Total knee replacement: Recent advancements in this surgical procedure

Total Knee Replacement (TKR), also known as Total Knee Arthroplasty, is a transformative surgical procedure that provides relief to thousands of patients suffering from debilitating knee arthritis. As a senior orthopaedic surgeon specializing in joint replacements , I aim to shed light on the critical aspects of TKR: patient selection, implants, and recent advancements.

Patient selection
The decision to undergo TKR is based on several factors. Ideal candidates are typically individuals who:

• Experience severe knee pain that limits daily activities and quality of life.
• Experience disturbed sleep pattern due to pain which in turn leads to psychological imbalances and ailments like diabetes, stroke and cardiovascular accidents.

Have significant joint stiffness and swelling despite conservative treatments such as medications and physical therapy.

Show evidence of joint damage and degeneration on imaging studies like X-rays or MRI scans.

It's crucial to assess each patient comprehensively, considering their overall health, age, activity level, and expectations. A thorough evaluation helps in predicting surgical outcomes and tailoring treatment plans to individual needs.

Implants
TKR involves replacing damaged knee joint surfaces with artificial components (implants) made from durable materials such as metal alloys, high-grade plastics, and ceramic. These implants are designed to mimic the natural movement and function of the knee joint, restoring mobility and reducing pain.

Recent advancements in implant technology focus on:

• Improved longevity and wear resistance of materials to withstand the demands of daily activities.
• Enhanced stability and range of motion to promote more natural knee function.
• Customizable implants that cater to the unique anatomy of each patient, ensuring a precise fit and alignment.
• Choosing the right implant involves careful consideration of factors such as durability, biocompatibility, and surgical technique. Modern TKR implants are meticulously designed and rigorously tested to maximize patient outcomes and satisfaction.

Recent advances:
Advancements in TKR techniques and technologies have significantly enhanced surgical precision and patient recovery:

• Minimally invasive approaches reduce surgical trauma, leading to smaller incisions, less blood loss, and quicker recovery times.
• Virtual augmented reality and robotic surgery assist surgeons in achieving precise implant placement and alignment, optimizing long-term outcomes.

Rapid rehabilitation protocols and multidisciplinary care pathways aim to expedite recovery and improve post-operative function.

Moreover, innovations in anesthesia, pain management strategies, and post-operative care protocols have contributed to enhanced patient comfort and faster rehabilitation following TKR.

Conclusion
Total Knee Replacement remains a transformative option for patients suffering from severe knee arthritis, offering significant pain relief and restoring mobility. As a senior orthopaedic surgeon, I emphasize the importance of thorough patient assessment, choosing appropriate implants, and staying updated with the latest advancements in TKR technology.

By focusing on patient-centric care and integrating cutting-edge innovations, we strive to achieve optimal outcomes and improve the quality of life for individuals undergoing TKR surgery.

In conclusion, TKR continues to evolve with advancements in patient selection criteria, implant technology, and surgical techniques, reaffirming its role as a reliable solution for patients seeking relief from debilitating knee arthritis.

(Author: Dr. Sai Krishna B Naidu, MBBS, MRCS, Dip SICOT, FRCS Ortho(UK), Mch Ortho, Senior consultant/ Additional Director Bone & Joint surgery Fortis Hospital, Richmond Road, Bengaluru)