Osteoarthritis (OA) of knee occurs due to wear and tear of cartilage. It is usually due to aging and seen mostly in elderly people. Females usually get affected at slightly earlier age than males. OA can also occur in some cases due to injury in the knee, congenital malformation or due to any other diseases affecting other joints of the body.

Patients suffering with OA have pain around knee, difficulty in standing/walking/using stairs, difficulty in bending the knee or sitting on floor. They also find difficulty in getting up from a sitting position. As the months progresses, these symptoms tend to worsen. At times, patients also notice swelling in their knee joint. It can also affect their sleep pattern. Gradually over the years, the distance which patient could walk earlier, reduces considerably. They also find difficulty in performing day-to-day activities. This reduces their “self-esteem” further. In very advance stages, patient becomes bedridden and crippled.

In initial stages, these patients are managed with analgesics, physiotherapy and intra-articular injections. As the symptoms worsen, they require surgery for pain relief and deformity correction. In slightly earlier stages, ‘Partial Knee Replacement Surgery” is helpful. At advance stages, “Total Knee Replacement Surgery” is performed to help the patient getting back to a normal lifestyle.

Stages of Osteoarthritis:

Although there has been an attempt to perform knee replacement in the 19th and early 20th century, Total Knee replacement surgery has come a long way since 1970s with continuous improvement in the design of implants and fixation techniques. Success from Charlney’s hip replacement surgery got surgeons and engineers interested again leading to modern-day implants. It has been successfully being performed worldwide from 1980 onwards. Diseased part of femur and tibia are removed using special instruments and metal implants mimicking design of femur and tibia are inserted using antibiotic-laden polymethyl methacrylate (bone cement). A polyethylene inset is fixed onto the tibial implant thus allowing movement at the knee joint. The undersurface of patella may be replaced with a patellar button in some cases. Due to improved technique and implant design, this surgery has gained immense popularity and has given a new lease of life for the patients suffering with arthritis of the knee joint. Patients can walk comfortably with the help of support following surgery and aren’t dependent on others for day-to-day life activities. Quality of postoperative care in recent times has further boosted the confidence among the patients undergoing this surgery. Patients are taught to strengthen the thigh muscle post-operatively and encouraged to become mobile. Gradually, they learn to climb stairs and later they walk around independently without any aided support. It is recommended that patients should not sit on the floor or squat. This helps maintain the longevity of the implants. As per the American Association of Orthopaedics, success rate of total knee replacement after 15 years is almost 90% and at the end of 25 years is almost 82%.

Investigations Before Surgery:

1. Blood: CBC, LFT, KFT, Viral Markers, Blood group, Bleeding, and Clotting Profile
2. Urine: Routine & Microscopic
3. Radiology: X-Ray, Both Knee AP Standing view, Lateral View & Skyline View
4. X-Ray: LS Spine – AP & Lateral | XRay: Chest – PA
5. ECG: Dobutamine Stress Echo, (DSE)
6. Further Investigate the way needed for underlying medical Co-Morbidities (e.g., DM, Hypothyroid, etc.)

Once all investigations are done, you will be asked to see a physician from the team to evaluate the fitness for anesthesia.