Total Knee Replacement


Now you can get medical tourism type price and quality for procedures received in the US.

How is that possible?
Because Healthbase has partnered with several US healthcare providers that offer procedures at very competitive prices that are comparable to what American-accredited foreign providers offer.

So now affordable high quality medical care is made available closer to home for patients from the US, Canada and Mexico. Patients from European countries and other nations looking for top quality care in the United States also stand to benefit from this partnership.

According to Saroja Mohanasundaram, CEO of Healthbase,

Majority of our clients from North America are drawn to medical tourism for the cost advantage it offers. However, some may not be able to take advantage of it due to the travel involved. So Healthbase has negotiated with US-based providers to offer the same top US-standard quality of care to our customers at a much reduced rate than what is prevailing. Hence, those who need quick access to top quality healthcare can avail of the low prices right here at home.

We all know that US providers charge a much higher rate to uninsured patients than they do to insured patients or insurers. But not anymore. A heart bypass tagged at over $100,000 (for uninsured patients) can now be had for an 85% discount. Such rates also closely match the lower foreign rates.

Mohanasundaram adds,

Our US providers offer a complete slew of services in all departments of medicine including cardiac (heart bypass, valve replacement, aneurysm repair), orthopedic (hip replacement, total knee replacement), general surgery, diagnostics, and so on

Who to contact for discounts on major procedures conducted within the US?
Healthbase

Further reading:
News release from Healthbase about this partnership

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Total Knee Replacement

Bethesda, Maryland – A panel charged with reviewing all of the available evidence on total knee replacement (TKR) today found that for persons suffering from intractable and persistent knee pain and disability, TKR surgery is a safe and cost-effective therapy that restores mobility and alleviates discomfort.
Over 20 years of follow-up data indicate that the procedure is successful in the vast majority of patients. The panel reported that there is clear evidence of racial, ethnic, and gender disparities in the provision of total knee replacements, as there is for many other health care interventions, but the reasons for this are unclear.Physicians’ beliefs about their patients, limited familiarity with these procedures in minority communities, and patient mistrust of the health care system may all have a role. The consensus panel is calling for more research to determine the causes of these disparities.

“TKR is not for everyone – it’s major elective surgery that carries a variety of important risks, but it often offers dramatic relief after other therapies fail,” said the panel chair, orthopaedic surgeon Dr. E. Anthony Rankin of Providence Hospital in Washington, D.C.

The panel emphasized that for patients considering TKR, important factors to consider include surgeon and hospital volume of TKRs performed, as these are associated with lower complication rates. Dr. Rankin explained, “Basically, the more they do, the better they do it.”

Loosening of the implant is the main cause of failed total knee prostheses that necessitate revision procedures, and that proper alignment of the prosthesis is critical to minimizing long-term wear and loosening of the implant.

The panel noted that computer navigation may eventually reduce the risk of substantial malalignment, but the technology is as yet unproven and its cost may be prohibitive for many hospitals. (Source: Medical News TODAY, 14 Dec 2003)  

Healthbase is a medical tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more. 

To learn more, visit http://www.healthbase.com/ and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.Healthbase LogoMedical Tourism – Healthbase – Medical ProceduresHealthbase provides a wide range of medical procedures through its partner hospital network. Over hundred medical procedures are available in various categories: orthopedic procedures such as hip replacement, Birmingham hip resurfacing, artificial knee replacement, knee surgery, cosmetic procedures such as breast augmentation, face lift, rhinoplasty (nose surgery), liposuction, dental procedures such as bridges, implants and much more. The savings are up to 80% from typical USA prices.

Healthbase offers more than just procedural availability, we also provide customers with extensive information on medical treatments, hospital and doctors profiles to help them make an educated decision regarding their treatment.

 

Partial list of procedures available:

Categories

Orthopedic 
Hip Replacement (partial) 
Hip Replacement (full) 
Hip Resurfacing (Birmingham) 
Knee Surgery 
Knee Arthroplasty 
Rotator Cuff Surgery 
Total knee replacement, Bilateral knee (TKR) 
Total knee replacement, Single knee (TKR) 
Arthroscopy with Ligament Reconstruction 
Anterior Cruciate Ligament (ACL) Repair 
Medial Cruciate Ligament (MCL) Repair 
Posterior Cruciate Ligament (PCL) Repair 
Elbow Replacement 
Fusion 
Hand Reconstruction 
More... 

Dental 
Cosmetic Dentistry 
Oral Surgery 
Smile Designing 
Root Canal Treatments 
Dental Implants 
Dental Crowns 
Dental Bonding 
Dental Caps 
Dental Bridges 
Dental Fillings 
Teeth Whitening 
Periodontal Flap Surgery 
Full mouth Radiograph 
Tooth Contouring and Reshaping 
Veneers, Bonding, Inlays and Overlays 
Tooth Extractions 
Tooth Impactions 
More... 

Obesity 
Gastric Bypass 
Lap Band 
Rouyn Y Loop 
More... 

Spinal 
Artificial Disc Implantation 
Bone Spur Treatments 
Cervical Discectomy 
Cervical Discectomy with Fusion 
Disc Degeneration Treatments 
Disc Surgery 
Discectomy 
Endoscopic Discectomy 
Fusion 
Herniated Disc Treatments 
Laminectomy + Posterior Instrumentation 
Laminectomy for excision of Spinal Tumors 
Decompressive Laminectomy 
Open Discectomy 
Percutaneous Endoscopic Lumbar Discectomy (PELD) 
Radiosurgical Treatment of Spinal Tumors 
Stenosis Treatments 
Thoracoplasty 
More... 

