Overview: There is a huge of number of people in the world who all are affected by arthritis, as a result of which they suffer from incapacitating pain which hinders their everyday activities – such as walking, climbing stairs or standing for long periods. The Partial Knee Replacement surgical procedure has generated significant interest because it entails a smaller incision and faster recovery than traditional total joint replacement surgery. Partial knee replacement, also called unicompartmental knee replacement' and 'minimally invasive knee surgery,' removes only the most damaged areas of cartilage, and replaces these surfaces.
What is Partial Knee Replacement Surgery?
A Partial knee replacement, also called a unicompartmental knee arthroplasty,' is a surgery that may be considered for treatment of osteoarthritis of the knee joint. Traditionally, patients have undergone total knee replacement for severe arthritis of the knee joint. In a total knee replacement, all cartilage is removed from the knee joint, and a metal and plastic implant is substituted.
Why Partial Knee Replacement Surgery?
Your health care provider will usually try medicine, injections, and physical therapy for 6 months before considering surgery. Your doctor may recommend this procedure if you have severe arthritis (osteoarthritis) in one side of one knee, which causes the following symptoms:
Inability to sleep through the night because of knee pain
Knee pain that does not improve with other treatments (medicine, injections, and physical therapy)
Knee pain that limits or keeps you from being able to perform your daily activities, such as bathing, preparing meals, and doing household chores.
Your doctor may also recommend this procedure if you have:
Avascular and aseptic necrosis
Who is the Good Candidate for Partial Knee Replacement Surgery?
The Partial Knee Replacement is indicated in patients who have severe arthritis of the knee that have failed conservative treatments may consider this procedure. Conservative measures may include, but are not limited to, medications (such as Advil, Naprosyn, Celebrex, and Vioxx), cortisone injections, strengthening exercises, and weight loss. If these treatments are not adequate, and you as a patient are not satisfied, then surgical procedures may be considered.
The Partial Knee Surgery may be possible if the arthritis in the knee is confined to a limited area. If the arthritis is widespread, then the partial knee replacement is NOT appropriate, and should not be considered. In addition, the partial knee surgery is recommended in patients who are:
Older than 55 years
Have intact ligaments (specifically the ACL)
If these qualifications are not met, then the Partial Knee Surgery may not be as successful. Unfortunately, many patients are therefore ineligible for this minimally invasive procedure.
How to Prepare for Partial Knee Replacement Surgery?
Always tell your doctor or nurse what drugs you are taking; even drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
Ask your doctor the drugs you should still take on the day of your surgery.
If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.
Tell your doctor if you have been drinking a lot of alcohol (more than one or two drinks a day).
If you smoke, you need to stop. Ask your doctor or nurse for help. Smoking will slow down wound and bone healing. Your recovery overall may not be as good if you keep smoking.
Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.
You may want to visit a physical therapist to learn some exercises to do before surgery and to practice using crutches or a walker.
On the day of your surgery:
You will usually be asked not to drink or eat anything for 6 - 12 hours before the procedure.
Take the drugs your doctor told you to take with a sip of water.
Your doctor or nurse will tell you when to arrive at the hospital.
What is the Procedure for Partial Knee Replacement Surgery? To begin the procedure, the surgeon makes an incision on the front of the knee to allow access to the joint. Several different approaches can be used to make the incision depending on whether the outer half (the lateral compartment) or the inner half (the medial compartment) is being replaced. The incisions used to perform the unicompartmental knee replacement are much smaller than those used to perform a traditional artificial knee replacement. For this reason, this surgery is sometimes referred to as minimally invasive. Once the knee joint is opened, a special positioning device (a cutting guide) is placed on the end of the femur. This cutting guide is used to ensure that the bone is cut in the proper alignment to the leg's original angles, even if the arthritis has made you bowlegged or knock-kneed.
With the help of the cutting guide, the surgeon cuts several pieces of bone from the end of the femur. The artificial knee will replace these worn surfaces with a metal surface. Next, the surface of the tibia is prepared. Another type of cutting guide is used to cut the tibia in the correct alignment. The metal femoral component is then placed on the femur. In the uncemented prosthesis, the metal piece is held snugly onto the femur because the femur is tapered to accurately match the shape of the prosthesis. The metal component is pushed onto the end of the femur and held in place by friction. In the cemented variety, epoxy cement is used to attach the metal prosthesis to the bone.
