Six Facts About Total Knee and Total Hip Replacement

 

1. When were the first hip and knee replacement surgeries performed?

Total knee replacement is one of the most important orthopaedic surgical advances of the twentieth century. The development of total knee arthroplasty dates back to 1860, when the German surgeon, Themistocles Gluck, surgically implanted the first primitive hinge joints made of ivory. Since then, pig bladder, nylon, femoral sheath, anterior bursa of the knee, cellophane and many other materials have been used, but the results have been disappointing.

The use of metal (alloys) in total knee replacement surgery began in the late 1930s and over the years, the implants for knee replacement surgery have also advanced. This has resulted in more robust and longer-lasting joint replacements. In addition, the surgical techniques used to place the implants have also significantly improved. This allows for shorter duration surgeries, shorter hospital stays and a quicker return to normal levels of activities.

Hip replacement surgeries began in the late 19th century. During this time, many of the patients were veterans who had received traumatic battlefield injuries, resulting in significant diseases in their hips. Many different materials were used in these early surgeries, including ivory, glass and various types of metals. The materials and surgeries advanced rapidly in the 20th century, resulting in the modern implants used today.

2. What benefits does a joint replacement surgery offer?

The main benefit of Joint replacement surgery is pain relief from arthritis. The ability to move again without pain will enhance your daily life, allowing you to resume activities and improve your overall quality of life. Also, the majority of arthritic patients have deformed knees and hips which get corrected following a joint replacement surgery, thereby making them walk better.

Unfortunately, the surgery will not give you back the hip or knee you had when you were young. However, it can allow you to return to activities and experiences you’ve been unable to enjoy because of your joint pain.

3. Is it the right time to undergo joint replacement surgery?

Pain and stiffness are the most common symptoms of arthritis. Often times, this is most severe in the morning and improves throughout the day. However, too much activity can also increase pain.

In the early stages, you may experience pain or discomfort only while climbing or going downstairs. Subsequently, as the arthritis advances, you can expect your knees to get deformed and have constant pain in them.

The only way to know if arthritis is the cause of your pain is to obtain X-rays of your knee or hip and discuss your pain with a Joint specialist doctor.

If you and your doctor determine that arthritis is the culprit, then you may decide that a joint replacement is the right thing for you.

4. Can I Avoid Surgery?

Before you consider surgery, your doctor may recommend the following non-surgical options :

  • Weight Loss

  • Physiotherapy

  • Pain Killers / Anti Inflammatory medications

  • Cortisone (Steroid) injections

  • Hyaluronic (Gel) Injections

In some cases, these solutions may ease knee and hip pain for a while. However, if symptoms persist or become worse, surgery might be the best option. Delaying or declining surgery for a long period of time may result in the need for a more complex operation and less favourable outcome.

5. Are there any risks involved?

The risks of joint replacement are the same as any other surgery. The two most common risks are bleeding and infection. One can even expect blood clots to form in your legs post any such major surgery. Overall, the risks are quite low, and many steps are taken to prevent such complications.

Risk specific to hip replacement surgery includes dislocation, where the ball comes out of the socket. However, with the advent of new implants and surgical techniques, this has been minimized to a great deal.

6. Why might someone need to see a joint replacement physician?

There are many causes of hip and knee pain. However, in order to help determine what is causing your symptoms, you may need to seek help from a specialist. If arthritis is what is causing your pain, then you will likely be referred to a joint replacement surgeon to discuss non-operative and operative treatment of your pain.

 

Dr Rohan R Dessai 

Orthopaedics, Joint Replacement Surgeon

Manipal Hospital, Goa 

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