Cardiac 
Coronary Angioplasty (PTCA or PCI) 
Coronary Artery Bypass Graft (CABG) 
Coronary Angiography 
Artial Septal Defect (ASD) and Ventricular Septal Defect (VSD) 
ASD Device 
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) 
Off Pump Coronary Artery Bypass (OPCAB) 
Enhanced External CounterPulsation (EECP) (noninvasive) 
Implantable Cardioverter and Defibrillator (ICD) 
Pacemaker Implantation (Single Chamber) 
Pacemaker Implantation (Dual Chamber) 
Peripheral Vascular Treatment 
PDA Device 
Robotic Cardiac Surgery (daVinci Telemanipulation) 
Stenting 
Totally Endoscopic Coronary Artery Bypass (T-CAB) 
Trans Myocardial Laser Revascularisation (TMLR) 
Valvuloplasty 
More... 

Cosmetic 
Arm Lift (Brachioplasty) 
Breast Augmentation (Mammoplasty - Augmentation) 
Breast Lift (Mastopexy) 
Brow Lift 
Buttocks Lift 
Chin Surgery (Mentoplasty) 
Chin Implants 
Cheek Implants 
Circumferential Body Lift 
Ear surgery (Otoplasty) 
Eyelid surgery (Blepharoplasty) 
Face Lift (Rhytidectomy) 
Facial implants 
Forehead / Brow Lift 
Gynecomastia 
Hair Transplant 
Jaw Reconstruction 
Jaw Shaving 
Lip Enhancement 
Liposuction 
Mole Excision 
Neck Lift (Platysmaplasty) 
Nose Surgery (Rhinoplasty) 
Ptosis Correction 
Skin Grafts 
Spider Veins (Sclerotherapy) 
Thigh Lift (Thighplasty) 
Tummy Tuck (Abdominoplasty) 
More... 

Gastroenterology 
Colonoscopy 
Gastroscopy / Endoscopy 
Flexible Sigmoidoscopy 
Colonoscopic Polypectomy 
Foreign Body Removal 
Achalasia Cardia Dilatation 
Colonoscopic Balloon Dilatation 
Sigmoidoscopic Balloon Dilatation 
Esophageal Metal Stenting 
Endoscopic Ryle`s Tube Placement 
Endoscopic Sclerotherapy 
Percutaneous Endoscopic Gastrostomy 
Endoscopic Hemoclip Appln. GI Bleed 
ERCP Diagnostic 
ERCP Therapeutic 
Mechanical Liphotripsy of Biliary Stones 
Paracentesis 
Ultrsound Guided Liver Biopsy 
Glue Injection of Fundal Varices 
Gastrectomy 
Sigmoidoscopic Polypectomy 
Esophageal / Pyloric / Duodenal Dilatation 
Endoscopic Banding 
Laparoscopy Appendicetomy 
Endoscopy 
Gastroplasty 
Laparoscopy assisted Hemicolectomy 
Laparoscopy Cardiomyotomy 
Laparoscopy Cholecystectomy with Choledochoduodenestomy 
Laparoscopy Fundoplication 
Laparoscopy Gastrojejunostomy 
Laparoscopy Rectopexy 
Laparoscopy Splenectomy 
Laparoscopy duonenal, Preforation closure 
Liver Cyst 
Psudopancreatic Cyst 
Wireless capsule Endoscopy 
Laparoscopy Cholecystectomy 
laparoscopic adrenaloctomy 
More... 

Opthalmology 
LASIK 
Squint 
Retinal Detachment 
Vitrectomy 
Vitrectomy + Retinal Detachment 
Ptosis 
Fundus fluroscein Angiography (FFA) 
Phaco + IOL (Intra Ocular Lens) 
Cataract + Glaucoma 
Pterygium Removal 
Squint Correction - horizontal 
Squint Correction - vertical 
Glaucoma (Trabeculectomy) 
More... 

ENT 
Myringoplasty 
Superficial Parotidectomy 
Tonsillectomy 
Septoplasty 
Stapedotomy 
Ossiculoplasty 
Thyroplasty 
Micro Larynglean Surgery 
Tympanoplasty 
Thyroidectomy 
Cochlear Implant 
Somnoplasty 
More... 

Urology 
Lithotripsy 
Uroendoscopy 
Cystoscopy 
Optical Internal Urethrotomy 
Endoscopic Surgery - TURP / TUEVP 
Pyeloplasty 
Variocele - unilateral 
Endoscopic Surgery - Optical Internal Urethrotomy 
Endoscopic Surgery - Endopyelotomy 
Stone Treatments 
Percutaneous Nephrolithotomy (PCNL) 
Ureteroscopy (URS) 
More... 

More Categories 
Oncology 
Vascular 
General Surgery 
Wellness 
More...

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Shoulder Replacement

Provided by Wockhardt Hospital
Brought to you by Healthbase

Shoulder ReplacementSimilar to other joint replacement procedures, shoulder replacement surgery is generally done to address persistent pain that is not controlled by non-surgical therapy. Less commonly, poor shoulder motion may also be a reason for replacement surgery.

The shoulder is a ball-and-socket joint, with the top of the arm bone (humeral head) fitting into a socket known as the glenoid. Muscles and tendons, such as the rotator cuff, help hold the joint in place. Surgery involves replacing the humeral head and the glenoid with artificial components. The humeral head replacement is generally made from a metal alloy, while the glenoid component is made from polyethylene plastic. The new components may be anchored by cement or press-fit into place so that the bone grows in around them.

During surgery, a three- to four-inch incision is made along the space between the arm and the collarbone. The procedure lasts about 90 minutes, and the incision is then closed with staples or stitches. Patients typically stay in the hospital for one to two nights, and full recovery usually takes six to 12 weeks.

