Knee Replacement Surgery in Delhi, India

The knee is a complex joint that connects the bones of the legs. Knee replacement surgery, also known as knee arthroplasty, is conducted when the knee’s bones and cartilage are severely worn down by arthritis or any injury. The replacement parts, also called prostheses, are generally made of metal and plastic and last for a long time. If traditional medication, therapy, injections and more have not brought relief to the patient, they may be eligible for knee replacement surgery.

There are many types of knee replacement surgeries based on the extent of the procedure and the specific needs of the patient. Some common types are:

Total Knee Replacement (TKR)

Also known as total knee arthroplasty, total knee replacement (TKR) surgery involves replacing the entire damaged knee joint with an artificial prosthesis. The prosthesis includes metal components for the femur and tibia and a plastic spacer in between to allow smooth movement.

Partial Knee Replacement (PKR)

Partial knee replacement surgery (PKR) is performed when only one compartment of the knee is affected by arthritis or damage. In PKR, only the damaged portion of the knee joint is replaced with a prosthetic implant, preserving healthy bone and ligaments.

Bilateral Knee Replacement

Bilateral knee replacement surgery involves replacing both knees in a single surgical procedure. It is typically performed for patients with significant arthritis or damage in both knees, allowing them to undergo a surgery and recovery period instead of two separate ones.

Complex or Revision Knee Replacement

This surgery is performed when a previous knee replacement has failed or requires correction. Complex or Revision knee replacement involves removing the existing prosthesis and replacing it with a new one to address complications, instability, or wear and tear.

Minimally-Invasive Knee Replacement

In this approach, smaller incisions are made compared to traditional knee replacement surgery. Minimally invasive knee replacement surgery aims at minimising muscle and tissue disruption, potentially leading to shorter hospital stays, reduced scarring, and faster recovery times.

The procedure is recommended when other treatments, such as medication, physiotherapy, or lifestyle modifications, have failed to provide relief from knee pain or restore mobility. Some conditions may also lead to the need for a knee replacement, including:

Osteoarthritis

Osteoarthritis is a common degenerative joint disease, it may occur when the protective cartilage that cushions the bones in the knee joint wears away, leading to pain, stiffness, and limited mobility.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune condition causing inflammation and damage to the joints, including the knees. The resulting pain, swelling, and stiffness can make it difficult to perform daily activities.

Post-traumatic Arthritis

Post-traumatic arthritis is a form of arthritis that may develop after a knee injury, such as a fracture or ligament tear. The resulting damage to the joint can lead to pain, swelling, and decreased mobility.

Avascular Necrosis

Avascular necrosis is a condition in which the bone tissue in the knee joint dies due to a lack of blood supply. It can be caused by trauma, medications, or medical conditions such as sickle cell anaemia.

Knee Deformities

A knee replacement may be necessary to correct a deformity in the knee joint, such as bowing or twisting.

Several risk factors can contribute to the need for knee replacement surgery. These include:

• Age: Advanced age is a common risk factor, as wear and tear on the knee joints tend to increase with time.
• Osteoarthritis: Osteoarthritis, a degenerative joint disease, is a primary contributor to the need for knee replacement. It causes the gradual breakdown of cartilage in the knee joint, leading to pain and stiffness.
• Rheumatoid arthritis: Individuals with rheumatoid arthritis, an autoimmune disorder affecting the joints, may require knee replacement surgery due to joint damage and inflammation.
• Gender: Women, particularly those over the age of 50, are more likely to undergo knee replacement surgery. Hormonal factors and anatomical differences may contribute to this increased risk.
• Obesity: Excess body weight places additional stress on the knee joints, increasing the risk of joint deterioration and the need for knee replacement.
• Trauma or injury: Previous knee injuries or trauma, such as fractures or ligament tears, can accelerate joint damage and contribute to the need for surgical intervention.
• Genetics: Genetic factors may predispose individuals to conditions such as osteoarthritis, influencing the likelihood of requiring knee replacement surgery.
• Inactive lifestyle: Lack of physical activity or an inactive lifestyle can contribute to weakened muscles and joint instability, increasing the risk of knee problems that may necessitate surgery.
• Other medical conditions: Certain medical conditions, such as avascular necrosis, gout, or bone dysplasia, can contribute to the deterioration of knee joints and elevate the risk of needing a knee replacement.
• Occupational factors: Jobs or activities that involve repetitive stress on the knees, such as heavy lifting or prolonged kneeling, may contribute to joint wear and tear, increasing the likelihood of requiring knee replacement surgery.

The complications of knee replacement surgery are low, but they include:

• Anaesthesia-related complications: Though rare, may include reactions to anaesthesia drugs or adverse responses, emphasising the importance of thorough preoperative assessments.
• Loosening or wear and tear of prosthesis: The potential for loosening or wear and tear of the prosthesis over time underscores the need for regular monitoring through follow-up appointments to ensure the continued effectiveness of the knee replacement.
• Infections: Though uncommon, infections pose a risk following knee replacement surgery, necessitating vigilant postoperative care and prompt medical attention if signs of infection, such as swelling or redness, arise.
• Poor wound healing: Poor wound healing is a possible complication that emphasises the importance of postoperative wound care and adherence to medical advice to minimise the risk of infection and other complications.
• Persistent pain: Despite the success of knee replacement surgery, some individuals may experience persistent pain, highlighting the need for ongoing communication with healthcare providers to address and manage pain effectively.

Bleeding: Although uncommon, bleeding is a potential complication, underscoring the significance of preoperative assessments and meticulous surgical techniques to minimise the risk of excessive bleeding during and after the procedure.

