Unilateral knee replacement(TKR) Cost in India

Know More About Procedure & Surgery

What is Unicompartmental/total/partical Knee Replacement?

During knee replacement surgery, damaged bone and cartilage is resurfaced with metal and plastic components. In unicompartmental knee replacement (also called "partial" knee replacement) only a portion of the knee is resurfaced. This procedure is an alternative to total knee replacement for patients whose disease is limited to just one area of the knee. Because a partial knee replacement is done through a smaller incision, patients usually spend less time in the hospital and return to normal activities sooner than total knee replacement patients.

Your knee is divided into three major compartments:

• Medial compartment (the inside part of the knee)
• Lateral compartment (the outside part)
• Patellofemoral compartment (the front of the knee between the kneecap and thighbone)
• Quicker recovery
• Less pain after surgery
• Less blood loss

Advantages

The advantages of partial knee replacement over total knee replacement include:

• Quicker recovery
• Less pain after surgery
• Less blood loss

Also, because the bone, cartilage, and ligaments in the healthy parts of the knee are kept, many patients report that a unicompartmental knee replacement feels more natural than a total knee replacement. A unicompartmental knee may also bend better.

Disadvantages

The disadvantages of partial knee replacement compared with total knee replacement include:

• Slightly less predictable pain relief
• Potential need for more surgery. For example, a total knee replacement may be necessary in the future if arthritis develops in the parts of the knee that have not been replaced.

Candidates for Surgery

In addition, if you have any of the following characteristics, you may not be eligible for the procedure:

• Inflammatory arthritis
• Significant knee stiffness
• Ligament damage

With proper patient selection, modern unicompartmental knee replacements have demonstrated excellent medium- and long-term results in both younger and older patients.

Physical Examination

Your doctor will closely examine your knee. He or she will try to determine the location of your pain. Your doctor will also test your knee for range of motion and ligament quality. If your knee is too stiff, or if the ligaments in your knee feel weak or torn, then your doctor will probably not recommend unicompartmental knee replacement (although you still may be a great candidate for total knee replacement).

Imaging Tests

• X-rays. These images help to determine the extent of damage and deformity in your knee.
• Magnetic resonance imaging (MRI) scans. Some surgeons may also order an MRI scan to better evaluate the cartilage.

Before Surgery

You will likely be admitted to the hospital on the day of surgery. Before your procedure, a doctor from the anesthesia department will discuss anesthesia choices with you. You should also have discussed anesthesia choices with your surgeon during your preoperative clinic visits. Anesthesia options include:

• General anesthesia (you are put to sleep)
• Spinal (you are awake but your body is numb from the waist down)
• Your surgeon will also see you before surgery and sign your knee to verify the surgical site.

Surgical Procedure

• A partial knee replacement operation typically lasts between 1 and 2 hours.
• Inspection of the joint. Your surgeon will make an incision at the front of your knee. He or she will then explore the three compartments of your knee to verify that the cartilage damage is, in fact, limited to one compartment and that your ligaments are intact.
• If your surgeon feels that your knee is unsuitable for a partial knee replacement, he or she may instead perform a total knee replacement. This contingency plan will have been discussed with you before your operation to make sure that you agree with this strategy.

There are three basic steps in the procedure:

• Prepare the bone. Your surgeon will use special saws to remove the cartilage from the damaged compartment of your knee.
• Position the metal implants. The removed cartilage and bone is replaced with metal coverings that recreate the surface of the joint. These metal parts are typically held to the bone with cement.
• Insert a spacer. A plastic insert is placed between the two metal components to create a smooth gliding surface.

Complications

Although rare, the most common risks include:

• Blood clots. Blood clots in the leg veins are a common complication of knee replacement surgery. Blood clots can form in the deep veins of the legs or pelvis after surgery. Blood thinners such as warfarin (Coumadin), low-molecular-weight heparin, and aspirin can help prevent this problem. Newer blood thinners, such as apixaban (Eliquis) and rivaroxaban (Xarelto), may also be prescribed by your doctor, depending upon your needs.
• Infection. After surgery an infection may occur in the skin over the wound or deep in the wound. An infection may happen while you are in the hospital or after you go home. You will be given antibiotics before the start of your surgery and these will be continued for about 24 hours afterward to prevent infection.
• Injury to nerve. Although it rarely happens, nerves or blood vessels may be injured or stretched during the procedure.
• Continued pain
• Risks of anesthesia
• Need for additional surgery

Recovery

Hospital discharge. Partial knee replacement patients usually experience less postoperative pain, less swelling, and have easier rehabilitation than patients undergoing total knee replacement. In most cases, patients go home 1 to 3 days after the operation. Some patients go home the day of the surgery.

Pain management. After surgery, you will feel some pain, but your surgeon and nurses will make every effort to help you feel as comfortable as possible. Many types of medicines are available to help control pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Treating pain with medication can help

Weight bearing. You will begin putting weight on your knee immediately after surgery. You may need a walker, cane, or crutches for the first several days or weeks until you become comfortable enough to walk without assistance.

Rehabilitation exercise. A physical therapist will give you exercises to help maintain your range of motion and restore your strength.

Doctor visits. You will continue to see your orthopedic surgeon for follow-up visits in his or her clinic at regular intervals.

You will most likely resume all of your regular activities of daily living by 6 weeks after surgery.

With proper care individuals who have had a Total Knee Replacement can expect many years of faithful function. Studies show that patients can expect a greater than 95 percent chance of success for at least 20 years.

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