 

Rehabilitation

 

Arthritic shoulders are stiff. One of the major goals of total shoulder replacement surgery is to relieve much of this stiffness. However, after surgery scar tissue will tend to recur and limit movement unless motion is started immediately. This early motion is facilitated by the complete surgical release of the tight tissues so that after surgery the patient has only to maintain the range of motion achieved at the operation. Later on, once the shoulder is comfortable and flexible, strengthening exercises and additional activities are started.

A careful, well-planned rehabilitation program is critical to the success of a shoulder replacement. You usually start gentle physical therapy on the first day after the operation. You wear an arm sling during the day for the first several weeks after surgery. You wear the sling at night for 4 to 6 weeks. Most patients are able to perform simple activities such as eating, dressing and grooming within 2 weeks after surgery. Driving a car is not allowed for 6 weeks after surgery.

Here are some “do’s and don’ts” for when you return home:

  • Don’t use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.

  • Do follow the program of home exercises prescribed for you. You may need to do the exercises 4 to 5 times a day for a month or more.

  • Don’t overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.

  • Don’t lift anything heavier than a glass of water for the first 6 weeks after surgery.

  • Do ask for assistance. Your physician may be able to recommend an agency or facility if you do not have home support.

  • Don’t participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.

  • Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.
    Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function

Frequently Asked Questions

 

What are the symptoms to detect Shoulder Replacement?

 

Patients with arthritis typically describe a deep ache within the shoulder joint. Initially, the pain feels worse with movement and activity, and eases with rest. As the arthritis progresses, the pain may occur even when you rest. By the time a patient sees a physician for the shoulder pain, he or she often has pain at night. This pain may be severe enough to prevent a good night’s sleep. The patient’s shoulder may make grinding or grating noises when moved. Or the shoulder may catch, grab, clunk or lock up. Over time, the patient may notice loss of motion and/or weakness in the affected shoulder. Simple daily activities like reaching into a cupboard, dressing, toileting and washing the opposite armpit may become increasingly difficult.

 

How do I know if I am ready for shoulder replacement surgery?

 

Patients who have tried the usual treatments for shoulder arthritis, but have not been able to find adequate relief, may be a candidate for shoulder replacement surgery. Patients considering the procedure should understand the potential risks of surgery, and understand that the goal of joint replacement is to alleviate pain. Patients generally find improved motion after surgery, but these improvements are not as consistent as the pain relief following shoulder replacement surgery.

 

How long is the recovery following shoulder replacement surgery?

 

Hospital stays vary from one to three days for most patients. You will be sent home wearing a sling and you should not attempt to use the arm except as specifically instructed by your doctor.

Most physicians will begin some motion immediately following surgery, but this may not be true in every case. Usually within two to three months, patients are able to return to most normal activities and place an emphasis on strengthening the muscles around the shoulder and maintaining range of motion.

 

What are the symptoms of severe arthritis of the shoulder?

 

Common symptoms of shoulder arthritis include:

  • Pain with activities

  • Limited range of motion

  • Stiffness of the shoulder

  • Swelling of the joint

  • Tenderness around the joint

  • A feeling of grinding or catching within the joint

Can rehabilitation be done at home?

 

In general the exercises are best performed by the patient at home. Occasional visits to the surgeon or therapist may be useful to check the progress and to review the program.

 

When can I return to ordinary daily activities?

 

In general, patients are able to perform gentle activities of daily living using the operated arm from two to six weeks after surgery. Walking is strongly encouraged. Driving should wait until the patient can perform the necessary functions comfortably and confidently. Recovery of driving ability may take six weeks if the surgery has been performed on the right shoulder, because of the increased demands on the right shoulder for shifting gears.

With the consent of their surgeon, patients can often return to activities such as swimming, golf and tennis at six months after their surgery.


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Total Knee Replacement

Provided by Wockhardt Hospital
Brought to you by Healthbase

Your knees work hard during your daily routine, and arthritis of the knee or a knee injury can make it hard for you to perform normal tasks. If your injury or arthritis is severe, you may begin to experience pain when you are sitting down or trying to sleep.

Sometimes a total knee replacement is the only option for reducing pain and restoring a normal activity level. If your and your doctor decide a total knee replacement is right for you, the following information will give you an understanding about what to expect.

A total knee replacement involves replacing the damaged bone and cartilage of the knee joint, which provides articulating surfaces.

The total procedure takes approximately an hour to hour and a half to perform and recovery time varies between patients. Correct rehabilitation following surgery significantly improves outcomes.

 

Implant Components

 

Total Knee ReplacementIn the total knee replacement procedure, each prosthesis is made up of four parts. The tibial component has two elements and replaces the top of the shin bone (tibia). This prosthesis is made up of a metal tray attached directly to the bone and a plastic spacer that provides the bearing surface.

The femoral component replaces the bottom of the thigh bone (femur). This component also replaces the groove where the patella (kneecap) sits.

The patellar component replaces the surface of the kneecap, which rubs against the femur. The kneecap protects the joint, and the resurfaced patellar button slides smoothly on the front of the joint. This may or may not be replaced depending on the condition of the patient.

 

Advantages of Total Knee Replacement

 

The most important advantage is that this operation produces very effective and long lasting relief from joint pain. It also gives a joint which functions normally. The recovery period from the operation is very short and the patient is able to walk from the second or the third day after the operation. Walking support that is needed can often be discarded by around a month’s time. The patient regain a normal lifestyle and mobility with significant improvement in quality of life.