The metal tray that holds the plastic spacer is then attached to the top of the tibia. This metal tray is either cemented into place or held with screws if the component is of the uncemented variety. The screws are primarily used to hold the tibial tray in place until bone grows into the porous coating. The screws remain in place and are not removed. The plastic spacer is then attached to the metal tray of the tibial component. If this component should wear out while the rest of the artificial knee is sound, it can be replaced. The replacement procedure is sometimes called a retread. Finally, the soft tissues are sewn back together, and staples are used to hold the skin incision together.
What are the Post-Operative Care after Partial Knee Replacement Surgery?
For the best result of having the Partial Knee Replacement Surgery, the patients must take care of the following post operative care:
Most patients go home the day after surgery. You can put your full weight on your knee immediately. There is usually less rehabilitation or physical therapy required compared to total knee replacement.
After surgery, you will be encouraged to do as much as you can for yourself. This includes going to the bathroom or taking walks in the hallways, always with someone helping you.
Most people do not need a short stay in a rehabilitation center after they leave the hospital and before they go home.
Most patients have a rapid recovery and have considerably less pain than they did before surgery.
What is the Recovery after Partial Knee Replacement Surgery?
After your surgery, you can expect to start rehab almost immediately. Patients usually stay in the hospital for one or two nights but putting weight on your knee is usually permitted immediately. Exercise training will depend on the age and activity level of the patient and are customized to that patient's abilities. At follow-up appointments with your surgeon, you will get a better idea of the actual length of time to your full recovery, and it depends largely on your regaining your muscle strength. Several studies have demonstrated the advantages of this treatment option over the more conventional total knee replacement. These include: a smaller scar, less pain, a potentially shorter hospital stay, a faster rehab and recovery time, and possibly a greater range of motion when compared to standard total knee procedures. In addition, because more of the knee remains untouched, patients often report that the knee feels more normal to them.
What are the Benefits of having a Partial Knee Replacement Surgery?
The following are the benefits of having a Partial Knee Replacement Surgery:
Smaller Incision: A traditional knee replacement surgery involves an incision about 8 inches over the front of the knee. There is more significant dissection necessary to complete the procedure compared to the unicompartmental knee surgery. In the minimally invasive partial knee replacement, the incision is about 3 inches, and the amount of dissection and bone removal is much smaller.
Less Blood Loss: Because of the extent of dissection and bone removal necessary for a total knee replacement, the need for a blood transfusion is relatively common. With the unicompartmental knee procedure, a blood transfusion is infrequently needed, and patients do not need to consider giving blood preoperatively.
Shorter Recovery: Both the time in hospital and the time to functional recovery are less with the partial knee replacement. Patients are known to have been discharged on the day of the procedure, although most often patients are discharged on the first or second post-operative day. With traditional total knee replacement, patients seldom leave before three or four days in the hospital, and often require a stay in an in-patient rehabilitation unit.
What are the Risks after having a Partial Knee Replacement Surgery?
The risks may include, a higher revision rate for partial knee replacement than total knee replacement and it has infection of the joint, which occurs in <1% of patients.
What are the Alternatives to Partial Knee Replacement Surgery?
Pain and Anti-inflammatory Medications (NSAIDs):Non-steroidal anti-inflammatory pain medications are available over-the-counter (e.g. Ibuprofen, Motrin, Aleve) or as a prescription (e.g. Celebrex, Bextra). NSAIDs are effective at pain relief (analgesia), and to reduce swelling (anti-inflammatory).
Intra-articular Injections: Two medications are commonly used for this purpose; cortisone and synvisc. These medications can be injected into the knee joint (intra-articularly). They provide temporary relief of pain and inflammation in the knee joint, thus helping through the delay and waiting period before Partial Knee Replacement surgery.
Bracing: Braces are devices made of plastic, metal, leather and/or foam, and are designed to stabilize a joint, reduce knee pain and inflammation, and strengthen the muscles of the knee.
