Common questions on TKR | மூட்டுவலி பற்றிய பொதுவான கேள்விகள் part 2 | Dr. Shriram Krishnamoorthy

Common questions on TKR | மூட்டுவலி பற்றிய பொதுவான கேள்விகள் | Dr Shriram Krishnamoorthy

Hello friends, this video is going to be a continuation of what we saw in the last video. We have been trying to answer the questions related to knee pain and knee arthritis.

Question 1:what is the ideal age for knee replacement?
60 years of age is an approximate cut off. Let me tell you the reason. The lifespan of a knee replacement is somewhere between 15 to 20 years. It means that the replaced knee would not be as good as it was in the initial days. We fix the bone and the implant using a type of cement. There is a chance of loosening at the interface. So when you get the surgery at 60 years, you can push till 80 years. Normally after 80 years, there would not be much demand. So, 60 years is the right cutoff and some hospitals also do it at 65 years. Having said that, we have operated for an 18 to 20 year old rheumatoid arthritis patient and we have also operated for an 80 year old man. It all depends on the problem of arthritis, and the patient's demand.

Question 2: Should it be done in one knee or both the knees?
If the problem is in both the knees, better to do both in the same sitting. Whether one knee is operated on or both the knees are operated on, the rehabilitation duration is almost the same. The hospital stay might get extended by a day or two. If the problem is only in one knee, it is enough to replace one knee. But if you have a disease in both the knees, both can be done at the same time. It takes only one hour for a knee. It is safe and effective.

Question 3: How would life be after knee replacement?
Definitely the quality of life improves significantly after knee replacement. It takes 6 weeks to 3 months for the knee to set well. That can be taken as the time taken by the body to accept the implant. After proper exercise, rehab and physiotherapy for those three months if you start your life you would be really great.

Question 4: What are the restrictions after knee replacement?
In general, there are no major restrictions. For the first 6 weeks we will insist that the legs are placed at a height as there are chances for the legs to swell. This also applies for all lower limb surgeries. In my opinion, one restriction that has to be informed to the patient is, Sitting on the floor with legs folded is not recommended by the implant companies. Somewhere between 130 to 135 degrees is allowed when it comes to the maximum bending of the knee. There would be no problem sitting on the floor. When having to get up, only if you bend the knee more you will be able to get up, which may not be technically possible, and can definitely have an impact on your knee implants in the long run. That is why, it is better to avoid sitting on the floor.
Secondly it is better to avoid running. In our country, at 65 to 70 years, people do not do that, but lately we see more people going to marathons and the elderly population becoming active. So for them, it is better if they avoid running.

Question 5: what is the duration of the hospital stay?
In case both knees are operated on, the hospital stay would be 7 days and if one knee is operated on, the hospital stay would be 5 days. So 5 days and 7 days is what we follow according to our hospital policy. So it is divided as 1 day before surgery, 1 day for the surgery, 3 days in case of single knee, 5 days in case of bilateral or both knees. But it is not always a standard rule. If the patient is really doing good it is possible for them to get discharged 1 or 2 days earlier. So it is not a strict rule again.

Question 6: Should physiotherapy be done after going home?
It is purely based on the individual and not mandatory. The reason is that there are not too many exercises like ligament reconstruction and a young sports injury. For knee replacement such intense physiotherapy is not needed. You need some simple exercises which usually will be taught in the hospital itself. If you feel that you can do better with physiotherapy and if you feel that you can do it in a controlled manner, you can employ a physiotherapist and it is not mandatory.


Chapters

00:28 What is the ideal age for knee replacement?
01:44 Should knee replacement be done in one knee or both knees?
02:33 What would be the quality of life after knee replacement?
03:27 What are the restrictions after knee replacement?
04:40 What would be the duration of hospital stay?
05:23 Is physiotherapy needed after going home?



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