 

Exercise Program and Physical Therapy/ Rehabilitation after Knee Surgery

 

Knee replacement surgery is a complex procedure, and physical knee rehabilitation is crucial to a full recovery. In order for you to meet the goals of total knee surgery, you must take ownership of the rehabilitation process and work diligently on your own, as well as with your physical therapist, to achieve optimal clinical and functional results. The knee rehabilitation process following total knee replacement surgery can be quite painful at times.

Your knee rehabilitation program begins in the hospital after surgery. Early goals of knee rehabilitation in the hospital are to reduce knee stiffness, maximize post-operative range of motion, and get you ready for discharge.


When muscles are not used, they become weak and do not perform well in supporting and moving the body. Your leg muscles are probably weak because you haven’t used them much due to your knee problems. The surgery can correct the knee problem, but the muscles will remain weak and will only be strengthened through regular exercise. You will be assisted and advised how to do this, but the responsibility for exercising is yours.

Your overall progress, amount of pain, and condition of the incision will determine when you will start going to physical therapy. You will work with physical therapy until you meet the following goals:

1. Independent in getting in and out of bed.
2. Independent in walking with crutches or walker on a level surface.
3. Independent in walking up and down 3 stairs.
4. Independent in your home exercise program.

Your doctor and therapist may modify these goals somewhat to fit your particular condition.

In your physical therapy sessions you will walk, using crutches or a walker, bearing as much weight as indicated by your doctor or physical therapist. You will also work on an exercise program designed to strengthen your leg and increase the motion of your knee.

Your exercise program will include the following exercises:

 


Quadriceps Setting
The quadriceps is a set of four muscles located on the front of the thigh and is important in stabilizing and moving your knee. These muscles must be strong if you are to walk after surgery. A “quad set” is one of the simplest exercises that will help strengthen them.

Lie on your back with legs straight, together, and flat on the bed, arms by your side. Perform this exercise one leg at a time. Tighten the muscles on the top of one of your thighs. At the same time, push the back of your knee downward into the bed. The result should be straightening of your leg. Hold for 5 seconds, relax 5 seconds; repeat 10 times for each leg.

You may start doing this exercise with both legs the day after surgery before you go to physical therapy. The amount of pain will determine how many you can do, but you should strive to do several every hour. The more you can do, the faster your progress will be. Your nurses can assist you to get started. The following diagram can be used for review.

 

Terminal Knee Extension
This exercise helps strengthen the quadriceps muscle. It is done by straightening your knee joint.

Lie on your back with a blanket roll under your involved knee so that the knee bends about 30-40 degrees. Tighten your quadriceps and straighten your knee by lifting your heel off the bed. Hold 5 seconds, then slowly your heel to the bed. You may repeat 10-20 times.

 

Knee Flexion
Each day you will bend your knee. The physical therapist will help you find the best method to increase the bending (flexion) of your knee. Every day you should be able to flex it a little further. Your therapist will measure the amount of bending and send a daily report to your doctor.

In addition, your therapist may add other exercises as he or she deems necessary for your rehabilitation.

 

Straight Leg Raising
This exercise helps strengthen the quadriceps muscle also.
Bend the uninvolved leg by raising the knee and keeping the foot flat on the bed. Keeping your involved leg straight, raise the straight leg about 6 to 10 inches. Hold for 5 seconds. Lower the leg slowly to the bed and repeat 10-20 times.

Once you can do 20 repetitions without any problems, you can add resistance (ie. sand bags) at the ankle to further strengthen the muscles. The amount of weight is increased in one pound increments.

 

Use of heat and ice

Ice: Ice may be used during your hospital stay and at home to help reduce the pain and swelling in your knee. Pain and swelling will slow your progress with your exercises. A bag of crushed ice may be placed in a towel over your knee for 15-20 minutes. Your sensation may be decreased after surgery, so use extra care.

Heat: If your knee is not swollen, hot or painful, you may use heat before exercising to assist with gaining range of motion. A moist heating pad or warm damp towels may be used for 15-20 minutes. Your sensation may be decreased after surgery so use extra care.

 

Long-Term Knee Rehabilitation Goals
Once you have completed your knee rehabilitation therapy, you can expect a range of motion from 100-120 degrees of knee flexion, mild or no pain with walking or other functional activities, and independence with all activities of daily living.

 

 

Guidelines at Home – What happens after I go home?

 

Medication

  • You will continue to take medications as prescribed by your doctor.

  • You will be sent home on prescribed medications to prevent blood clots. Your doctor will determine whether you will take a pill (Warfarin or coated aspirin) or give yourself an injection. If an injection is necessary, your doctor will discuss it with you, and the nursing staff will teach you or a family member what is necessary to receive this medication.

  • You will be sent home on prescribed medications to control pain. Plan to take your pain medication 30 minutes before exercises. Preventing pain is easier than chasing pain. If pain control continues to be a problem, call your doctor.

Activity

  • Continue to walk with crutches/walker.

  • Bear weight and walk on the leg as much as is comfortable.

  • Walking is one of the better kinds of physical therapy and for muscle strengthening.

  • However, walking does not replace the exercise program which you are taught in the hospital. The success of the operation depends to a great extent on how well you do the exercises and strengthen weakened muscles.

  • If excess muscle aching occurs, you should cut back on your exercises.

Other Considerations

  • For the next 4-6 weeks avoid sexual intercourse. Sexual activity can usually be resumed after your 6-week follow-up appointment.

  • You can usually return to work within two to three months, or as instructed by your doctor.

  • You should not drive a car until after the 6-week follow-up appointment.

  • Continue to wear elastic stockings (TEDS) until your return appointment.

  • No shower or tub bath until after staples are removed.

  • When using heat or ice, remember not to get your incision wet before your staples are removed.

