FAQ Frequently Asked Questions

Patients are kept in hospital for 3 to 4 days for TKR and THR surgery.

Patients are made to stand and walk on the day of surgery or the next day. They can use toilet from next day onwards. They will require walker or a stick for few days.

Early post-operative complications include bleeding from wound, urinary retention, constipation and fever. They can be very well managed with help from a physician. Complication after discharge from hospital include swelling of leg which may be due to blood clot formation in leg vein (Deep Vein Thrombosis). This may also lead to shortness of breath and chest pain, due to Pulmonary embolism (Clot entering to lungs). This is a life threatening complication and all patients receive blood thinner medication for 2 weeks after TKR and 5 weeks after THR.

Wound infection is other worrisome complication, which may present with increasing pain, stiffness, fever and discharge from the wound. Patients are operated in clean operation theaters and due attention is paid to sterilization and asepsis to prevent infection. Patients are given IV antibiotics peri-operatively and Antibiotic mixed cements are used in high-risk cases.

Late complications include persistent pain, stiffness and instability. Most of the patients are pain free by the end of 3 months after surgery. Persistent pain requires investigation to find cause of pain. Range of motion after TKR gradually improves and most of the patients can bend the knee up to 110 degrees by 3 months time, which can improve till one year. Pre-operative range of motion is the most important determining factor for post-operative movement. Ligament instability after surgery requires supporting braces or revision surgery to constrained prosthesis.

Apart from complications mentioned above, Dislocation is one complication specific to THR. Patients have to follow certain precautions for first 3 months, which include avoiding sitting on low chair or sofas and crossing legs while sleeping. Another possible complication after THR is leg length inequality. We use variety of techniques to prevent this complication, still 0.5 to 1 cm difference in leg length may occur in up to 1% patients.

Most of the patients are able to bend their knees and hip enough to sit in crossed leg position by 6 months time. Some patients with muscle stiffness may not be able to do this.

The so called Hi-flex knee is suppose to have more flexion as compared to conventional knee. There are certain designs of Knee prosthesis, which accommodate deeper flexion after TKR; but they don't guarantee better flexion after surgery. Flexion after surgery depends up on muscle flexibility, preoperative flexion, surgical technique and implant design.

Currently used knee joint prosthesis have survivorship of around 15 years in 80-90% cases. Early failure may occur in case of infection, instability or fracture. Ceramic-on-ceramic hip has longest survivorship followed by Ceramic-on-poly and Metal-on-poly has shorter survivorship (around 15 years) amongst all.

You can climb stairs as early as second day after surgery, depending up on your comfort. Patients who have cementless THR are allowed to climb stairs after 6 weeks.

Patients can start car driving after 4 to 6 weeks depending up on comfort level. Two wheelers are allowed after 3 months.

Patients undergo routine blood and urine examination before finalizing date of surgery. TKR patients are also tested for MRSA bacteria. Patients' cardiac status is evaluated with ECG and Echocardiography before surgery.

Humans carry bacteria on their skin. Some of them carry bacteria which are difficulty to treat with routine antibiotics. MRSA (Methicillin Resistant Staph Aureus) are such bacteria. Postoperative infections caused by them is difficult to cure. So, patients are tested for their presence before surgery, by swab taken from finger tips, nose and axilla. Those who turn out to be positive are called MRSA Carriers and they have to apply ointment in their nose and use anti-bacterial soap for treatment.

Weight is not an issue when we perform TKR using Computer Navigation system. Computer precisely guide us with implant placement and ligament balance, thereby give satisfactory and long lasting result. We have successfully operated a patient of 130 kg using this technique.

Overall physical condition is more important than chronological age. We have operated patients up to 92 years of age for joint replacement. Absence of Co-morbidities like diabetes and high blood pressure and absence of heart, lung, kidney or liver disease make operation safer at any age.

Blood thinner medicines should be avoided from 5 days prior to surgery, but, you MUST discuss this with your physician, because, in some cases alternative medication may be required.

You can take bath as soon as you are comfortable to visit bathroom. You can cover the wound with plastic and take bath.

We usually open the wound dressing after 14 days of surgery, unless it is soaked.

You can sleep on either side as soon as you are comfortable after TKR surgery. In case of THR, you can sleep on opposite side as soon as you are comfortable, sleeping on side of surgery is allowed 6 to 8 weeks after THR as per patient's comfort.

You can sleep on either side as soon as you are comfortable after TKR surgery. In case of THR, you can sleep on opposite side as soon as you are comfortable, sleeping on side of surgery is allowed 6 to 8 weeks after THR as per patient's comfort.

There is no upper or lower age limit for partial knee replacement.

All surgeries result in some pain. While pain after partial knee replacement varies by patient, typically patients experience less pain and stiffness following partial knee replacement than they do after total knee replacement.

Although not all patients are able to return to unrestricted sports activity, most patients are able to resume biking, golf, tennis and skiing.

Partial knee replacement usually involves minimal blood loss and is associated with a low rate of complications. As with any joint replacement surgery, complications may include instability of the knee, loosening of the implant, infection, nerve injury and deep vein thrombosis. Generally, complications occur less frequently after partial knee replacement than they do following total knee replacement. Be sure to discuss any concerns you have regarding these or other issues with your surgeon.

One of the advantages of partial knee is that the recovery is faster and hence many patients go home within 48 hours. Others may take longer.

Please ensure that your wound is covered with the dressings and kept dry until the clips/sutures are removed. You can take shower keeping the wound covered with plastic. Contact our clinic if you see discharge or bleeding from the wound.

Yes. This is an extremely important part of the recovery as only you can get the movement and strength back in your knee. They aim to stop your knee getting stiff and to strengthen the muscles. It is common to have pain immediately after surgery and for some weeks. Use pain medication to control the pain and do not be frightened to gently move your knee joint and walk. Initially the best exercise will be moving the knee during normal, gentle activities. You cannot damage the surgery that has been done but overall let the pain settle before over-challenging the knee. Follow the advice from your physiotherapist.

There are no restrictions (other than the pain) to movement although kneeling on your knee is not recommended until about 6 weeks after surgery.

Drive once you are no longer using your crutches or sticks and feel you can be in complete control of your vehicle. For most patients it may be possible to drive at around 6 weeks depending on how quickly you are recovering.

Returning to work depends on your level of mobility and your job but you must avoid any strenuous activities for at least three months (for example lifting heavy objects). Ask your consultant and physiotherapist about specific work related or sporting activities.

Research shows that 80% of patients will still have a well functioning partial knee at 20 years after surgery.

Partial knee replacement is a more complex operation to perform than total knee. It requires special training and expertise on part of operating surgeon, not all surgeons are trained in partial knee, that is why very few surgeons offer this option to their patients. In addition to that, surgeons and patients have fear of progression of arthritis in other compartments of knee, requiring another operation.

Partial knee can be performed in presence of bowing of leg, provided deformity is correctable to pre-arthritis level. This procedure will restore natural alignment of the knee.

It can be, but operating two knees at a time will put more stress on body and increase the risk of complications. It is safer to perform one knee at a time. Usually, two knees can be safely performed at an interval of six weeks.

In majority of patients, arthritis starts from inner compartment of knee. Other compartments are damaged secondary to progression of deformity and ligament damage. If we correct alignment at early stage of the disease, arthritis will not progress to other parts.

This can happen if patient has inflammatory arthropathy, partial knee should be avoided in such cases. This can also happen if ligament is damaged. If this happens, total knee replacement can be performed.