Joint Fluid Therapy: This kind of treatment involves intra-articular injections to increase lubrication in the knee joint. This method of treatment to relieves pain and is most often used to avoid or delay Partial Knee Replacement surgery.
Why Partial Knee Replacement Surgery in India?
Of late, India has become the most preferred medical destination for Partial Knee Replacement Surgery. India has some of the best orthopedic hospitals and treatment centers in the world and some truly superior facilities, with almost zero patients wait list. The hospitals and orthopedic medical centers have high end facilities, equipped with latest technology equipments and gadgets.
Hospitals adhere to international standards of clinical care, safe environment, medication safety, respect for rights and privacy, international infection control standards. The panel of Indian orthopaedic surgeons is highly qualified, having the experience of thousands of Partial Knee Replacement Surgery procedures.
They are trained and worked in some of the prestigious medical centres in England, USA & Europe. They have a good success rate and are world renowned medical professionals known to cater service both India and abroad. The Partial Knee Replacement in India is available at various hospitals in the following cities with latest amenities and state-of-art-facilities.
And besides, India has world heritage places and exotic beaches, where the patients can rejuvenate while they recover following any orthopedic surgery.
What is the Cost of Partial Knee Replacement in India?
Significant cost difference is the key in bringing patients all across the world for Partial Knee Replacement in India. India is not only cheaper but delivers medical services at international benchmark. This is due to the outburst of the private sector which is comprised of hospitals and clinics with the latest technology and best practitioners.
Partial Knee Replacement Surgery
Total Knee Replacement
Knee replacement (bilateral)
Some of the common countries from which patients travel to India for surgery are:
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.
Mumbai - Mumbai, formerly known as Bombay in English, is the capital of the Indian state of Maharashtra. This port city (India's largest and busiest) accounts for a major share of the government's revenue, and has one of the world's largest harbour. There are many things to love about Mumbai. One is simply the geographical names, like The Queen's Necklace and Elephanta Island, all with roots in the British Empire.
Hyderabad - Also known as City of Nizams. The city of Hyderabad has its own individual character, which is evident in the beautiful, ancient palaces and the equally modern, and state-of-the-art offices and buildings. Medical tourism at hospitals in Hyderabad combines care for your health with international tourism. The primary reason
behind its surging popularity is better healthcare services at an affordable budget.
Goa - Popularly known as the ‘Rome of the East’, Goa boost of natural, magnificent churches and exquisite works of man. Plunge into the clear blue water of the large pool, or soak in the blissful sunshine on the picturesque island. Goa is an interesting location for getting your health propped up and getting those long postponed surgeries done. You have modern facilities, short waiting times and very affordable prices for procedures, hospital services and medicines.
Bangalore - The progressive and modern city of Bangalore is the state capital, being located within India's Karnataka state. Bangalore is often referred to as the country 'Garden City', due to its high concentration of parks and green spaces. Bangalore has few of the world’s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA.
Nagpur - Nagpur City has many distinctions. It is also the second greenest in India and is located at the very center of the heartland, almost equidistant from Kolkata, Chennai and New Delhi and Mumbai. The present city was founded in the early 18th century by Bhakt Buland, a Gond prince of the kingdom of Deogad in the Chhindwara district. The Nagpur District has a varied culture, as well as being in the central part of India, the market in Nagpur is flooded with products from all over India. Nagpur has few of the world’s best doctors and medical practitioners, who have been trained in countries like UK and USA.
Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet.
Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.
Pune - Once referred to as the Oxford of the east, Punecontinues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism.
Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India.
Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.
Gurgaon - Located in the National Capital Region, Gurgaon is one of the most rapidly growing cities in Greater Delhi. In the last few years Gurgaon has boomed as the hub of IT and other new-age businesses. Gurgoan is the latest destination for Medical Tourism in India as it is the latest modern upcoming city near Delhi.
Chandigarh - Located near the foothills of Shivalik range of the Himalayas, Chandigarh is one of the most beautiful and happening cities of India. Chandigarh has great potential for Medical tourism as the unpolluted and excellent environs give many opportunities to patients to recover from their illness.
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