Category Archives: Knee

Revision surgery is different in that the original components are removed and new components are implanted. The technical aspects of the surgery are more complex than the original total knee replacement. However, the preparation for surgery and hospital experience tend to be very similar to the primary knee replacement.

The decision to perform a revision surgery is based on several factors. After partial knee replacement osteoarthritis may have advanced to other compartments of the knee. After total knee replacement the implant may have become loose, worn or infected. As the implant fails the patient may experience a limp, stiffness, or instability. X-rays or computer imaging may show a change in the position or condition of the implant components. Assessment of these indicators will help determine when knee revision surgery is needed. It’s estimated that over 50% of knee revision procedures will be performed within two years of the initial knee replacement.

• Loosening: Cemented implants can become loose because the cement-bone interface has failed. This is usually due to bone die back, meaning the tiny projections of bone that the cement initially attaches to having either broken off in weight bearing or simply deteriorated due to infection or weak bone (osteoporosis). Non-cemented implants can loosen for much the same reason except it is the implant-bone interface that fails. However, current state-of-the-art materials and techniques have improved the quality of implant fixation to the bone which had historically been a weak link that created a potential site of failure.
• Wear: The plastic parts of knee replacements are softer than the metal and are more prone towards wear during use. Usually this happens after a long period of time as modern plastics (ultra high molecular weight polyethylene or UHMWPE) are very durable and can withstand a considerable amount of wear and impact. Generally speaking, plastic parts are more likely to wear because the accompanying metal parts are not properly aligned, the plastic itself is misaligned, there is a presence of infection, or because they are very old. It is known that wear actually begins from day one after surgery, but the implants can cope with the early stages of wear very well. Implant manufacturers have significantly decreased the amount of wear particles that are created by friction on joint surfaces. However, after several years there may be a build-up of worn off particles which can cause problems in nearby tissues as microscopic fragments get absorbed into the cells and create inflammatory conditions causing pain.
• Infection: With modern surgical techniques the risk of infection from total knee replacement is very low at about 0.5%. If infection does occur, it usually arises due to a substance on the devices called bio-film. This organic material is a microscopic layer of fungal material containing microbes living in a state of hibernation. All implanted devices have this phenomena including items such as stents and pacemakers. Infection arises when the microbes become active and multiply. It is not yet known what provokes this sudden change, but it is known that a series of changes occurs, allowing the microbes reach a state of maturity and become more susceptible to eradication with antibiotic treatment.
• Fractures: Although rare, trauma to the knee may result in a fracture that disrupts the stability of the implant and fixation to the bone which may require surgery to repair.
• Patient-related factors: Rarely do age, activity level, health or being overweight contributes to implant failure. Most knee replacement patients are over 50 years of age and older individuals tend to put lower demands on their implants.

A revision procedure is typically more complex than the initial knee replacement surgery because your surgeon must remove the original implant. The surgery also takes longer to perform than an initial knee replacement. Revision knee replacement usually does not provide the same expected lifespan as an initial replacement. Surgical trauma, scar tissue, and mechanical weakening of components tend to reduce performance of a revised implant.

Care after knee revision surgery is similar to the care you’d receive after total knee replacement. This includes a combination of light physical therapy and pain medications as needed. Blood thinning medication will also be given to prevent blood clots. A walker or crutches will be used early in the recovery period, and you will progress to a cane or walking without any assistance as your condition improves. Although pain relief and increased stability are expected outcomes, complete pain relief and restoration of function is not always possible. Up to 20% of patients may still experience some pain following knee revision surgery. This may persist for several years after the procedure. More than 90% of patients who undergo revision procedures can expect to have good to excellent results.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

You can most definitely choose hotels as per your convenience to you and your budget.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

The pre-operative nurse will call you from the hospital 1 to 3 days before your surgery to discuss several details; including the exact time of surgery, when to last eat and drink prior to surgery, and when to last take certain medications. These are very important questions to have answered prior to your surgery. Therefore, we ask that you be certain that the hospital has your updated phone number.

