Knee Replacement Surgery in Gurgaon

Knee replacement is required for advanced arthritis of the knee joint, producing painful limitation of movements and restriction in activities of daily living.

We always strive to avoid knee replacement surgery in people younger than 65 yrs of age for two reasons- 1) Knee Replacement implants can survive well for a period of 15-18 yrs; thereafter many such patients will need a revision surgery. Patients undergoing knee replacement after 65 yrs usually do not need second surgery. 2) Up to 75 -80% patients under 65 yrs of age with Gr 3 or 4 stage arthritis have responded very well to Intraarticular injections particularly PRP & GFC therapy or lubricant ( Sodium Hyaluronic Acid). This method has helped our patients delay or avoid knee replacement surgery. Steroid injections should be avoided at all times.
Knee Replacement is an elective procedure, and should only be offered to patients after all conservative treatment options have failed.

Knee replacement can be total or unicondylar, depending on the number of compartments involved. Among the total knee replacement, there are two popular designs- Cruciate Retaining, and Posterior Stabilized. The decision for the design is best taken by the operating orthopedic surgeon based on the integrity of ligaments. Patella resurfacing as a routine is a debatable subject. Some surgeons replace it; some don't.

Bilateral knee replacement in the same sitting, can be performed if both the knee joints are damaged to the same extent, however the medical condition of patient, and bone quality must be kept in consideration.
Recovery after single knee replacement takes approx. 3 weeks; both knee replacement take about 2 months for good recovery.
In case of Heart conditions or uncontrolled Diabetes mellitus or Kidney/ Liver damage, we advocate knee replacement in stages to minimize risk to the patient.

Knee Replacement patient start standing or walking from the next day of surgery.
After a unilateral knee replacement, most patients can resume community ambulation within approximately 3-4 weeks, and start office after 6 – 8 weeks.
In a Bilateral Knee replacement, patients attain community ambulation status after an average of 10-12 weeks (approximately 3 months).

In our practice, most of the patients are able to walk without support approximately 3-4 weeks after surgery.

The most significant risks include Infection, Deep vein thrombosis, and Aseptic loosening of implants. The risks correlate with the co-morbid medical condition, and must be discussed with the patient before surgery. Adequate information and precautions help in significantly reducing risk of complications.
Overall, Knee Replacement is considered successful in > 95 % of patients.

All knee replacement surgeries are performed under tourniquet control; so there is almost no blood loss during surgery. After operation a drain is inserted to remove any collected blood from the joint. Routine use of Tranexamic acid injection significantly reduces the post surgery blood loss.
Most of our Single Knee replacement patients do no need any blood transfusions. For those undergoing a simultaneous both knee replacement surgery, we keep 1 unit of blood as standby, and use it only when absolutely necessary.

A single knee replacement takes approximately 90 min- 2 hours. Both knee replacement surgery takes approx. 3- 4 hours.
Patients normally require hospitalization for 3 days in single knee replacement, and up to 5 days in both knee replacement surgery.

We routinely do knee replacement surgery under Combined Spinal & Epidural anesthesia. It not only provides adequate pain control during surgery, but also helps with faster painless recovery. Additional options including a Adductor Catheter and dermal patches have helped our patients maintain good mobility starting next day of surgery.

Due to placement of a foreign implant inside the body, patients should always get a medical opinion in case of any suspicion of infection elsewhere in body, and a proper antibiotic prophylaxis before planned surgical procedures, or even a dental procedure.

The approximate cost for a single knee replacement surgery starts around 2.5 to 3 lakh in a corporate hospital. Both Knee replacement surgery cost between 4.8 - 5.5 lakh. Cost of surgery varies according to the 1) Accommodation, 2) Implant Category.

In a robotic knee replacements, a few cuts are made using the robotic arm based on information fed into the system.
The robotic system utilizes the same implants as standard knee replacement; blood loss, post operative pain, recovery speed or long term results are also similar.

Based on world wide studies, there is no statistically significant difference in clinical or functional results, or complications between a standard or robotic knee replacement. (Pubmed Article)
Patient may choose either technique based on the recommendation of their treating surgeon.

Robotic Knee Replacement needs an additional cost of 60,000- 1 lakh INR towards the expenses on technology. It is not covered by insurance. 

If you have been recommended for a Knee Replacement, we can help you understand the best treatment plan for long term survival of the implant.