An operation called a total knee and hip replacement involves replacing the worn-out or damaged knee and hip joints with prosthetic (artificial) joints made of metal or plastic. The femur, which is the lower half of the thighbone, the tibia, which is the upper portion of the shin bone, and the patella can all be replaced (the back portion of the kneecap). Three components make up the prosthetic hip joint: a stem, a ball, and a cup.

Why is total knee and hip replacement recommended?

Patients with severely damaged knee and hip joints from osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, or accident are advised to have a total knee and hip joint replacement. Even short distances of walking become uncomfortable and difficult due to arthritis' stiffening of the joints. When previous treatments, such as medication, exercise, or other therapy, have not been successful, joint replacement surgery for the knee and hip is typically explored.

How it is performed

The procedure for total knee and hip replacement is discussed below:

• Total Knee Replacement

Total knee arthroplasty, or knee replacement surgery, is carried out under general anaesthesia, spinal anaesthesia, or epidural anaesthesia. An 8 to 10 inch long incision is used to open the knee. To cut away the diseased cartilage at the thighbone and shin bone's ends and replace it with a metal prosthetic, the kneecap is relocated. A medical-grade plastic spacer is put between the metal prosthesis to provide a smooth gliding surface. The prosthesis, which is often constructed of robust plastic, is used to replace the kneecap's back section.

• Total Hip Replacement

Total hip arthroplasty, or hip replacement surgery, is carried out under general anaesthesia, spinal anaesthesia, or epidural anaesthesia. Traditionally, longer incisions are made over the hip joint during hip replacement surgery. A few tiny incisions are made on the hip joint in a more sophisticated technique to access the hip joint (minimally invasive hip replacement). Hip prostheses consisting of metal, plastic, or ceramic are used to replace the damaged cartilage and bone after they have been removed. The stem is inserted into the femur, which is the thigh bone, and a cup is positioned inside the socket of the hip joint. A ball or head joint is then fastened to the stem. Book an appointment at our Joint Pain Treatment Hospital in India to know more about Total Hip Replacement.

• Pins, screws

Pins, screws or cement are used to secure the replacement joint in place once the prosthetic knee and hip joints have been repaired. To stop infection, the wound is treated and sutured.

Advantages of total knee and hip replacement surgery

Following are the advantages of total knee and hip replacement surgery:

• Knee and hip pain that is unresponsive to medicine, exercise, or other treatments can be relieved by total knee and hip replacement surgery.

• The alignment and functionality of the knee and hip can be efficiently restored by prosthesis.

• Following joint replacement surgery for the knee and hip, the patient can function normally and perform daily tasks on their own.

Cause of Total Knee Replacement (TKR)

The most frequent causes of persistent knee pain and impairment that result in complete knee replacement surgery are as follows:

• Osteoarthritis

It is a form of arthritis that typically affects adults over 50. The cartilage that shields the knee bones deteriorates with age and from the wear and tear of the bones over time, which causes the bones to rub against one another and cause discomfort and stiffness in the knee.

• Rheumatoid arthritis

The cartilage that cushions and protects the knee joint is damaged when the synovial membrane surrounding it becomes inflamed.

• Post-traumatic arthritis

Any accident that damages the bone or cartilage in the joint, producing early arthritic degeneration.

Cause of Total Hip Replacement (THR)

The major cause of chronic pain and disability in the hip results into total hip replacement involving:

• Osteoarthritis

It is the arthritis type that primarily affects those over 50 or those with a family history of the condition. The cartilage that shields the hip bones deteriorates with age and from the wear and tear of the bones over time, which causes the bones to rub against one another and cause hip pain and stiffness.

• Rheumatoid arthritis

This autoimmune condition, also known as inflammatory arthritis, causes destruction to the cartilage that cushions and protects the hip joint by inflaming the synovial membrane around the joint.

• Post-traumatic arthritis

Any accident that damages the bone or cartilage in the joint, producing early arthritic degeneration.

• Osteonecrosis

Osteonecrosis, also known as avascular necrosis, is brought on when the hip joint dislocates or fractures, reducing blood flow to the femoral head and resulting in the collapse of the bone surface.

• Childhood hip disease

The hip may not develop normally in new-borns and kids with hip issues, which could compromise the joint surfaces.

Why is surgery recommended?