While this can vary, typically you are in the operating room for 15 to 45 minutes. Then you are taken to the recovery area for 1 to 2 hours before being discharged home. You will be given specific post-operative instructions at that time.

Your surgeon will speak with your loved ones immediately following your surgery. It is very important that your loved ones are with you at the hospital and stay in the waiting room during your surgery. If someone is not in the waiting room at the end of surgery, your surgeon will not be able to meet with them that day. We will be able to discuss your surgery at our office during your first post-operative appointment (typically 6 to 8 days later).

You will likely be given narcotic pain medications for pain control. Patients generally only find these necessary for the first few days after surgery.

This varies based on the procedure you are having. If you are having meniscectomy (removal of torn cartilage), you may begin putting weight on your leg when you get home the day of surgery. Crutches are generally used for 1 to 3 days (based on comfort). If you are having an ACL reconstruction or knee cap realignment, you will be required to use crutches at least 1 week and wear a special knee brace for 5 to 6 weeks.

Your first post-operative appointment at our office is scheduled for 6 to 10 days after surgery for suture removal and a thorough discussion of your surgery.

This is a difficult question, as every patient is different. You will typically be given a narcotic pain medication to take after surgery. Most patients require this for only the first few days after surgery.

This is a personal decision that you must make. The timing depends upon when you feel you are ready to safely drive. Do not drive if you are taking any narcotic medication. Also, driving a vehicle with manual transmission soon after surgery is not possible due to the motions and strength required. We recommend taking your vehicle for a test drive in an empty parking lot before driving on the road.

This varies on an individual basis and with your occupation. It is best to discuss this with your surgeon or a PA prior to surgery.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

We accept different methods of payment like, cash, plastic cash, via net banking, etc.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

• So how do you know if you have one? Well, symptoms may include:

• Knee pain
• A painful calf
• Noticeable fluid around the knee joint
• Sometimes locking or clicking may occur

Occasionally, you may get no pain at all- you can just feel a lump at the back of your knee.

Usually some sort of knee trauma or direct blow to the knee may cause this type of swelling. Often this may be due to a sports injury, but there are a number of other causes, such as osteoarthritis (joint wear and tear), Rheumatoid arthritis (a systemic inflammation of joints caused by the immune system attacking itself), or Gout (a specific type of reactive systemic arthritis which is caused by excess uric acid in the blood stream).

Anyone! However, it is more common in males and people over 40 years old, although any age or sex can be affected.

• There are several options.

• Like any inflammatory problem, RICE protocol will help (Resting your leg, applying a wrapped Ice compress for 10 minutes each hour, keeping it Compressed with a tubigrip bandage, and keeping your leg Elevated).

• Simple over the counter anti-inflammatory medication and pain killers may also help, however, it is Baker’s Cyst Painimportant to determine the underlying condition causing the swelling and to ideally treat this.

• Using crutches may be necessary to get about until your symptoms ease. They help to take the weight off the affected leg while you are walking.

• Rehabilitation to keep your knee joint moving and using strengthening exercises to help the muscles around your knee may be helpful. Ask your osteopath for help.

• Prescription painkillers – usually a combination of paracetamol and codeine – can be used to control any pain. See your GP for a prescription.

Occasionally your GP may refer you to an orthopaedic knee surgeon to drain the cyst or remove it. If your doctor uses a needle to drain excess fluid from your knee joint to help to relieve your symptoms, remember that it is common for the Baker’s cyst to re-form over time as the underlying cause has not been addressed.

Mild symptoms may settle by following the simple home-based treatments listed above, but if the swelling is persistent and causes you significant discomfort, you should see an osteopath or physical therapist for advice and treatment. Our team of osteopaths at the Joint Replacement Surgery Hospital India are on hand to examine you. You can contact our friendly reception team by filling up our form to book a consultation or ask to speak to a qualified osteopath. We will ask you questions about your complaint and some general health screening questions to ensure that treatment is safe and appropriate. You will then have a physical examination of the knee and surrounding tissues and joints so that your osteopath can formulate a diagnosis.

