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FAQ's Knee Joint Replacement

For a single total knee replacement, 4-5 days of hospitalization is sufficient. For bilateral knee replacement hospital stay of 7 days is good enough.

Normally within 24 - 48 hrs after the operation.

If the anaesthesia fitness is there, then both knees can be operated in one sitting (Bilateral simultaneous TKR). Older patients with compromised fitness and those with co-morbidities may be operated with gap.

You may need a walker for about 15 to 20 days and a cane/ stick for another 3 weeks. Then you can walk without any aids.

Primary TKR is a Routine Surgery and a notice of 3 days is reasonable. But for revision knee 5-6 days are desirable. If you want a patient specific instrumentation, then there will be a gap of four weeks between the MRI scan and your operation. This time is necessary for the cutting blocks to be manufactured and sent to us.

We use only standard prosthesis Implants made in the US. These Prosthesis are brought directly by the multinational companies and marketed through distributors. These are
PFC from Depuy( Johnson & Johnson)
Genesis metal & Oxinium, Journey metal & Oxinium ( Smith & Nephew )
NexGen prosthesis from Zimmer LPS flex fixed & mobile bearing

Post-operative pain is controlled to tolerable levels by an epidural block and analgesics. Two to three weeks of oral pain medication are required for most people, usually it is not a big concern of patients.

A primary total knee replacement takes between about 60 to 90 minutes. Sometime is needed for anaesthesia and other things in operation theatre. A difficult knee or Revision Knee may take about two to two and half hours.

You can have the operation done under general anesthesia (fully unconscious) or a regional anesthesia( spinal or epidural) in which you will be sedated but not knocked out. Regional anesthesia is a more Yes safe mode for diabetics and elderly people.

The diabetologist will bring your sugar levels to within normal levels. Our anaesthetist are very competent at epidural anaesthesia and hence the operation is pretty safe. Wound healing is good in well controlled diabetes.

Non-impact sports like walking, golf, swimming are allowed. You can walk, climb slopes/Stairs & be mobile.

Usually 40 to 45 days after surgery patients are back to job without any complaints. For Foreign Patients
In the case of overseas patients, you can do so safety after 20days. You need to spend only a week in the hospital for your recovery and enjoyably spend the rest in a hotel nearby. This is to ensure that you have recovered fully well after the operation and are fit to travel.

Yes, Sure Mostly after a month

The ideal age is more than 60 years after you have exhausted all conservative measures like painkillers (analgesics), a cane and shoe inserts. However I have done knee replacements for a few patients under 50 years. Depends on clinical stage and X-Ray.

Where suitable, cartilage surgery by arthroscopic and open methods. Abrasion chondroplasty and microfracture are arthroscopic procedures. Autologous cartilage implantation is suitable for small to medium areas of cartilage loss. In this your own cartilage cells are removed, cultured and put back in a damaged area of your knee. An osteotomy is advisable you have mal alignment; if your job is strenuous and the cartilage wear is one sided only (Seen on weight bearing x rays

Post op bending achieved is dependent on the pre op bend, body mass index (BMI), prosthesis & rehabilitation. With the High Flex knee, you can get about 155 degrees. Standard knees allow about 110 to 120 degrees of bending. Sustained self Physiotherapy helps a lot.

The most common reason for a Bilateral Total Knee Replacement is severe arthritis in both knees which are symptomatic interfering with the patient's activities of daily living and reducing the quality of life. Usually complaints are worst with weight bearing activities, as standing and walking. Untreated, knee arthritis is usually painful, functionally limiting, as it progressively compromises the patient's independence over time. Another indication is significant deformities in both knees, a situation in which failure to correct both knees deformities at the same time would compromise the clinical result.

The advantages of having a simultaneous procedure include: only one surgical event, a single anesthesia, a shorter overall hospital stay, and the possibility of rehabilitating the patient symmetrically & reduced costs of surgery.

The disadvantages of having a simultaneous procedure include a probable risk increase in cardiovascular & renal complications and a higher possibility of requiring banked blood after surgery.. The initial 2-4 days rehabilitation is slightly more difficult.

