Knee replacement can recreate movement, feel of a natural knee

In an interview with Lovleen Bains, Dr Harpreet Singh Gill, a post-doctoral fellow at Johns Hopkins University and ex-president of the Punjab Orthopaedic Association, shared valuable insights into the importance of orthopaedic surgery and notable advances in the field.

What are common misconceptions about knee replacement in India?

The number of total knee replacement (TKR) is increasing each year. In India, about 200,000 knee replacements are done each year as compared to the USA, where around 700,000 TKR’s are done annually. Unfortunately, misunderstandings regarding the surgical procedure, recovery and prognosis deter many individuals suffering from knee arthritis from undergoing this life-changing treatment.

Should one postpone getting knee replacement surgery?

One of the most common perceptions of knee replacement is that it should be postponed for as long as possible. By delaying surgery, many people who are good candidates for knee replacement begin to give up daily activities. Increased damage around the knee due to delayed surgery can make return to activity more difficult. The most suitable age for knee replacement is between 55 – 90 years. However, in case of fracture and rheumatoid arthritis, it can be performed in younger age groups too.

Patients feel they won’t feel natural post-knee replacement . Is this correct?

There have been significant advances in materials, designs and surgical procedures for knee replacement that help recreate the movement of a natural knee more accurately. In India, a person must be able to sit cross-legged on the floor. It is certainly possible to sit on the floor, and one must discuss it with the surgeon prior to surgery for a suitable implant.

How long does the replacement last?

In most people it will last a lifetime. Studies show survivorship of knee replacements is 95% at 10 years and 85% at 20 years. Since these studies assess implants that were made 20 years ago, the advanced knee implants used in today’s knee replacements are likely to function for even longer.

Is weight a crucial factor for deciding against knee replacement surgery?

Patients up to 136 kg have undergone knee replacement surgery successfully and obesity is not a contraindication to surgery. However, patients with such high BMI (Body Mass Index) would wear out their implants faster.

Is knee replacement painful?

With modern pain management techniques, patients have minimal pain after surgery. In some patients’ epidural anaesthesia and in some nerve blocks are given to minimise pain.

Is recovery and rehab after knee replacement long and hard?

Most people are able to perform routine tasks within a few weeks. Patients can start moving the joint the day after surgery. In 4-6 weeks, most of the patients can walk independently and even climb stairs. They can drive a car or two-wheeler in around 6-8 weeks.

What sporting activities can be done after knee replacement?

With newer implants and improved surgical techniques, a patient is able to get good knee motion. He can go swimming for around 8 weeks, can play golf and do cycling on level surfaces. Patients can even go for slow jogging and play double tennis.

What are some recent advancements in knee replacement?

Earlier, just walking pain-free was the aim of surgery. However, now patients want to do all activities possible, with a natural healthy knee. We have the advent of new implants material, shapes and accuracy, which make the knee replacements last lifetime. Earlier, it was computer guided knees, gender knees, personal knees and now we have robotics. The aim of all these technologies is to help the surgeon achieve the best results. Presently, the technology is focusing on robotic or AI-guided knees. Various follow-up studies from around the world have found not much advantage of these technologies and concluded that surgeon and his experience are paramount.