• Treatment for Baker’s cyst usually involves some gentle joint manipulation, some stretching or massage of the soft tissues. We may also us an ultra-sound machine to further reduce the swelling.
• Usually you will be asked to do some home exercises, before being seen again for a review of your symptoms a few days later.
• Sometimes it may be necessary to refer you for further tests (e.g. ultra-sound or MRI scans) in order to rule out a more serious condition such as an aneurysm or tumour.
• Medical treatment may involve you being offered a corticosteroid injection to reduce the swelling and inflammation caused by the cyst. It does not necessarily prevent it from coming back again.

If there is significant damage to the knee joint (e.g. by osteoarthritis or a torn ligament or cartilage), then surgery may be indicated. Normally this is done as a day-case, using a keyhole procedure called an arthroscopy, which allows the surgeon to look inside the knee with a camera to identify and fix any damage. Surgery may remove the cyst, especially if a cyst is very large or painful and/or other treatments have not worked. Although usually a keyhole method is used to close off the connection between the Baker’s cyst and the knee joint, the cyst can also sometimes removed using open surgery.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

Most people after an osteotomy can return to sport somewhere between six to nine months. This will depend on your pre-operative level of activity, the severity of arthritis of your knee, as well as the progress you make with your rehabilitation.

If you work in an office setting, it is possible that you may be able to return to work between two and three weeks, however, if your occupation requires a lot of walking or heavy manual labour your return to work may be more prolonged, somewhere between six weeks and three months.

An osteotomy has a good chance of delaying the need for a knee replacement in the future. Most people down the track will develop arthritis in other parts of the knee or have arthritis that progresses within the same compartment of the knee. When this occurs, you may require a total knee replacement.

Most people who have an osteotomy require removal of the plates, commonly between one and two years after their operation. This is performed as a day operation and the recovery time is minimal. It is safest to have the plates removed at this time, so that when surgery is performed in the future, there are no plates that could interfere with further treatment.

Most people will have pain for 3-4 weeks after an osteotomy. This is generally well controlled with oral medication. Once the osteotomy fully heals it is expected that the majority of the arthritis pain symptoms will improve significantly as weight is carried on the healthier cartilage of the unaffected compartment.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.

Joint Replacement Surgery Hospital India offers highest quality bone and joint health care with attentiveness, care and compassion to meet the needs of the patients and their loved ones. The medical team includes board-certified orthopedic surgeons who are familiar with all the aspects of the musculoskeletal system. Our hospital uses the most advanced technologies available for the orthopaedic procedures and has a lower complication rate.

The Oxford knee is an artificial joint utilizing the mobile bearing system.

The Oxford procedure can be very successful for treatment of osteonecrosis of the knee, as this process typically destroys a very limited area of the knee. Replacing this with a partial knee replacement, with the remaining knee structures intact, is often one of the best strategies for treatment

The Oxford knee appears to have the best track record. If you follow the links on my website, information regarding statistics and studies can be found on the Oxford website.

An Oxford medial unicompartmental knee replacement has been shown to have over 95% survival of the implant at 10 years, if appropriate screening was done prior to the surgery. “Screening” means that it was ascertained that the lateral compartment was preserved and that the cruciate ligaments were intact. This compares to the best total knee results. Furthermore, it appears that if a revision is necessary, i.e. in the 5% of patients that develop a problem during the first 10 years, taking a unicompartmental knee replacement out and replacing it with a total knee replacement is less of an operation and has better results than taking a total knee replacement being replaced by another total knee replacement.

Therefore, the strategy utilizing a smaller prosthesis, i.e. unicompartmental knee replacement, as the first procedure, is predicted to give similar outcomes and better revision options than using a total knee replacement as the first procedure. It minimizes “burning your bridges”.

You can most definitely choose hotels as per your convenience to you and your budget.

You can talk to the doctor and satisfy all your medical queries. You can also send us your queries for answers from the top doctors.

To know about the procedure of getting an Indian Medical Visa, please go to our website where you will find all the details regarding the initial procedure. You can also send us a query regarding the same.

Many hospitals in India have language translators to help you communicate better and effortlessly with the doctors and medical staff.