 

Your Incision

 

Keep the incision clean and dry. Also, upon returning home, be alert for certain warning signs. If any swelling, increased pain, drainage from the incision site, redness around the incision, or fever is noticed, report this immediately to the doctor. Generally, the staples are removed in three weeks.

 

Prevention of Infection

 

If at any time (even years after the surgery) an infection develops such as strep throat or pneumonia, notify your physician. Antibiotics should be administered promptly to prevent the occasional complication of distant infection localizing in the knee area. This also applies if any teeth are pulled or dental work is performed. Inform the general physician or dentist that you have had a joint replacement. You will be given a medical alert card. This should be carried in your billfold or wallet. It will give information on antibiotics that are needed during dental or oral surgery, or if a bacterial infection develops.

 

Frequently Asked Questions

 
  • Who is a candidate for a total replacement?
  • What are the risks of total knee replacement?
  • When do I return to the clinic?
  • Should I have a total knee replacement?
  • Who develops a more severe or an earlier arthritis?
  • When can I return home?
  • What measures should be taken after the surgery/operation (Post operative instruction)
  • What activities should I Avoid after Knee Replacement?

Q 1 Who is a candidate for a total replacement?

 

Total knee replacements are usually performed on people suffering from severe arthritic conditions. Most patients who have artificial knees are over age 55, but the procedure is performed in younger people.

The circumstances vary somewhat, but generally you would be considered for a total knee replacement if:

  • You have daily pain.

  • Your pain is severe enough to restrict not only work and recreation but also the ordinary activities of daily living.

  • You have significant stiffness of your knee.

  • You have significant instability (constant giving way) of your knee.

  • You have significant deformity (knock-knees or bowlegs).

Q 2 What are the risks of total knee replacement?

 

Total knee replacement is a major operation. The most common complications are not directly related to the knee and usually do not affect the result of the operations. These complications include urinary tract infection, blood clots in a leg, or blood clots in a lung.

Complications affecting the knee are less common, but in these cases the operation may not be as successful. These complications include:

  • some knee pain

  • loosening of the prosthesis

  • stiffness

  • infection in the knee

A few complications such as infection, loosening of prosthesis, and stiffness may require reoperation. Infected artificial knees sometimes have to be removed. This would leave a stiff leg about one to three inches shorter than normal. However, your leg would usually be reasonably comfortable, and you would be able to walk with the aid of a cane or crutches, and a shoe lift. After a course of antibiotics the surgery can often be repeated to give a normal knee.

 

Q 3 When do I return to the clinic?

 

Even if everything is fine, it is advisable to return every three years after the surgery for a review.

 

Q 4 Should I have a total knee replacement?

 

Total knee replacement is an elective operation. The decision to have the operation is not made by the doctor, it is made by you. All your questions should be answered before you decide to have the operation.

 

Q 5 Who develops a more severe or an earlier arthritis?

 

One who has family history (this having a strong hereditary influence), who has history of injury in the joint (e.g. a fracture or a ligament/meniscal injury in the knee), who has deformity of knees and the one who is overweight. Medicines are not the treatment for this form of arthritis. Weight reduction, regular exercises, local heat therapy help in early stages. Physiotherapy is the mainstay of the treatment. Painkillers should be used only occasionally as they adversely affect our kidneys, cause intestinal ulcers and bleeding.

Another form of Arthritis is Inflammatory arthritis (Rheumatoid or its variants). This does need medical treatment (DMARD’s), which changes the course of the disease and prevents further damage to joints. Surgical treatment is needed when structural joint changes have taken place. Before and after the surgery, the patient should remain under care of a Physician/Rheumatologist.

Post Traumatic Arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee’s ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

 

Q 6 When can I return home?

 

You will be discharged when you can get out of bed on your own and walk with a walker or crutches, walk up and down three steps, bend your knee 90 degrees, and straighten your knee.

 

Q 7 What measures should be taken after the surgery/operation (Post operative instruction)

 

The success of your surgery also will depend on how well you follow your orthopaedic surgeon’s instructions at home during the first few weeks after surgery.

Wound Care you will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal.

Avoid soaking the wound in water until the wound has thoroughly sealed and dried. A bandage may be placed over the wound to prevent irritation from clothing or support stockings.

Diet some loss of appetite is common for few days after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and restore muscle strength.

Activity Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within three to six weeks following surgery. Some Pain with activity and at night is common for several weeks after surgery. Your activity program should include:

  • A graduated walking program to slowly increase your mobility, initially in your home and later outside.

  • Resuming other normal household activities, such as sitting and standing and walking up and down stairs.

  • Specific exercises several times a day to restore movement and strengthen your knee. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery.

Driving usually begins when your knee bends sufficiently so you can enter and sit comfortably in your car and when your muscle control provides adequate reaction time for braking and acceleration. Most individuals resume driving about four to six weeks after surgery.

 

Q 8 What activities should I Avoid after Knee Replacement?

 

Even though you may increase your activity level after a knee replacement, you should avoid high-demand or high-impact activities. You should definitely avoid running or jogging, contact sports, jumping sports, and high impact aerobics.

You should also try to avoid vigorous walking or hiking, skiing, tennis, repetitive lifting exceeding 50 pounds, and repetitive aerobic stair climbing. The safest aerobic exercise is biking (stationary or traditional) because it places very little stress on the knee joint.

 


Brought to you by Healthbase www.healthbase.com info@healthbase.com 1-888-MY1-HLTHHealthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

Brought to you by Healthbase www.healthbase.com info.hb@healthbase.com 1-888-MY1-HLTH


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Total Knee Replacement

Provided by Wockhardt Hospital
Brought to you by Healthbase

Your knees work hard during your daily routine, and arthritis of the knee or a knee injury can make it hard for you to perform normal tasks. If your injury or arthritis is severe, you may begin to experience pain when you are sitting down or trying to sleep.

