Joint Replacement Surgery in Mumbai

The joint replacement surgery can be done to various joints, for example, shoulder, ankle, hip, knee, elbow, with the following surgeries.

• Total Hip Replacement
• Total Knee Replacement
• Unicompartmental Knee Replacement
• Shoulder Joint Replacement
• Reverse Total Shoulder Replacement
• Total Elbow Replacement
• Wrist Joint Replacement (Wrist Arthroplasty)
• Arthritis of the Foot and Ankle

However, most patients visit our center for knee joint replacement surgery in Dadar, Mumbai because the knee is the relay station of the entire body weight. In addition, certain conditions such as arthritis, fracture, drying of bursae, or other conditions may lead to severe pain and restricted mobility in knee joints. Therefore Unicompartmental Knee Surgery and Total Knee surgery are two kinds of joint replacement surgeries that aim to mitigate the condition causing pain, replace the joint with prosthetics, and mimic the natural knee joint functions.

Unicompartmental OR Partial Knee Replacement Surgery

Partial knee replacement is usually recommended to osteoarthritis patients who undergo severe knee pain, with chances of pain escalation in the future.

Arthritis is a medical condition in which joints become inflamed and cause pain, swelling (inflammation), and stiffness in joints. Osteoarthritis is a very common type of knee arthritis that causes joint cartilage degeneration. As a result, the joints undergo friction, become inflamed and cause pain. It is common among older people.

Normally, in a knee joint, articular cartilage helps in the joint’s smooth movement. But in arthritic knee conditions, the cartilage wears and becomes thin. On the contrary, the bones swell and become thicker on joint edges, forming bone spurs. In addition, the inflamed joints with lost cushioning lead to bones friction and restrict joint mobility.

Diagnosis of Arthritis

Dr. Savadekar diagnoses osteoarthritis on the following basis:

• Medical history
• Physical examination
• Screening tests that include X-rays and multiangular bone scan

Treatment for Arthritis

Arthritis can be treated with both conservative and surgical approaches. However, the choice of treatment depends on the following factors:

• Severity of osteoarthritis
• Patients age
• Patients’ medical condition to bare minimum blood loss or sedatives given during surgery
• Speed of disease progression

The surgery is an option when:

• Patients see exacerbated pain
• Loss of joint mobility
• Restricted mobility also afflicting other changes such as obesity
• Obstruction in day-to-day lifestyle.

Unicompartmental or partial knee replacement is a MISS minimally invasive surgery that aims to replace the partially damaged part of the knee with an implant that helps the femur bone( thigh bone) in knee joint) glide over tibia(lower knee-long bone to joint) bone easily. The knee can be divided into three major compartments: patellofemoral compartment between kneecap and thighbone; the medial compartment, or inner knee part; and lateral compartment, or outer portion of the knee joint.

When Is Unicompartmental Knee Replacement Indicated?

Traditionally, partial knee replacement is indicated in patients with severe knee osteoarthritis. In a total knee replacement, all the worn out or damaged knee joint surfaces, including the damaged or inflamed femur bone, are cut and replaced with ball socket implant artificial implant parts. On the contrary, partial knee replacement removes and replaces the partially damaged cartilage and trims the bone spurs of arthritis knee confined to a single compartment of your knee. The doctor recommends this surgery if Non-surgical treatment such as medications, steroidial injections, or physical therapy fails to give substantial relief.

How Is Unicompartmental Knee Replacement Performed?

The partial knee replacement MISS surgery is done in the following steps:

• A small incision is made on the knee to expose the knee joint.
• The surgeon removes only the damaged cartilage or bone spurs and places an implant into the bone joint by trimming the shinbone and the thighbone to conform to the implant.
• The prosthesis is docked inside the newly prepared area and secured with adhesive bone cement.
• Now, the damaged edges of the femur or thighbone are trimmed, and a new metal component is fixed with bone cement or screws.
• A small plate is implanted in the tibia, and on it, a specially designed plastic is fitted to function like cartilage. The component's mechanism will help the femur to glide on it easily and perform movements.
• Once the tibial components and femoral components are consolidated, the joint movements are checked for effectiveness.
• The muscles and tendons removed for the joint surgery is repaired, and finally, the incision is closed with dissolvable sutures.

Postoperative Care Following Unicompartmental Knee Replacement

Our joint replacement surgeon in Mumbai will advise upon the following postoperative partial knee replacement care:

• Ask you to walk with the help of a walker or cane for the first 1-2 weeks after surgery.
• Your doctor will ask you to consult a physical therapist to teach you some exercise programs for the next 4 to 6 months to practice motions and gain muscle-bone strength over time.
• You will be allowed to perform low-impact activities like walking, swimming, and biking, but you will be barred from high-impact activities like jogging or cardio exercises.