The reasons for the surgery recommendation is discussed below:

• Total Knee Replacement

Surgery is advised when other treatments, such as anti-inflammatory drugs, lubricating injections, cortisone injections, or physical therapy, have failed to provide relief from severe knee pain and stiffness in patients; when knee pain persists even while resting or sleeping; when knee swelling does not go away with rest and medications; or those who find performing daily activities like walking, bending, sitting, or standing to be a struggle due to their knee pain and stiffness.

• Total Hip Replacement

When other treatments, such as anti-inflammatory drugs or physical therapy, have failed to provide relief from hip pain and stiffness in patients who find performing regular activities, such as walking, sitting, or standing, an ordeal due to severe hip pain and stiffness, and when hip pain persists even while resting, surgery is advised.

The Orthopaedics Evaluation

Your situation is evaluated by an orthopaedic specialist to establish the best course of action for treating your chronic knee or hip pain, stiffness, and disability. Typical components of an orthopaedic evaluation are:

• Medical history: Your orthopaedic physician will inquire about your general health as well as the level of hip or knee discomfort you experience while doing daily activities.

• To examine knee or hip motion, strength, stability, and overall alignment, a physical examination will be conducted.

• X-rays can be used to evaluate the degree of injury and deformity to the knee or hip.

• To examine the bone and soft tissues of your knee or hip, other procedures, such as blood tests and advanced imaging tests like MRIs, may also be carried out. Visit Manipal Hospitals for Knee and Hip Replacement Surgery in India.

Outcome

Numbness and stiffness at the location of the incision are possible; these symptoms are typical and often go away with time. The majority of patients report being substantially more able to kneel or bend their knee than they were before the implantation. While bending or walking, you might also hear or feel the metal and plastic clicking, which is typical. Your new metal knee or hip implants could trigger metal detectors at malls, airports, and other public places. In such circumstances, tell the security guard about your hip or knee replacement operation.

Precautions after surgery or the possible complications

Following surgery, you must exercise considerable caution by avoiding accidents, slips, and falls, as well as sudden movements that could break or fracture a bone and necessitate additional surgeries. Your new knee or hip may become stronger and more mobile with little light exercise. If a dental operation necessitates the use of antibiotics, you might need to get in touch with your orthopaedic surgeon. Be sure to attend all of your scheduled follow-up exams and x-rays.

Surgery on the hips and knees is both safe and successful. Post-knee or post-hip surgical complications are typically rare. A knee joint infection is one of the major consequences that less than 2% of patients have reported. Among the potential side effects from knee or hip operations are:

• Infection: Infection at the location of the incision or close to the implant might develop soon after surgery, even years later. While small infections are typically treated with medication, major infections may necessitate additional surgery. Your knee or hip joint replacements could become infected if it has already begun in another area of your body.

• Blood clots: The development of blood clots in the leg veins is one of the most often occurring side effects of any operation, even those involving knee or hip replacements (pelvis, calf, or thigh). When they circulate through your body and get to your heart or lungs, they become life-threatening. This complication can be avoided with the help of blood-thinning medications, early mobilisation, stockings, and regular evaluation of your legs by a doctor.

• Leg-length inequality: Patients may feel that one leg is longer or shorter than the other, especially after a hip replacement.

• Dislocation: In particular during the initial few months following surgery, there is a substantial danger of the hip ball coming out of the socket. This issue can be solved, though.

• Wear and tear of the Implant: Even with new and improved implants, parts may become loose and the surface may become damaged with time. It is possible for the knee or hip to become scarred, which would limit movement.

• Even after a knee or hip replacement, a few people still experience discomfort. But this is really unusual.

• Neurovascular injury: Rarely, the procedure may cause injury to nearby blood vessels or nerves near the knee or hip.

Activities to avoid at home or daily routine after both TKR and THR surgeries

The advantages of TKR or THR surgery include a notable increase in pain reduction and the capacity to carry out daily tasks. To continue to receive these benefits, proper caution must be used. Avoid gaining weight, moving heavy objects, or engaging in vigorous exercise like leaping, sprinting, skipping, etc. as these activities increase the risk of the implants becoming loose and dislocating. You can, however, routinely engage in activities like walking, swimming, driving, etc. Knee or hip replacements can survive for several years when used normally.