Sometimes a total knee replacement is the only option for reducing pain and restoring a normal activity level. If your and your doctor decide a total knee replacement is right for you, the following information will give you an understanding about what to expect.

A total knee replacement involves replacing the damaged bone and cartilage of the knee joint, which provides articulating surfaces.

The total procedure takes approximately an hour to hour and a half to perform and recovery time varies between patients. Correct rehabilitation following surgery significantly improves outcomes.

 

Implant Components

 

Total Knee ReplacementIn the total knee replacement procedure, each prosthesis is made up of four parts. The tibial component has two elements and replaces the top of the shin bone (tibia). This prosthesis is made up of a metal tray attached directly to the bone and a plastic spacer that provides the bearing surface.

The femoral component replaces the bottom of the thigh bone (femur). This component also replaces the groove where the patella (kneecap) sits.

The patellar component replaces the surface of the kneecap, which rubs against the femur. The kneecap protects the joint, and the resurfaced patellar button slides smoothly on the front of the joint. This may or may not be replaced depending on the condition of the patient.

 

Advantages of Total Knee Replacement

 

The most important advantage is that this operation produces very effective and long lasting relief from joint pain. It also gives a joint which functions normally. The recovery period from the operation is very short and the patient is able to walk from the second or the third day after the operation. Walking support that is needed can often be discarded by around a month’s time. The patient regain a normal lifestyle and mobility with significant improvement in quality of life.

 

Exercise Program and Physical Therapy/ Rehabilitation after Knee Surgery

 

Knee replacement surgery is a complex procedure, and physical knee rehabilitation is crucial to a full recovery. In order for you to meet the goals of total knee surgery, you must take ownership of the rehabilitation process and work diligently on your own, as well as with your physical therapist, to achieve optimal clinical and functional results. The knee rehabilitation process following total knee replacement surgery can be quite painful at times.

Your knee rehabilitation program begins in the hospital after surgery. Early goals of knee rehabilitation in the hospital are to reduce knee stiffness, maximize post-operative range of motion, and get you ready for discharge.


When muscles are not used, they become weak and do not perform well in supporting and moving the body. Your leg muscles are probably weak because you haven’t used them much due to your knee problems. The surgery can correct the knee problem, but the muscles will remain weak and will only be strengthened through regular exercise. You will be assisted and advised how to do this, but the responsibility for exercising is yours.

Your overall progress, amount of pain, and condition of the incision will determine when you will start going to physical therapy. You will work with physical therapy until you meet the following goals:

1. Independent in getting in and out of bed.
2. Independent in walking with crutches or walker on a level surface.
3. Independent in walking up and down 3 stairs.
4. Independent in your home exercise program.

Your doctor and therapist may modify these goals somewhat to fit your particular condition.

In your physical therapy sessions you will walk, using crutches or a walker, bearing as much weight as indicated by your doctor or physical therapist. You will also work on an exercise program designed to strengthen your leg and increase the motion of your knee.

Your exercise program will include the following exercises:

 


Quadriceps Setting
The quadriceps is a set of four muscles located on the front of the thigh and is important in stabilizing and moving your knee. These muscles must be strong if you are to walk after surgery. A “quad set” is one of the simplest exercises that will help strengthen them.

Lie on your back with legs straight, together, and flat on the bed, arms by your side. Perform this exercise one leg at a time. Tighten the muscles on the top of one of your thighs. At the same time, push the back of your knee downward into the bed. The result should be straightening of your leg. Hold for 5 seconds, relax 5 seconds; repeat 10 times for each leg.

You may start doing this exercise with both legs the day after surgery before you go to physical therapy. The amount of pain will determine how many you can do, but you should strive to do several every hour. The more you can do, the faster your progress will be. Your nurses can assist you to get started. The following diagram can be used for review.

 

Terminal Knee Extension
This exercise helps strengthen the quadriceps muscle. It is done by straightening your knee joint.

Lie on your back with a blanket roll under your involved knee so that the knee bends about 30-40 degrees. Tighten your quadriceps and straighten your knee by lifting your heel off the bed. Hold 5 seconds, then slowly your heel to the bed. You may repeat 10-20 times.

 

Knee Flexion
Each day you will bend your knee. The physical therapist will help you find the best method to increase the bending (flexion) of your knee. Every day you should be able to flex it a little further. Your therapist will measure the amount of bending and send a daily report to your doctor.

In addition, your therapist may add other exercises as he or she deems necessary for your rehabilitation.

 

Straight Leg Raising
This exercise helps strengthen the quadriceps muscle also.
Bend the uninvolved leg by raising the knee and keeping the foot flat on the bed. Keeping your involved leg straight, raise the straight leg about 6 to 10 inches. Hold for 5 seconds. Lower the leg slowly to the bed and repeat 10-20 times.

Once you can do 20 repetitions without any problems, you can add resistance (ie. sand bags) at the ankle to further strengthen the muscles. The amount of weight is increased in one pound increments.

 

Use of heat and ice

Ice: Ice may be used during your hospital stay and at home to help reduce the pain and swelling in your knee. Pain and swelling will slow your progress with your exercises. A bag of crushed ice may be placed in a towel over your knee for 15-20 minutes. Your sensation may be decreased after surgery, so use extra care.

Heat: If your knee is not swollen, hot or painful, you may use heat before exercising to assist with gaining range of motion. A moist heating pad or warm damp towels may be used for 15-20 minutes. Your sensation may be decreased after surgery so use extra care.