• Medical assessment: The doctor will conduct a comprehensive review of the patient's personal and family medical history.
• Diagnostic tests: A series of lab, diagnostic, and imaging tests will be performed to assess the patient's fitness for the procedure.
• Medication review: The doctor may adjust current medications, either starting or discontinuing them as necessary. Patients should inform the doctor about their current medication regimen.
• Health discussion: Patients are encouraged to communicate any medications and chronic conditions they have to ensure a thorough understanding of their health status.
• Lifestyle considerations: Quitting smoking a few weeks before the procedure is advised, as it can impact the healing process.
• Physical activity: Regular exercise before the procedure is recommended to enhance post-operative healing.

• Preoperative checks: The doctor and care team will confirm the absence of allergies to medications and latex used during surgery.
• Anaesthesia administration: The anaesthetist administers anaesthesia to ensure the patient's comfort during the procedure.
• Incision and access: Precise incisions are made in and around the knee to provide access to the affected area.
• Removal of damaged parts: Injured or damaged portions of the knee are carefully removed, and the joint is meticulously prepared for the placement of prostheses.
• Prosthesis attachment: The doctor securely attaches the prostheses using specialised cement, ensuring a stable and durable fixation.
• Quality checks and adjustments: Thorough checks for movement, along with any necessary adjustments and repairs, are performed to optimise the functionality of the replaced joint.

• Hospital stay duration: The length of the hospital stay varies based on the type of procedure performed.
• Activity restrictions: Patients are advised to refrain from lifting heavy objects, engaging in strenuous activities, or operating heavy machinery during the initial recovery period.
• Assistance arrangements: Arrangements should be made for someone to assist the patient until they regain the ability to perform daily activities independently.
• Mobility support: The doctor may recommend using a splint or a walker to aid in movement during the early stages of recovery.
• Home modifications: Home modifications may be necessary to create a more accommodating environment for the patient.
• Timeline for recovery: Full weight-bearing on the ankle and a return to daily activities may take up to 4 months, with a complete recovery extending up to a year.
• Follow-up appointments: Regular follow-up appointments are crucial for monitoring potential complications and ensuring a smooth recovery.
• Pain management: Pain relief medications will be provided to enhance the patient's comfort during the healing process.

Max Institute of Musculoskeletal Sciences & Orthopaedics, is equipped with a state-of-the-art Digital Orthopaedic Operating Suite. We offer comprehensive care for several orthopaedic afflictions, including knee, hip, and joint problems. The joint implants are planned pre-operatively for perfect size and positioning as per the anatomy of the patient, thereby safeguarding their health. Our wide range of offerings has made us rank among the best hospitals for knee replacement surgery in India. We focus on providing the highest level of patient care with professional expertise for early mobilisation and have taken orthopaedic treatment to a world-class level.

How long does it take to recover from a knee replacement?

The doctor would recommend returning to regular activities after 6 weeks, but it can take up to four months to make the pain subside and up to a year for a full recovery.

How long does it take to walk after a full knee replacement?

Most patients can start walking with assistance within a day or two after a full knee replacement. The timeline for walking independently varies, but it typically takes a few weeks to a few months. Full recovery and returning to normal walking patterns can take up to a year. Following a structured rehabilitation program and guidance from your healthcare provider are crucial for optimal recovery and walking abilities.

How painful is a total knee replacement? 

There is an amount of pain associated with a total knee replacement, but the patient will be provided with pain medication so they can heal comfortably. In case the pain is too much, they should consult their doctor immediately.

What is the best age to have a knee replacement? 

While the average age range of knee replacement surgery is between 50- 70, the best age to have a knee replacement is when the pain does not seem to subside, interfering with daily functioning, and traditional therapy and medications do not bring relief.

Is a knee replacement worth it? 

A knee replacement is worth it if the patient has been experiencing pain and discomfort for a long time with no relief from traditional therapy and medications.

How long does knee replacement surgery take? 

Knee replacement surgery can take 1-3 hours, depending on the extent of the condition.

Is ACL surgery the same as knee replacement surgery?

No, ACL (Anterior Cruciate Ligament) surgery and knee replacement surgery are distinct procedures that address different issues within the knee joint. While ACL surgery is focused on repairing or reconstructing a specific ligament, knee replacement surgery involves replacing the entire knee joint or its damaged components. The choice between these surgeries depends on the nature and extent of the knee condition or injury.

What is robotic surgery for knee replacement?

Robotic surgery for knee replacement involves the use of advanced robotic technology to assist orthopaedics surgeons in performing precise and personalised knee replacement procedures.

What is Platelet-Rich Plasma therapy for the knee?

Platelet-rich plasma therapy, also known as PRP therapy, involves extracting a concentrated form of the patient's own blood, rich in platelets, and injecting it into the knee to promote healing and reduce inflammation.

How much does knee replacement surgery typically cost?

The cost of knee replacement surgery can vary widely based on geographic location, the specific hospital or surgical centre, and the type of knee replacement procedure.

What components contribute to the overall cost of knee replacement surgery?

The total cost includes preoperative assessments, surgeon fees, hospital or surgical facility charges, anaesthesia fees, the cost of implants used in the procedure, postoperative care, and physical therapy.

Does insurance cover the cost of knee replacement surgery?

Many health insurance plans cover a significant portion of the cost of knee replacement surgery. However, the extent of coverage can vary, and patients should check with their insurance providers to understand their out-of-pocket expenses.

Are there additional costs beyond the initial estimate for knee replacement surgery?

Patients may incur additional costs for postoperative rehabilitation, medications, and follow-up appointments. It's essential to factor in these potential expenses when planning for the overall cost of the procedure.

Are there different costs for partial vs. total knee replacement surgery?

Reviewed by Dr. Palash Gupta, Director & Coordinator - Orthopaedics & Joint Replacement on 19-Jan-2024.

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