Myths and truths of total knee replacement
M: Total knee replacement is a complicated surgery.
T: Total knee replacement is a major surgery
Surgery qualifies as a major procedure as it involves cutting of bones and placing implants in the joint. Healthy patients recover normally without complications. Recovery is delayed only if the patient has multiple other health problems.
M: total knee replacement requires prolonged bed rest.
T: total knee replacement needs no rest; but only rehabilitation.
Surgery is a invasive procedure; it changes the natural architecture of the joint in 2 hours; which is a stress to the body. The knee joint and the surrounding muscles need to adjust to the new knee joint. Physiotherapy is the only way to get out of this sudden change in the joint. So, TKR patients require rehabilitation physiotherapy for quite some time but they don’t require bed rest at all.
M: TKR is an extremely painful surgery
T: TKR is a nearly painless surgery now-a-days.
Advanced surgical techniques- minimally invasive approach, less cauterization and proper pre-operative planning with patient controlled analgesia during the post-operative period help make the surgical pain a passing cloud in the total recovery period.
M: TKR patients walk with weakness as muscles and tendons are cut.
T: minimally invasive techniques don’t cut any tissues except the damaged bone.
Traditional technique was to cut the tissues infront of knee to open the joint to perform the surgery. Patients had to undergo weakness for some time as the tissues take some time to heal. Minimally invasive technique is a novel technique to open the joint without cutting the tissues; by sliding the tissues to a side to open the joint. This procedure allows faster recovery without weakness in the legs.
M: Implants are metal; so they cause allergic reactions in the body.
T: No allergies have been noted in TKR patients in the last 30 years.
implants in TKR are made up of multiple metal mixture( alloys) to match the tissue structure of the body and thus have least chance of causing allergic reaction in the body.
M: choosing costly implants gives a good result in TKR
T: Properly performed surgery gives best result in TKR.
Implant manufacture, coating with new metal alloys and design giving good flexion ; vitamin –e plastic are all additional benefits of a properly performed surgery. Costly implants have an advantage of wear resistance and proper matching to the bones of the patient. Properly performed surgery gives the best result with better implants giving an added advantage.
M: TKR is a risky procedure.
T: TKR is a safe surgery.
With extensive research over the past 30 years, development of new techniques and advanced implants make TKR a safe, effective procedure to lead a normal life without arthritic pain. It carries the normal risks associated with any other major surgery(1% only)
Dr. Muralidhar Sagi
Consultant - Orthopaedics , Arthroscopy & Joint Replacement
Gleneagles Global Hospitals, Hyderabad