After a single total knee replacement, 4-5 days of hospitalization is sufficient. This is to provide pain relief and mobilization. For sequential bilateral knee replacement you will get ten days in hospital. For simultaneous bilateral surgeries under one anesthesia, you will get 6 days in hospital.
You can do so within 24 – 48 hrs after the operation.
If you are young & fit, then both knees can be done in one sitting (Bilateral simultaneous TKR). An approximat cut off age for bilateral simultaneous knee replacements is 65 years. In older patients and those with co morbidities I advice a gap days or months between the two procedures.
We can operate on patients with notice of a day or two for a straight forward primary knee and one week for revision knees. If you want patient specific instrumentation, then four to five weeks are required between the MRI scan and operation for cutting blocks to be manufactured and shipped.
A primary total knee replacement takes between about an hour to 90 minutes. Anesthetic induction time is about 30 minutes. Extubation and shifting takes another 15 minutes. The turnaround time is about 3 hours. A difficult knee may take about two to two and half hours.
You can have the operation done under general anesthesia (fully unconscious) or a regional anesthesia( spinal or epidural) in which you will be sedated but not knocked out. Regional anesthesia is a safe mode for diabetics and elderly people. Both are often supplemented by regional nerve blocks.
Many patients in our practice are diabetic. My anesthetist is very competent at epidural anesthesia and hence the operation is pretty safe. Wound healing is good in well controlled diabetes. If control is poor, I recommend working with your diabetologist to achieve adequate control.
This depends on the nature of the job. In a sedentary or desk top job it would be possible after a month to six weeks. If the job requires a lot of standing and walking, then two months are required.
The ideal age is more than 65 years. I don’t refuse the procedure to younger patients with incapacitating pain. My youngest patient so far is twenty five years and my olderst patient in India is 87 years. Durable implants and smart tools technology have made this possible.
Where suitable, I perform cartilage surgery by arthroscopic and open methods. Abrasion chondroplasty and microfracture are arthroscopic procedures. Autologous cartilage implantation is suitable for small to medium areas of cartilage loss. In this your own cartilage cells are removed, cultured and put back in a damaged area of your knee. An osteotomy is advisable you have mal alignment; if your job is strenuous and the cartilage wear is one sided only (Seen on weight bearing x rays).
