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Total Knee Replacement

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Total Knee Replacement

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Total knee replacement surgery in Dubai at Emirates Hospitals Group. Also known as total knee arthroplasty (TKR), is a highly successful procedure that relieves chronic knee pain and improves joint function. At Emirates our Orthopedic Surgeons that specialise in knee replacement surgery are German, French and UK Trained. It involves replacing the damaged surfaces of the knee joint with artificial implants made of metal, plastic, or a combination of both. This surgery is considered life changing for patients with severe arthritis or injuries that significantly impair their daily activities.

– The TKR Surgery Procedure
– Symptoms Indicating the need for TKR
– Diagnosis of TKR
– Recovery Process & Protocols of TKR Surgery

The TKR Surgery Procedure

Total knee replacement surgery in Dubai is typically performed under general anesthesia, though spinal anesthesia may be an option in some cases. During the surgery, the surgeon makes an incision over the knee joint to access the damaged bones. The damaged portions of the femur (thigh bone), tibia (shin bone), and patella (kneecap) are carefully removed and resurfaced with the implants. These implants are designed to mimic the natural movement of the knee joint and restore its stability. Following the implant placement, the surgeon repairs any surrounding tissue damage, closes the incision with stitches, and applies a bandage.

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Symptoms Indicating the need for TKR

Chronic knee pain is the primary symptom that may necessitate a TKR. This pain is often persistent and interferes with daily activities like walking, climbing stairs, or getting up from a seated position. The pain may also worsen at night, making sleep difficult. Other symptoms that might indicate the need for TKR include:

  • Stiffness in the knee, making it difficult to bend or straighten the joint
  • Swelling and inflammation around the knee
  • Deformity of the knee joint (bowing inward or outward)
  • Weakness or instability in the knee
  • Difficulty performing basic activities due to knee pain

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Diagnosis of TKR

Diagnosing the need for a TKR involves a comprehensive evaluation that normally includes:

  • Medical history: The doctor will discuss your symptoms, duration of pain, and any previous injuries or surgeries on the knee.
  • Physical examination: The doctor will assess your knee joint for tenderness, swelling, range of motion, and stability.
  • Imaging tests: X-rays are used to visualize the bones and assess the extent of joint damage. In some cases, an MRI scan may be recommended to evaluate the soft tissues like ligaments and cartilage.

Recovery Process and Protocols:

Following TKR surgery, our patients typically stay in the hospital 2 or 3 days, although same day discharge in selected cases maybe a possibility. During this time, pain management is a priority, and physical therapy is initiated to help regain strength and mobility in the knee. The physical therapy program will gradually increase in intensity, focusing on strengthening the muscles around the knee and improving flexibility. A recovery process overview is below:

  • The first few weeks: Focuses on pain management, reducing swelling, ensuring you use crutches or a walker safely. Gentle exercises to improve knee movement and circulation are also initiated.
  • 6-12 weeks: Physical therapy becomes more intensive, with exercises aimed at strengthening the muscles and increasing range of motion.
  • 3-6 months: Continued physical therapy sessions help regain full strength and flexibility in the knee. Most patients are able to resume most daily activities during this period.
  • Beyond 6 months: Continued exercise and maintaining a healthy weight are crucial to ensure long-term success and maximize the lifespan of the knee replacement.

Knee Replacement Recovery Dubai

Total knee replacement surgery is a major procedure, but advancements in surgical techniques and pain management have significantly improved patient outcomes while reducing recovery times and pain. Most patients experience significant pain relief and improved mobility after TKR surgery, allowing them to participate more actively in their daily lives.

Frequently Asked Questions

Minimally invasive knee replacement surgery is where we as surgeons use specific techniques to avoid damage to tendons and muscles when performing a knee replacement surgery (via the use intermuscular planes so that muscles or tendons are not disturbed or cut). These approaches are associated with less muscle damage, less bleeding and faster recovery.

Any joint replacement surgery whether it is minor or major surgery is associated with a certain level of discomfort, however we have a very customized approach to pain management where we use spinal anaesthesia, regional and local anaesthetic infiltration around the knee itself, we use a nerve block, so patients are very comfortable once they wake up after the knee replacement. The intensity of the pain level is also very much controlled.

On average a knee replacement surgery should take anywhere between 60 to 70 minutes. This is the time taken from skin incision to skin closure.

On average most patients go home between the third and fourth day, however everyone recovers at a different rate and some people the criteria in terms of vital signs, exercise routines etc and are happy to leave after 48 hours. There are specific enhanced recovery protocols where in very select cases, patients maybe eligible (with correct home support) to discharge same-day. 

There are well-documented bodies of evidence to indicate that a well-performed  total knee replacement surgery should last the patient 20-25 years of full functional capability. 

A total knee replacement surgery is a procedure performed  when a patient is suffering from advanced osteoarthritis resulting in the articular cartilage of the knee becoming completely worn out. This results in excess osteophytes (excess bone) developing, which becomes painful. An artificial implant is used to replace and resurface the worn out parts of the knee.

Although a frequently conducted procedure with very low likelihood of complications, TKR is still considered a major surgery, and with any major surgery certain complications even if minimal are a possibility.  These include: Fracture, wearing out of the prosthesis, Persistent pain, Potential bleeding, Infection, blood clots in the legs or lungs

There are different schools of thought, however If the surgeon has determined clinically and radiologically that knee replacement is the definitive treatment of choice then there are a number of reasons why it may be best not to delay a total knee replacement too long:

  • Loss of muscle bulk due to reduced activity level
  • Reduced cardiovascular activity due to reduced activity level can affect the overall recovery 
  • When muscle bulk is lost if can affect function post TKR as you need muscles to work the new knee

It all depends on what that individual was doing before their knee surgery.  For sporting activities it varies. Working out in the gym, some basic cardio training cardio can start within four to six weeks after the knee replacement surgery. 

For outdoor activity, it’s advisable to wait longer, 6-12 weeks, but you need to take a customised approach based on your own confidence, healing, activity level. You may need to take things a but easier as you should avoid putting yourself at risk with a new knee replacement. 

 

Whether a patient will have an artificial kneecap or keep original kneecap is usually determined by the surgeon at the time of surgery.  If the kneecap has worn out a lot and is affected by grade 4 osteoarthritis then it is better to replace with an artificial kneecap.

Last update date: 23-06-2024

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