 

Long-Term Knee Rehabilitation Goals
Once you have completed your knee rehabilitation therapy, you can expect a range of motion from 100-120 degrees of knee flexion, mild or no pain with walking or other functional activities, and independence with all activities of daily living.

 

 

Guidelines at Home – What happens after I go home?

 

Medication

  • You will continue to take medications as prescribed by your doctor.

  • You will be sent home on prescribed medications to prevent blood clots. Your doctor will determine whether you will take a pill (Warfarin or coated aspirin) or give yourself an injection. If an injection is necessary, your doctor will discuss it with you, and the nursing staff will teach you or a family member what is necessary to receive this medication.

  • You will be sent home on prescribed medications to control pain. Plan to take your pain medication 30 minutes before exercises. Preventing pain is easier than chasing pain. If pain control continues to be a problem, call your doctor.

Activity

  • Continue to walk with crutches/walker.

  • Bear weight and walk on the leg as much as is comfortable.

  • Walking is one of the better kinds of physical therapy and for muscle strengthening.

  • However, walking does not replace the exercise program which you are taught in the hospital. The success of the operation depends to a great extent on how well you do the exercises and strengthen weakened muscles.

  • If excess muscle aching occurs, you should cut back on your exercises.

Other Considerations

  • For the next 4-6 weeks avoid sexual intercourse. Sexual activity can usually be resumed after your 6-week follow-up appointment.

  • You can usually return to work within two to three months, or as instructed by your doctor.

  • You should not drive a car until after the 6-week follow-up appointment.

  • Continue to wear elastic stockings (TEDS) until your return appointment.

  • No shower or tub bath until after staples are removed.

  • When using heat or ice, remember not to get your incision wet before your staples are removed.

 

Your Incision

 

Keep the incision clean and dry. Also, upon returning home, be alert for certain warning signs. If any swelling, increased pain, drainage from the incision site, redness around the incision, or fever is noticed, report this immediately to the doctor. Generally, the staples are removed in three weeks.

 

Prevention of Infection

 

If at any time (even years after the surgery) an infection develops such as strep throat or pneumonia, notify your physician. Antibiotics should be administered promptly to prevent the occasional complication of distant infection localizing in the knee area. This also applies if any teeth are pulled or dental work is performed. Inform the general physician or dentist that you have had a joint replacement. You will be given a medical alert card. This should be carried in your billfold or wallet. It will give information on antibiotics that are needed during dental or oral surgery, or if a bacterial infection develops.

 

Frequently Asked Questions

 
  • Who is a candidate for a total replacement?
  • What are the risks of total knee replacement?
  • When do I return to the clinic?
  • Should I have a total knee replacement?
  • Who develops a more severe or an earlier arthritis?
  • When can I return home?
  • What measures should be taken after the surgery/operation (Post operative instruction)
  • What activities should I Avoid after Knee Replacement?

Q 1 Who is a candidate for a total replacement?

 

Total knee replacements are usually performed on people suffering from severe arthritic conditions. Most patients who have artificial knees are over age 55, but the procedure is performed in younger people.

The circumstances vary somewhat, but generally you would be considered for a total knee replacement if:

  • You have daily pain.

  • Your pain is severe enough to restrict not only work and recreation but also the ordinary activities of daily living.

  • You have significant stiffness of your knee.

  • You have significant instability (constant giving way) of your knee.

  • You have significant deformity (knock-knees or bowlegs).

Q 2 What are the risks of total knee replacement?

 

Total knee replacement is a major operation. The most common complications are not directly related to the knee and usually do not affect the result of the operations. These complications include urinary tract infection, blood clots in a leg, or blood clots in a lung.

Complications affecting the knee are less common, but in these cases the operation may not be as successful. These complications include:

  • some knee pain

  • loosening of the prosthesis

  • stiffness

  • infection in the knee

A few complications such as infection, loosening of prosthesis, and stiffness may require reoperation. Infected artificial knees sometimes have to be removed. This would leave a stiff leg about one to three inches shorter than normal. However, your leg would usually be reasonably comfortable, and you would be able to walk with the aid of a cane or crutches, and a shoe lift. After a course of antibiotics the surgery can often be repeated to give a normal knee.

 

Q 3 When do I return to the clinic?

 

Even if everything is fine, it is advisable to return every three years after the surgery for a review.

 

Q 4 Should I have a total knee replacement?

 

Total knee replacement is an elective operation. The decision to have the operation is not made by the doctor, it is made by you. All your questions should be answered before you decide to have the operation.

 

Q 5 Who develops a more severe or an earlier arthritis?

 

One who has family history (this having a strong hereditary influence), who has history of injury in the joint (e.g. a fracture or a ligament/meniscal injury in the knee), who has deformity of knees and the one who is overweight. Medicines are not the treatment for this form of arthritis. Weight reduction, regular exercises, local heat therapy help in early stages. Physiotherapy is the mainstay of the treatment. Painkillers should be used only occasionally as they adversely affect our kidneys, cause intestinal ulcers and bleeding.

Another form of Arthritis is Inflammatory arthritis (Rheumatoid or its variants). This does need medical treatment (DMARD’s), which changes the course of the disease and prevents further damage to joints. Surgical treatment is needed when structural joint changes have taken place. Before and after the surgery, the patient should remain under care of a Physician/Rheumatologist.

Post Traumatic Arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee’s ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

 

Q 6 When can I return home?

 

You will be discharged when you can get out of bed on your own and walk with a walker or crutches, walk up and down three steps, bend your knee 90 degrees, and straighten your knee.

 

Q 7 What measures should be taken after the surgery/operation (Post operative instruction)

 

The success of your surgery also will depend on how well you follow your orthopaedic surgeon’s instructions at home during the first few weeks after surgery.

