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Pain in the knee joints. Knee replacement advised. What type of implant and anesthesia will be used?

I am 61 yrs old female. I have severe pain in my knee joints from last several years. I have taken medications prescribed by local doctors but of no use till date. Now, some of renowned local doctors are prescribing for knee replacement surgery. I need help from your side regarding the following queries regarding the operation----
•     What type of anesthesia will be used? What are the risks?
•     What type of implant will be used? What is the track record for this type of prosthesis?
•     What is duration for the whole operation (including pre- operative preparation and post operative rehabilitation)
•     What options are available to avoid a blood transfusion?
•     How long will I have to stay in the hospital?
•     How much pain is normal to expect and how long will it last? Will I receive medication for the pain?
•     When will I start physical therapy? Will I need home or outpatient therapy?

•     Does your hospital offer any in house rehab facility?

•     Will I need to arrange for some assistance at home? If so, for how long?
•     What limits will there be on activities - such as driving, bathing, climbing stairs, eating?
•     How long will I need to be out of work?
•     How often will I need to return for follow-up visits?
•     What complications can arise after surgery? What are the signs of complications?
•     What is the overall cost of the whole treatment (including the operation)?
Asked On : Wed, 27 Mar 2013
Answers:  1 Views:  85
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

The answers for your questions are as follows -
* Anesthesia will be Combined spinal and epidural analgesia
* There are many complications associated with the surgery itself (the main ones being infection and deep vein thrombosis) and the anesthesia risks (anesthetist is a better person to explain them)
* Cobalt chrome implant. Either PS(posterior stabilized) or CR(cruciate retaining) prosthesis are used commonly
* The survivorship of these implants is 95%-98% at 15 years
* Surgical procedure takes around 60-90 minutes
* You won't perceive any pain as long as the epidural catheter is in
* Once the epidural catheter is removed (generally after 2 days), you will receive conventional pain killers afterwards
* If your Pre-op Hb% is good and you don't bleed too much in the Post-op period, then blood transfusion is not necessary
* Generally, PT is started within the first week and is patient tailored
* This if patient dependent
* I don't have a hospital of my own. I am a consultant only
* Generally, there is no need of an extra caretaker. You can ambulate using a walker or a cane (for 3 weeks maximum)
* You may need around 6-8 weeks to regain your normalcy
* For sedentary work (office chair work), you can attend within a week. For outdoor jobs, 6-8 weeks
* Follow ups every one month for initial 3 months of discharge from the hospital and then depending upon the need
* It not possible to mention here about all the possible complications (as mentioned earlier infection and DVT are the most feared ones)
* It will cost you around 1.5 lakh - 2 lakhs (depending upon the implant and the package you opt for )

Hope this information is helpful . Good day
Answered: Sun, 21 Jul 2013
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