The advantages of having a staged procedure include apparently lower stress level for the cardiovascular system, fewer complications related to the heart, a lower incidence of blood clots within the deep veins, as well as a lower possibility of requiring banked blood after surgery. This is an excellent choice for patients with cardiac, vascular or pulmonary diseases or above 75years old

The disadvantages of having a staged procedure are that it requires two hospital stays, two anesthesias and delays full return from disability. However a sequential bilateral knee replacement done a few days apart, obviate these negative points. The total duration of the hospitalization will be about 10 days

In both type of procedures, simultaneous and staged, results are excellent and equivalent in terms of relieve of pain and daily activities. Patients should expect a greater than 95% chance of success.

FAQ's about Hip Replacement

The hip joint is ball and socket ball of the upper end of the thigh bone and the hip socket. This cartilage covering the ball and socket allows for smooth motion of the hip. Arthritis is a wearing away of this cartilage, which leads to pain, swelling and stiffness.

A total hip replacement is an operation that removes the arthritic surfaces of the upper thigh bone and the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the thigh bone. The socket is replaced with a plastic liner. This creates a smoothly functioning joint and is painfree

Based on your history, an examination and X-rays, your orthopaedic surgeon will decide if pain, stiffness and disability justify surgery. One can wait if conservation treatment is working.

Age is not an issue so long as you are in reasonable health and have the desire to continue living an active life.

Most hips last more than 15 years. but there is no guarantee, and around 5 percent may not last that long. Such cases require Revision Surgery.

The most common reason for failure is loosening of the artificial ball or socket. Wearing of the plastic is an issue in long run.

Most surgeries go well without any complications. Infection and blood clots in veins - are two serious complications. To avoid these , we use antibiotics and blood thinners. Special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are 1 percent or less. Dislocation of the hip after surgery is a risk. Your surgeon and physical therapist will discuss ways to reduce that risk.

You may need blood after the surgery. Donate your own blood, prior if possible, or use the donor /blood-bank. Usually 1 Unit for 1 Hip is sufficient.

After 24 hours you will get up, sit in a chair or recliner and walk with a walker with help from the staff. Putting weight on limb is delayed for 3 weeks in uncemented hip, in cemented one can walk putting weight.

Most hip-replacement patients are hospitalized for three to four days after surgery. Make arrangements before your surgery to have someone stay with you after you are discharged.

Approximately One hour and half for surgery. Some extra time is taken by the operating-room staff and anaesthetist.

You may have a general anesthetic, which most people call "being put to sleep," or a spinal/ epidural anesthetic. Choice is based on preference of patient and risk calculation by anaesthetist.

Not really, we will keep you comfortable with appropriate medication. Generally most patients are able to stop very strong medication within two days.

Orthopaedic surgeon will do the surgery (in this case Dr. Sushil Sharma) an assistant often helps during the procedure.

The scar will be approximately 6?7 inches long. It will be along the side of your hip.

Yes. Until your muscle strength returns after surgery, you will need a walker, later a cane.

Yes. In the first ten days or weeks after surgery, you will need someone to assist you with meal preparation, housekeeping, etc. Family members or friends must be available to help.

Usually Hip replacement patients can manage their own exercises.

The ability to drive depends on whether surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving within two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks. Consult with your surgeon for advice on your activity. You should not drive if you are taking narcotic pain medicine.

Most people take at least one month off from work, even if your job allows you to sit frequently. More strenuous jobs will require a longer absence from work.

High-impact activities such as contact sports, running, singles Tennis , Hockey, Cricket and basketball are not recommended. You are encouraged to participate in low-impact activities such as walking, dancing, golfing, hiking, swimming, bowling and gardening.

Mostly patients with hip replacements think that the new joint feels completely natural. However, we recommend always avoiding extreme positions or high-impact physical activity. Some patients have aching in the thigh when bearing weight for a few months after surgery.

FAQ's About Arthroscopy

Arthroscopy is a surgery done to examine a joint visually. Most of the time, it is done on larger joints, like the knee or shoulder. A special tool called an arthroscope is used. It is an instrument that looks like a long tube with a miniature camera on the end. Repairs or corrections to the joint may be done by using the arthroscope and other tools.

It is used to see, diagnose, and treat problems inside your joint.

less than one hour Anaesthetic The type of anesthesia will depend on the joint your doctor is looking at. You may receive one of the following:
✅General anesthesia -You will be asleep.
✅Spinal anesthetic -Your lower body will be numbed by putting a numbing medicine in your back.