Risks and Complications Of Post Unicompartmental Knee Replacement Surgery

The possible risks and complications of unicompartmental knee replacement include:

• Knee stiffness
• Infection
• Blood clots (Deep vein thrombosis)
• Nerve and blood vessel damage
• Ligament injuries
• Patella (kneecap) dislocation
• Wearing of the plastic liner
• Loosening of the implant

Advantages of Unicompartmental Knee Replacement

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

• Smaller incision
• Less blood loss
• Quick recovery
• Less postoperative pain
• The better overall range of motion
• Native knee tissue is largely preserved except for damaged bone
• Feels more like a natural knee

The Total Knee joint replacement in Mumbai is recommended in severe knee arthritis with lost knee mobility.

When Is Total Knee Replacement Suggested Over Partial Knee Replacement?

Typically in partial knee replacement, the worn-out cartilage and bony edges are trimmed and replaced with prosthetics. However, in Total Knee replacement surgery, a part of the broken and inflamed femur is cut, shaped, and docked with a metal cap. The tibia is also cut into lamina to fix a plate prothetic. The Total Knee replacement is an option only when the knee is severely afflicted with osteoarthritis such that there are massive joint mobility issues and the knee is not responding to prior knee arthritis treatment.

What is Total Knee Replacement(TKR)?

Total knee replacement or total knee arthroplasty is a surgical procedure that completely removes worn-out or damaged knee joint surfaces and restores knee mobility. The surgery aims at the following three parts:

• Femur reconstruction for implant- The inflamed femur or thighbone is cut and trimmed in the shape of the socket to conform to a prosthetic ball socket. Then, the ball socket is joined with bone cement.
• Cartilage replacement- The worn cartilage is removed completely. The space is vacated to insert an artificial plastic or biocompatible device that will mimic cartilage function and allow femur or tibial bones to glide while executing a range of movements.
• Tibial implant- The third component is tibial reconstruction or implant. The tibia is cut into lamina, and an implant fitted with a plastic prosthetic is drilled in the tibia. The plastic or biocompatible device enables the ball socket to glide on it while easily performing a range of motions.

When is Total Knee Replacement Indicated?

Total knee replacement surgery is commonly indicated as a definitive surgical solution to severe osteoarthritis knee. Dr. Savadekar advises total knee replacement if you have the following conditions:

• Obstructed movements (such as walking, getting up from a chair, or climbing stairs)
• Moderate-to-severe pain that awakens you from slumber
• Chronic knee inflammation
• Knee showing no improvement to conservative treatments that include medications, injections, heat, or physical therapy
• Knee deformity

STEP-WISE Total Knee Replacement Procedure

The total knee replacement surgery aims to relieve chronic knee pain and restore its alignment and functions.

Following is the step-wise procedure of TKR:

• Firstly, our joint replacement surgeon in Mumbai injects general anesthesia into the joint site.
• Then, the surgeon makes a small incision in the skin to expose the knee joint.
• The surgeon access the damaged femur bone portion and cut it in angular wedges using specialized jigs一 to form a socket for docking an implant.
• Then, the femoral implant component is attached to the femur either with screws or with bone cement.
• Now, the surgeon prepares the tibia bone. The joint replacement surgeon in Mumbai cuts or shaves off the damaged cartilage and tibia. The surgeon also removes the deformed bone or bony projections, creating a smooth surface for base implants attachment.
• Next, the tibial implant component is secured to the end of the bone with bone cement or screws.
• Onto the tibial implant, a plastic structure is already attached that mechanically allows the femoral implant component to glide over it without creating joint stress. The plastic component mimics original meniscus cartilage function, supports body weight, and allows flexible joint movements.
• Finally, the joint replacement surgeon ensures the patella (kneecap) has firmly conformed in the knee joint. With implant replacement, the surgeon test it to perform a range of motion. Once satisfied, the surgeon irrigates the surgical site with a sterile solution and closes the incision with dissolvable sutures.

Postoperative Care After Total Knee Replacement

Rehabilitation begins immediately after the surgery. The doctor will first give some knee immobilizer to strengthen the artificial joint, stabilizing it. After that, however, you will be able to walk with crutches or walkers. The surgeon may also affix a Continuous Passive Machine (CPM) machine to the knee joint. The CPM machine attached to the artificial joint will make the joint perform a controlled range of motions. Later, your physical therapist will teach home exercises to strengthen knee joint, thigh, and calf muscles, restoring complete artificial knee mobility.

Risks and Complications Involved in Total Knee Replacement

Total Knee replacement surgery is very common a highly recommended to older adults for it offers a versatile range of benefits. In India, it has more than 90% success rates; still, as in every surgery, total knee replacement surgery in Mumbai also involves certain risks and complications. They are as:

• Knee stiffness
• Infection
• Blood clots (Deep vein thrombosis)
• Nerve and blood vessel damage
• Ligament injuries
• Patella (kneecap) dislocation
• Wearing of the plastic liner
• Loosening of the implant

If you see any of the complications mentioned above, you can reach out to our doctor without any delay.