Dr Sanket Diwanji is the Best Knee Surgeon in surat.
Total knee replacement (TKR) is one of the most successful surgery today performed for endstage osteoarthritis of knee joint. TheDescription
A knee replacement (also called knee arthroplasty) might be more accurately termed a knee “resurfacing” because only the surface of the bones are actually replaced.
There are four basic steps to a knee replacement procedure.
After examinig your knee and verifying the investigations, we may recommend you to undergo TKR. Whether to get an operation and when to get an operation is entirely patinet’s choice.
There are several reasons why we may recommend knee replacement surgery. People who benefit from total knee replacement often have:
There are no absolute age or weight restrictions for total knee replacement surgery.
Recommendations for surgery are based on a patient’s pain and disability, not age. Most patients who undergo total knee replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis. The oldest patient operated by Dr Diwanji is 90 years at the time of surgery.
Overweight patients are encouraged to loose weight before surgery. The heaviest patient operated successfully by Dr Diwanji was 128 kg.
An evaluation with an orthopaedic surgeon consists of several components:
If you decide to have total knee replacement surgery, you will be asked to undergo blood and urine test, chest x ray, ECG and Echocardiography. These tests will tell us regarding your physical fitness for surgery.
Usually patients are sent to Physician (internist) to assess problems such as High blood pressure, Diabetes, Heart disease, Asthama, Thyroid problems, Kidney or liver disease. Physicians recommends apporpriate medications to control such problems. Usually blood thinner medications such as Aspirin needs to stopped 4 days prior to surgery.
Although the incidence of infection after knee replacement is very low, an infection can occur if bacteria enter your bloodstream. To reduce the risk of infection, major dental procedures (such as tooth extractions and periodontal work) should be completed before your total knee replacement surgery.
People with a history of recent or frequent urinary infections should have a urological evaluation before surgery. Older men with prostate disease should consider completing required treatment before undertaking knee replacement surgery.
Dr Diwanji normally operates at Mahavir Superspeciality Hospital, Unique Hospital and Nirmal Hospital in Surat. He also operates at Amit Hospital and Zenith Doctor House in Valsad. Patients can choose hospital depending up on their insurance provider or their personal choice. Cashless admission at these hospitals may be possible depending up on tie up between TPA of insurance company and the hospital.
Patients are suppose to report to emenrgency room of the hospital on a day before surgery , where medical officer on duty will examine him/her and inform Dr Diwanji regarding the admission. At this stage any remaining investigation are performed. Blood samples are collected to send to Blood bank for Cross matching. Usually blood transfusion is not required during routine Knee replacement surgery, but two units of blood are reserved as precautionary measure.
From emergency room, patients are shifted to rooms of their choice (general, Semi special, Special or deluxe) or as per availability. Here Anesthetist visit him/her for pre anesthetic evaluation.Patients can take usual diet on day before surgery, usually they are advised to stop takking food or liquid 8 hours before surgery. Nurse and medical officer on duty will explain about any medication required to be taken on morning of surgery.
The extrimity on which the surgery is planned, is cleaned with antiseptic solution on night prior to surgery and also on morning of surgery. Patients can take bath before surgery if they wish to.
You will most likely be admitted to the hospital on the daybefore your surgery.
After admission, you will be evaluated by a member of the anesthesia team. The most common types of anesthesia are general anesthesia (you are put to sleep) or spinal, epidural, or regional nerve block anesthesia (you are awake but your body is numb from the waist down). The anesthesia team, with your input, will determine which type of anesthesia will be best for you.
The procedure itself takes approximately 1 to 2 hours. Your orthopaedic surgeon will remove the damaged cartilage and bone, and then position the new metal and plastic implants to restore the alignment and function of your knee.
After surgery, you will be moved to the recovery room, where you will remain for several hours while your recovery from anesthesia is monitored. After you wake up, you will be taken to your hospital room.
You will most likely stay in the hospital for three days.
After surgery, you will feel some pain, but your surgeon and nurses will provide medication to make you feel as comfortable as possible. Pain management is an important part of your recovery. Walking and knee movement will begin soon after surgery, and when you feel less pain, you can start moving sooner and get your strength back more quickly.
