism which can cause serious complications in rare cases.
At Nanavati Super Speciality Hospital we take special steps to avoid DVT
Aseptic Loosening of the Prosthesis (without infection): It is caused by the weakening of the bond between the new joint and the bone. Although it is expected that the new knee will last for many years, it can become loose earlier than anticipated, particularly if the patient is grossly overweight, if he/she returns to a hectic work schedule early or patient’s joint damage by accidental falling.Loosening of the
Prosthesis: It is a treatable risk factor which involves replacement of loosened prosthesis with new implants. It is common to see knee replacements lasting more than 30 years. At Nanavati Super Speciality Hospital we follow most modern technologies for joint replacement surgery protocol with post-surgery management to improve bone quality.
Persistent Pain: The operation may not relieve a patient of all the pain, and he or she may continue to experience some mild discomfort. The most common of all is complex regional pain syndrome, swelling, stiffness and skin changes. Other recognised risks of knee surgery include bone fractures, bruising, and urinary retention.
Q. Do I need a knee replacement?
A. It depends on the extent of pain and difficulty in walking. Advice is given after analysing X-ray find-ings. It is you who are suffering from pain and you are as much a part of the decision making as your doctor.
Q. Do I need computer-assisted or navigation / MIS for my knee replacement?
A. For routine knee replacement, available jigs are extremely good and accurate. Only in cases of com-plex deformities of thigh and leg bone that computer-aided assistance may be required. Computer navigation is an evolving technology and needs time to achieve perfection in all cases. While long incisions were made earlier, nowadays we utilize smaller incisions with the help of MIS jigs.
Q. Can I get both knees operated at the same time?
A. It depends on how badly both knees are affected and how sound is your medical status. Knee re-placement for both knees can be performed in one sitting if fitness is good
Q. Is knee replacement painful?
A. There are modern methods available for pain relief, such as continuous epidural anaesthesia, patient-controlled anaesthesia (PCA) and a mix of certain drugs that can control pain very effectively. Applying cold compresses around the knee also helps in reducing swelling and pain.
Q. Can I get full bending (flexion) of the knee after surgery?
A. There are reports in the media that some knee implants are capable of giving high flexion or full bending of the knee. The degree of movement achieved depends on your mobility status before surgery, your weight, and good technique of surgery. Surgery is likely to increase your knee movements partially. Implants can only absorb high stress associated with full movement.
Q. Can I sit cross-legged on the floor?
A. Knee replacement implants are bonded to the bone with bone cement. Even though most patients can sit cross-legged, it is not recommended. Preventing excessive stress on the bond increases the life of implant significantly.
Q. Do I need physiotherapy?
A. Physiotherapy is important in achieving early mobility and good knee movement. Physiotherapy starts immediately after surgery. You may need physiotherapy for 4 weeks. This can be organized at your home or a nearby clinic.
Q. How frequently do I need to visit the hospital?
A. You are required to visit the hospital 15 days after surgery for stitch removal. After that, you may be asked to return in 10 days to track your progress. Subsequent visits are required only after 3 months, 6 months and 1 year of surgery - unless medical condition dictates otherwise.
Q. Is knee replacement detected by a metal detector?
A. Yes. You should collect a credit card shaped certificate from the orthopaedic office certifying that you’ve had a knee replacement. This can be shown to the security staff.
If you think you are facing similar conditions, or have suffered from them in the past, please contact the Nanavati team to schedule an appointment at : +91 22 2626 7500
Prof.(Dr.) Pradeep B. Bhosale
Director - Arthritis & Joint Replacement Surgery
Dr. Suresh Shetty
Senior Consultant
Dr. Amandeep Gujral
Consultant - Nanavati Institute of Spine Surgery
Dr. Nikhil Arbatti
Senior Consultant - Minimally Invasive & Endoscopic Spine Surgery
Dr. Ashok Singhvi
Senior Consultant Orthopaedic, Trauma & Joint Replacement Surgeon