Wound Care you will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal.

Avoid soaking the wound in water until the wound has thoroughly sealed and dried. A bandage may be placed over the wound to prevent irritation from clothing or support stockings.

Diet some loss of appetite is common for few days after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and restore muscle strength.

Activity Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within three to six weeks following surgery. Some Pain with activity and at night is common for several weeks after surgery. Your activity program should include:

  • A graduated walking program to slowly increase your mobility, initially in your home and later outside.

  • Resuming other normal household activities, such as sitting and standing and walking up and down stairs.

  • Specific exercises several times a day to restore movement and strengthen your knee. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery.

Driving usually begins when your knee bends sufficiently so you can enter and sit comfortably in your car and when your muscle control provides adequate reaction time for braking and acceleration. Most individuals resume driving about four to six weeks after surgery.

 

Q 8 What activities should I Avoid after Knee Replacement?

 

Even though you may increase your activity level after a knee replacement, you should avoid high-demand or high-impact activities. You should definitely avoid running or jogging, contact sports, jumping sports, and high impact aerobics.

You should also try to avoid vigorous walking or hiking, skiing, tennis, repetitive lifting exceeding 50 pounds, and repetitive aerobic stair climbing. The safest aerobic exercise is biking (stationary or traditional) because it places very little stress on the knee joint.

 


Brought to you by Healthbase www.healthbase.com info@healthbase.com 1-888-MY1-HLTHHealthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

 

Medical Procedures

Healthbase provides a wide range of medical procedures through its partner hospital network. Over hundred medical procedures are available in various categories: orthopedic procedures such as hip replacement, Birmingham hip resurfacing, artificial knee replacement, knee surgery, cosmetic procedures such as breast augmentation, face lift, rhinoplasty (nose surgery), liposuction, dental procedures such as bridges, implants and much more. The savings are up to 80% from typical USA prices.


Procedure (cost in USD)* USA Singapore Thailand India
Dental Implants 3,500 1,600 1,100 950
Hip Replacement – full 48,000 30,000 18,000 12,000
Hip Replacement – partial 24,000 15,000 10,000 6,300
Hip Resurfacing (Birmingham) 48,000 14,000 10,000 7,000
Breast Augmentation (Mammoplasty – Augmentation) 10,000 8,000 3,150 2,200
Breast Reduction (Mammoplasty – Reduction) 10,000 8,000 3,919 3,000
Eyelid Surgery (Blepharoplasty) 7,000 3,750 1,413 2,200
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Nose Surgery (Rhinoplasty) 7,300 4,375 3,839 1,800
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Coronary Angiography 6,000 1,313 1,250 560
Coronary Angioplasty (PTCA or PCI) 41,000 11,250 4,150 3,500
Coronary Artery Bypass Graft (CABG) 56,000 12,900 13,250 9,000
Pacemaker 7,500 5,000 3,500
*Note: The above cost is for rough planning purposes only. For your FREE personalized quote, register here. The procedures list provided here is a partial list. Healthbase offers over hundred procedures. Complete list of medical, dental and cosmetic procedures offered are available for registered numbers.        
Partial list of procedures available:
Orthopedic
Knee Surgery
Knee Arthroplasty
Rotator Cuff Surgery
Total knee replacement, Bilateral knee (TKR)
Total knee replacement, Single knee (TKR)
Arthroscopy with Ligament Reconstruction
Anterior Cruciate Ligament (ACL) Repair
Medial Cruciate Ligament (MCL) Repair
Posterior Cruciate Ligament (PCL) Repair
Elbow Replacement
Fusion
Hand Reconstruction
Hip Replacement (partial)
Hip Replacement (full)
Hip Resurfacing (Birmingham)
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Spinal
Artificial Disc Implantation
Bone Spur Treatments
Cervical Discectomy
Cervical Discectomy with Fusion
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Discectomy
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Fusion
Herniated Disc Treatments
Laminectomy + Posterior Instrumentation
Laminectomy for excision of Spinal Tumors
Decompressive Laminectomy
Open Discectomy
Percutaneous Endoscopic Lumbar Discectomy (PELD)
Radiosurgical Treatment of Spinal Tumors
Stenosis Treatments
Thoracoplasty
More…
Cardiac
Coronary Angioplasty (PTCA or PCI)
Coronary Artery Bypass Graft (CABG)
Coronary Angiography
Artial Septal Defect (ASD) and Ventricular Septal Defect (VSD)
ASD Device
Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)
Off Pump Coronary Artery Bypass (OPCAB)
Enhanced External CounterPulsation (EECP) (noninvasive)
Implantable Cardioverter and Defibrillator (ICD)
Pacemaker Implantation (Single Chamber)
Pacemaker Implantation (Dual Chamber)
Peripheral Vascular Treatment
PDA Device
Robotic Cardiac Surgery (daVinci Telemanipulation)
Stenting
Totally Endoscopic Coronary Artery Bypass (T-CAB)
Trans Myocardial Laser Revascularisation (TMLR)
Valvuloplasty
More…

Cosmetic
Arm Lift (Brachioplasty)
Breast Augmentation (Mammoplasty – Augmentation)
Breast Lift (Mastopexy)
Brow Lift
Buttocks Lift

*Note: The above cost is for rough planning purposes only. For your FREE personalized quote, register here. The procedures list provided here is a partial list. Healthbase offers over hundred procedures. Complete list of medical, dental and cosmetic procedures offered are available for registered numbers.

Healthbase offers more than just procedural availability, we also provide customers with extensive information on medical treatments, hospital and doctors profiles to help them make an educated decision regarding their treatment.

 

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