Your will receive blood thiner to prevent blood clots and decrease leg swelling. In addition to that we will apply intermittent pneumatic compression pumps to both legs.
Foot and ankle movement also is encouraged immediately following surgery to increase blood flow in your leg muscles to help prevent leg swelling and blood clots.
Most patients begin exercising their knee the day after surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement to allow walking and other normal daily activities soon after your surgery.
Your Recovery at Home
All patients go home walking with a walker support. They are able to sit in a regular car and rarely require an ambulance at the time of discharge.
Patients are encouraged to move around every 2 hours at home.
You will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed 2 weeks after surgery. A suture beneath your skin will not require removal.
Avoid soaking the wound in water until it has thoroughly sealed and dried. Patients are allowed to take bath after covering the wound with a plastic.
Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to help your wound heal and to restore muscle strength.
Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within 3 to 6 weeks following surgery. Some pain with activity and at night is common for several weeks after surgery.
Your activity program should include:
You will most likely be able to resume driving when your knee bends enough that you can enter and sit comfortably in your car, and when your muscle control provides adequate reaction time for braking and acceleration. Most people resume driving approximately 4 to 6 weeks after surgery.
Possible complications after surgery:
The complication rate following total knee replacement is low. Serious complications, such as a knee joint infection, occur in fewer than 2% of patients. Major medical complications such as heart attack or stroke occur even less frequently. Chronic illnesses may increase the potential for complications. Although uncommon, when these complications occur, they can prolong or limit full recovery.
Infection. Infection may occur in the wound or deep around the prosthesis. It may happen while in the hospital or after you go home. It may even occur years later. Minor infections in the wound area are generally treated with antibiotics. Major or deep infections may require more surgery and removal of the prosthesis. Any infection in your body can spread to your joint replacement.
Blood clots. Blood clots in the leg veins are the most common complication of knee replacement surgery. These clots can be life-threatening if they break free and travel to your lungs. Your orthopaedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings, and medication to thin your blood.
Implant problems. Although implant designs and materials, as well as surgical techniques, continue to advance, implant surfaces may wear down and the components may loosen. Additionally, although an average of 115° of motion is generally anticipated after surgery, scarring of the knee can occasionally occur, and motion may be more limited, particularly in patients with limited motion before surgery.
Continued pain. A small number of patients continue to have pain after a knee replacement. This complication is rare, however, and the vast majority of patients experience excellent pain relief following knee replacement.
Neurovascular injury. While rare, injury to the nerves or blood vessels around the knee can occur during surgery
We may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.
Warning signs of blood clots. The warning signs of possible blood clots in your leg include:
Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:
A common cause of infection following total knee replacement surgery is from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your knee replacement and cause an infection.
After your knee replacement, you must take preventive antibiotics before dental or surgical procedures that could allow bacteria to enter your bloodstream.
Warning signs of infection. Notify your doctor immediately if you develop any of the following signs of a possible knee replacement infection:
A fall during the first few weeks after surgery can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile. You should use a cane, crutches, a walker, hand rails, or have someone to help you until you have improved your balance, flexibility, and strength.
We will help you decide what assistive aides will be required following surgery and when those aides can safely be discontinued.
Improvement of knee motion is a goal of total knee replacement, but restoration of full motion is uncommon. The motion of your knee replacement after surgery can be predicted by the range of motion you have in your knee before surgery. Most patients can expect to be able to almost fully straighten the replaced knee and to bend the knee sufficiently to climb stairs and get in and out of a car. Kneeling and sitting crossed leg is sometimes uncomfortable, but it is not possible..
Most people feel some numbness in the skin around your incision. You also may feel some stiffness, particularly with excessive bending activities.
Most people also feel or hear some clicking of the metal and plastic with knee bending or walking. This is a normal. These differences often diminish with time and most patients find them to be tolerable when compared with the pain and limited function they experienced prior to surgery.
Your new knee may activate metal detectors required for security in airports and some buildings. Tell the security agent about your knee replacement if the alarm is activated.
After surgery, make sure you also do the following:
Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following your orthopaedic surgeon’s instructions after surgery and taking care to protect your knee replacement and your general health are important ways you can contribute to the final success of your surgery.