Minimally Invasive Total Knee Replacement

What is minimally invasive total knee replacement? 

A minimally invasive total knee replacement is a type of surgical procedure that is carried out to replace an injured or damaged knee. 

A minimally invasive knee replacement differs from the traditional total knee replacement because it uses a smaller incision.

This kind of surgical procedure requires modified instruments and techniques. The surgeon makes a 3-4 inch incision as opposed to the usual 8-12 inch cut used in traditional total knee replacement surgery.

Your knee comprises three important parts: The tibia (shin bone), femur (thing bone), and patella (kneecap).

The ends of these parts are covered with cartilage, a smooth substance that prevents the bones from grinding with each other.

In case your knee joint gets injured, it can lead to an unusual scraping of the bones around the affected knee and can be very painful. 

During a minimally invasive total knee replacement procedure, the surgeon makes a small incision to reach the thing bone and shinbone.

The surgeon removes a section of the bones forming the knee joint. The injured or damaged ends of the bones get replaced with plastic or metal prosthetics.

The surgeon places the prosthetic between the shin bone and thigh bone to allow for smooth gliding. The procedure is administered under spinal or general anesthesia.

Why do you need minimally invasive total knee replacement?

If you have sustained substantial damage to your knee joint, your surgeon may recommend a total knee replacement surgery.

The following medical conditions could occasion such damage to your knee:

• Osteoarthritis is by far the main cause of total knee replacement surgery

• Fracture or injury to your knee joint

• Rheumatoid arthritis

• In case the knee joint develops a bone tumor

• Osteonecrosis – A health condition in which bone tissue dies because of a limited supply of oxygen

A damaged knee joint can greatly interfere with your daily activities, including walking. It can be painful.

A minimally invasive total knee replacement procedure will not only reduce such pain but also enhance joint mobility.

Your surgeon is likely to recommend a total knee replacement in case conservative techniques of treating the condition, such as corticosteroid injection and pain medication have failed.

Ask your surgeon about the advantages of having a minimally invasive total knee replacement over conventional total knee replacement surgery, such as faster recovery time and a high level of precision during surgery.

Your doctors can suggest other surgical options such as partial knee replacement or shortening of bone.

Make sure your surgeon has fully explained all the options available for the surgery, including the benefits and risks that come with such techniques.

Preparing for total knee replacement

Before the admission, your healthcare provider may administer pre-admission testing. This takes place several weeks before surgery.

You will undergo a detailed physical assessment. Your healthcare provider will also order several tests.

• Electrocardiogram (ECG) – An electrocardiogram test helps your healthcare provider assess your heart rhythm CT scan

• X-rays – This test lets your surgeon learn more about your hip

• Magnetic resonance imaging (MRI) – An MRI test gives detailed information about your hip

The results of these tests will guide your surgeon in choosing whether minimally invasive total knee replacement surgery is the best procedure for you.

If you are taking any prescribed drugs, over-the-counter medication, or multivitamin supplement, let your surgeon know about it.

You may be required to discontinue taking such medication for some time before surgery.

Let your surgeon know whether you are allergic to anesthesia or any medications.

If you have recently had a fever or an infection, it would be a good idea to inform your surgeon.

If you think or know you are pregnant, inform your healthcare provider about it.

If you are a smoker or take alcohol or recreational drugs, you will be asked to stop such a habit because it can delay your recovery.

You will be asked not to drink or eat anything for some time before surgery, usually after midnight on the scheduled date for surgery.

Your healthcare provider will request you to sign a consent form. By signing this form, you will be giving the surgical team the go-ahead to proceed with the surgery.

Make sure you have read the consent form very carefully. If there is anything that is not clear to you from the form, clarify this with your surgeon before signing it.

What happens during total knee replacement surgery? 

Once your surgeon has scheduled your time of surgery, you will be admitted to the healthcare facility for a few hours before the procedure.

A total knee replacement surgery takes a few hours. During the procedure:

You will have a session with an anesthesiologist before the procedure.

The anesthesiologist will explain the options available to you for the procedure. They will administer spinal or general anesthesia depending on what the surgical team determines will work best for you.

