Knee Replacement Surgery


With improved healthcare, the average human lifespan is extending. This is a good thing, as our loved ones are now living longer and healthier. But at the same time, this increased life expectancy has brought about some joint related problems, specifically to their hips and knees, due to the extended use and weight borne by these joints.

Hip Replacement

There are several reasons that make hip replacement surgery necessary. As mentioned previously, one reason would be severe pain in the hip resulting from a number of factors. Other causes could include the destruction of the hip joint, usually from fractures, which causes leg shortening; severe limping caused by hip pains, and restricted mobility to the hip joint due to hip pathology.

Sometimes only the femur head is replaced in a procedure that is called Hemiarthroplasty. However in total hip replacement surgeries, both the femur head and the acetabulum which is the socket in the pelvis, are replaced. The necessity of either procedure is dependent on the needs and requirements of the patient.

Knee Replacement

In knee replacement surgery, surgery is conducted if the patient is suffering from severe knee pain and the destruction of the knee joint, usually caused by bone trauma. In some cases, the surgery is also performed to correct varus and valgus deformity, where the joints in the knee experience an angulation, which causes the function of the knee to be reduced.

Certain diseases can also create a need for hip or knee replacement surgery. Osteoporosis can cause bone degeneration which leads to stiffness and joint swelling, rheumatoid arthritis, which causes inflammation, traumatic arthritis as a result of injury, septic L arthritis which causes joints to break down and vascular necrosis, breaking cartilage.

Replacement surgery is only conducted as a last resort if there are no other ways of relieving the pain that the patient is suffering from.

What are steps to replacement surgery?

An orthopaedic surgeon would advice on the need for a replacement. If the orthopaedic surgeon determines that surgery is necessary, then subsequent steps are taken.

The patient will undergo a pre-surgery assessment of their medical conditions. If patient is determined to be diabetic, then they would need to prepare their body for surgery. A cardiac evaluation is also conducted to ensure that their heart is strong enough for the surgery. Blood thinning and other drugs will be stopped prior to the surgery to avoid complications. The patient’s hygiene and skin conditions also need to be at an optimum level to avoid infection.

Assuming the surgery goes well and there are no complications, then the patient should come and be well on the road to recovery.

After the surgery

The length of recovery time varies with each patient depending on factors such as the overall health of the patient, the procedure and the recovery support that the patient receives after being discharged. Patients will need to use a walker for about 4 weeks after surgery, to aid in their locomotion. Light sports, such as golf, doubles tennis and bowling can be played in about 12 weeks’ time as well, if the patient feels confident enough.

Patients also need to have their first follow-up 2 weeks after the surgery for wound inspection. Their second follow-up is one month after surgery for x-rays to the joint. In most cases however, there are no issues that require monitoring by the surgeon, and the next scheduled visit will be 6 months, followed by 1 year after the surgery. All visits are to ensure that there will be no complications at a later time.

There will be slight pain post-surgery, which can last anywhere from a few days to a few weeks. This pain will eventually settle down once the soft tissues from the surgery incision have healed. There will be some post surgery swelling which will eventually subside after a week. The patient will also experience some numbness around the scar area, which will subside even­tually within a few months. Finally, there will be some cracking or popping sounds, especially to the knees. In this instance, do not be alarmed, for this is natural and will subside within a few months as well.

Dr. Premathevan Palaniappan
Consultant Orthopaedic & Trauma Surgeon
Suite 427, 4th Floor
Mahkota Medical Centre
Brought to you by Mahkota Bone & Joint Replacement Centre

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