The doctor will make tiny incisions in the skin along the joint. Special tools will be inserted through the incisions. The tools include the arthroscope. The picture from the arthroscope will show up on a screen so that the doctor can see the inside of your joint. The doctor will use the images to move around other tools that can cut and repair tissue in your joint.

Complications are rare, but no procedure is completely free of risk. If you are planning to have an arthroscopy, your doctor will review a list of possible complications, which may include:
✅Blood clots
✅Swelling or bleeding
✅Damage to blood vessels, nerves, or other tissue
✅The need to have another surgery or more extensive surgery
Factors that may increase the risk of complications include:
✅Pre-existing heart or lung condition
Before Surgery
Week before
A full medical history and physical examination are required prior to surgery. This may be done in the doctor's office or a medical clearance may be requested from our medical doctor (especially if you have heart, lung, or multiple medical problems).
Most importantly: Do not eat or drink anything after midnight the night before surgery or your surgery will be cancelled. The hospital staff will tell you which of your medications to take the day of surgery (with a SMALL sip of water only).

Day before
Typically the hospital will ask you to arrive about two hours before surgery. The time the surgery actually starts may vary, including on the day of surgery, depending on how long the cases before yours (if any) take. You will be checked in and brought into the pre-operative holding area. An IV will be started and the staff will check your paperwork. You will be asked which joint is the proper joint for surgery and a mark will be placed on that side. Once you are taken back to the operating room, it takes about twenty minutes to get situated. Surgery lasts anywhere from thirty minutes to a couple of hours or so. Don't be alarmed if surgery takes a bit longer; occasionally additional problems needing treatment are encountered.
After surgery, you'll spend an hour or so in the recovery room. Your visitors will be informed by telephone after you arrive in the recovery room.
Things to pack

✅ALL relevant tests-CT scans, MRIs, ultrasound scans, x-rays, blood and urine tests.

✅ALL current medication

After Surgery Successful postoperative pain management after arthroscopic surgery allows patients to go home earlier, decreases the potential for hospital readmission, and facilitates rehabilitation. Optimal pain control considers the physiological and psychological states of the patient, the resulting alterations due to the surgery, and the technical and economic resources available during recovery. A comprehensive approach to pain control should include preoperative, intraoperative, and postoperative efforts. Efforts at postoperative pain reduction should begin preoperatively with the establishment of an excellent patient/physician Accredited by Joint Commission International India's First Internationally Accredited Hospital relationship. Preoperative analgesia should be administered. Intraoperative efforts should include the administration of anesthetic medication intra- articularly. Postoperative management should include sleep medication, continuous cold-flow therapy, oral analgesics, and, if necessary, the use of narcotics.

After Discharge

The dressings can sometimes be removed as early as the next morning. When you return home after the procedure, do the following to help ensure a smooth


✅You may apply ice for the first 24 to 48 hours after surgery to help with swelling and pain.
✅While resting in bed, elevate the part of your body that you had surgery on.
✅Keep the incision area dry for the first 24 hours.
✅You may be instructed to use crutches or a cane for the first few days if the surgery was done on a joint in your legs.
✅If you have stitches or staples, your doctor will remove them in 10-14 days.
✅Be sure to follow your doctor's instructions.
It takes 4-6 weeks for the joint to recover. You can probably go back to work or resume daily activities within a few days, as long your doctor approves. A specific activity and rehabilitation program may be suggested. This will help speed your recovery and protect future joint function.
Athletes often return to athletic competition within a few weeks.

After arriving home, contact your doctor if any of the following occurs:
✅Signs of infection, including fever and chills
✅Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
✅Nausea and/or vomiting that you cannot control with the medicines you wee given after surgery, or which persist for more than two days after discharge from the hospital ✅Pain that you cannot control with the medicines you have been given
✅Cough, shortness of breath, or chest pain
✅Joint pain, fatigue, stiffness, rash, or other new symptoms
✅Swelling, tingling, pain, or numbness in your toes that is not relieved by elevating your knee above heart level for one hour
Your next appointment
You will usually be asked to attend a follow-up appointment within a week after the operation to discuss the results of the surgery, your recovery and any additional treatment that you may require

Repair of the anterior cruciate ligament (ACL) by arthroscope may require a recovery time of 4-6 months and a more specialized rehabilitation program.