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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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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)?
Mon, 22 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
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
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Pain In The Knee Joints. Knee Replacement Advised. What Type Of Implant And Anesthesia Will Be Used?

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