Knee is considered to be one of the most important joint in the body as it plays a leading role in bearing the body weight. Knee is the most common joint that gets worn out with age. Patients with diseases such as osteoarthritis, hemophilia, gout, rheumatoid arthritis etc. may also require knee replacement. When the knee joints get damaged, it is necessary to be replaced. The prosthesis used in joint replacements varies depending on patient factors and cost.
Indications
- 1. Deformity in knees.
- 2. Night pains disturbing your sleep.
- 3. Restricted knee bending and stiffness.
- 4. Failure of other treatments modalities like physiotherapy and medications.
- 5. Severe knee pain restricting day to day activities like walking, climbing stairs, using the commode etc.
Advantages:
- 1. Active lifestyle
- 2. Significant pain relief
- 3. Improved ambulatory status
- 4. Straighter knee free from deformity
- 5. Bending upto 100 degrees (Can go upto 130degrees)
Limitations:
- 1. Patients cannot squat on the floor or sit use Indian commodes
- 2. Patient cannot be involved in high energy activities and sports
Types of joint replacement
Partial knee replacement (Unicondylar): As the name indicates, only a part of the knee which is worn out is replaced. The knee is divided into three compartments. They are the medial compartment (the inner side of the knee), the lateral compartment (the outer part of the knee) and the patellofemoral compartment (the front of the knee between kneecap and thighbone).
Patient selection:
Patients with the above indications are ideal candidates for joint replacement. Age is not a criterion for joint replacement but symptoms are. Patients with associated co-morbidities like diabetes, hypertension, heart conditions, lung and urinary tract infections, dental caries etc. need a complete pre operative evaluation before deciding on surgery.
Implant selection:
A variety of implants are available in the market for joint replacement surgeries. They are available in stainless steel, cobalt chromium alloys, titanium alloys, tantalum alloys, zirconium alloys and the new oxinium implants. Different prosthetic designs with rotating platforms to promote more knee bending are also available. Implant selection is primarily dependent on patient factors and expectations. The cost also plays an important role in our society.