The anesthesia puts you to sleep during the procedure. That means you cannot feel any discomfort or pain as the surgeon is administering the total knee replacement surgery. 

A surgical team that comprises several healthcare professionals is on standby. They will monitor your vital signs carefully during the procedure, including blood pressure, pulse, and heart rate.

Your surgeon may recommend antibiotics during or after surgery to minimize the risk of infection.

The surgeon begins by making a small cut in the middle of the knee. The incision goes through the skin and into the underlying tissues.

The surgeon identifies and removes the sections of your shinbone and thighbone that are injured or damaged. A bit of the underlying bone is also removed.

The surgeon will place metal implants into the joint space where the damaged parts are removed.

The surgeon will use the remaining bone to cement the metal implants in place.

The surgeon can decide to remove a section of the kneecap, particularly on the underside.

Your surgeon will insert a plastic spacer between implants. The plastic spacer allows your knee joint to move with ease.

Finally, the surgeon will surgically close the muscle and skin.  

After total knee replacement 

After a total knee replacement surgery, you will wake up in a recovery room where the medical team will continue to monitor your recovery.

You may feel a lot of discomfort and pain around the site of incision immediately after surgery. For this, your surgeon will recommend pain medication. 

Your surgeon may order X-rays and imaging tests to assess the outcome of the surgery.

You could be allowed to go home after a few days in hospitals, depending on how quickly you become table and if there have been any complications.

You will be instructed to minimize movements or putting weight on the leg. For that reason, you will have to start using crutches or a walker for a few weeks.

Your healthcare provider will arrange a meeting with a physical therapist who will assist you in increasing the range of strength and motion on your leg.

Most people can comfortably resume their daily activities after a few weeks following surgery.

Make sure you have someone at home to assist you as you continue with your recovery at home.

You will experience fluid draining at the site of the incision from time to time. While this is normal, you will need to notify your surgeon in case of fluid leakage or swelling or the incision site as they could be a sign of an infection.

Let your provider also know in case you experience severe pain that gets worse with time or are running a high fever. 

Benefits of minimally invasive total knee replacement 

Having a minimally invasive total knee replacement surgery is associated with the following benefits: 

Smaller incisions

A minimally invasive total knee replacement surgery only requires small incisions of about 4-6 inches long. 

The surgeon uses miniature specialized tools and instruments during a minimally invasive total knee replacement surgery. 

That means the damage to surrounding tissue and structures is greatly minimized when compared to conventional surgery where the incisions are 10-12 inches long. 

Faster recovery

Since the incisions in minimally invasive total knee replacement surgery are smaller, that means the recovery time is also greatly reduced.  

Minimized post-operative pain

In a minimally invasive total knee replacement procedure, the knee joint and adjacent tissues are subjected to reduced trauma.

The pain expressed during recovery is significantly less. 

A minimally invasive procedure means less blood loss during surgery. 

Risks/complications

Minimally invasive total knee replacement surgery greatly reduces some risks observed with traditional total knee replacement surgery.

The procedure also carries its fair share of risks and complications. Some complications that might accompany this surgery include:

• Blood clots

• Nerve damage

• Infection

• Adverse reaction to anesthesia or medication

• Your body can reject the implant

Cost of total knee replacement surgery in India

If you are planning on having a total minimally invasive knee replacement surgery in India, starts from Rs. 2,00,000 but could go up to Rs. 4,50,000.

The difference in cost is determined by several factors:

The type of hospital room chosen

A deluxe room costs more than a twin-sharing room.

Surgeon’s expenses

The surgeon’s fee is determined by the city where your surgeon is located, their levels of skills, and experience in administering minimally invasive total knee replacement.

Pre-operative assessment

Any diagnostic tests and evaluation done including MRI and X-rays will add to the overall cost of the procedure.

Anesthesiologist charges

The cost charges of an anesthesiologist differ depending on the type of anesthesia used and the level of experience of your anesthesiologist.

City or location of a healthcare facility

If you undergo a minimally invasive total knee replacement surgery in any of the metro cities in India such as Bangalore or New Delhi, expect to pay more than if the procedure was performed at a tier II or tier III city.

The operations cost of running a clinic or healthcare facility in a metro city is higher.

References

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