With increase in longevity. More number of senior citizens demand a better quality of life. A painful knee can seriously hamper a person's capacity to walk freely and make him dependent not only on drugs to relieve pain but also on others for mobility. The solution to painful arthritic knee is now easily available in form of Knee Surface Replacement.
Imagine yourself pushing a fully loaded vehicle which has flat tyres. You would need considerable force to make it move. Same happens to an overweight person with an arthritic keen joint. Their knee joints feel stiff and are deformed and hence the person needs more physical energy to get up from sitting position, walk, climb stairs and negotiate slopes. To overcome this, he or she takes medicine to relieve pain and muscle spasm and may use a support to walk, but as the age advances, the ability to overcome pain decreases making the person confined to bed most of the time. Prolonged use of NSAIDS ( pain relieving medicines) can even damage the liver and the kidneys of the elderly person.
For an individual aged above 60 years, having painful knee joints which hamper day to day living, knee surface replacement is an ideal choice. With current state of progress in every field of medicine, conditions like diabetes, hypertension, cardiac insufficiency are no more contraindications for surgery. Even obesity is not a problem.
The surgery is relatively safe since it is carried out under Epidural Anaesthesia. This anaesthesia is better tolerated by the elderly. There is also an added advantage of postoperative analgesia by use of infusion pump. The infusion pump is used to deliver the calculated fractional dose suitable for an individual patient. Here the dose can be controlled by the patient hence it is called Patient Controlled Epidural Analgesia (PCEA).
The patient is constantly monitored with the Pulse Oxymeter to measure the Oxygen concentration of blood and Cardioscope to evaluate cardiac function during the surgery.
Being a planned surgery, Auto-transfusion is preferred wherein the patient is transfused his own blood which is withdrawn preoperatively, reducing the risk of transfusion related complications.
Unlike hip joint replacement. Where a large part of the upper end femur is removed to be replaced by metallic implant, in the Knee Surface Replacement, only the irregular superficial surface of femoral and tibal condyles are shaved, which are then resurfaced using cobalt chrome prosthesis for femur and Ultra Molecular Weight High Density Polyethylene ( UMWHDP ) implant for tibia and patella, as this combination of metal and plastic has minimum friction and is well tolerated by the body.
Even though the surgery involves bone resurfacing, it mainly consists of soft tissue realignment and balancing, hence the deformity is corrected and the patient is ready to be discharged on the 5th postoperative day in majority of cases. This reduce the cost as well social inconvenience to the family.
Resurfacing reduces the friction thereby reducing the pain and hence the patient starts exercise using Continuous Passive Motion Machine (CPM) within 48 hours and starts standing and walking in three to five days, initially requiring support for locomotion. During the post operative period at home, the patient needs to exercise regularly, use walking aid and use commode. Sitting on floor is not permitted. Unlimited stair climbing and walking is permitted.