Modern hip replacement implants are marvels of engineering. As with most manmade objects sensible and judicious use can prolong the life and utility of the implant. The life of Hip replacements is dependent upon the type of bearing material used. The Ceramic on ceramic bearings due to their low wear will last the longest, followed by Ceramic on crosslinked Poly, Metal on Metal. Metal on crosslinked poly and finally the Metal on Poly. Please see the choose your implant section to see which implant is best for you. The metal on Poly implants used 20 years ago has lasted in 97% of people as per reports available. So it is expected that the use of newer bearings, will prolong the life of implants EVEN FURTHER. In many people, the implants will last a lifetime.

In most people, Hip replacement is needed after the age of 60 years. However, for people who are suffering pain very badly and have exhausted all other non-surgical options, it is cruel to deny a patient a Hip replacement on basis of his/her age. Sometimes Hip replacement may be required in very young or very old individuals.

Knee replacement can be done any time after the age of 18 years. Unfortunately in diseases such as Juvenile Rheumatoid arthritis, Chondro epiphyseal dysplasia and hemophilia and tumors the the patient is faced with the option of staying in bed for their life or undergoing surgery and resuming a fulfilling lifestyle.

I would like you to meet Mrs. Meena Jain, 45 years, housewife and mother of 2 active children. She is 45 years old and has been put on 10 kgs in the last 2 years due to her inability to walk. She has suffered from pain associated with osteoarthritis for the last 10 years. She has been on all kinds of medicines allopathic, Homeopathic, and ayurvedic. She has also taken multiple injections in her knee. She has to take a painkiller tab every day and has been doing so for the last many years. Her X-rays show severe disease for which the only option is knee replacement. She demands a pain-free life and a medicine-free life. Do you feel it’s right to deny her this due to her age? 

After discussing various options with her, she chose knee replacement. She is now 47 years old she can walk as much as she desires and can go marketing and shopping alone as she is pain-free. Previously she was dependent on her husband and his scooter for going out of the house. She plays dandiya with her daughter and Competed in the parent’s 50 m run in her son’s school.

Since younger patients are more active, they will wear out a replacement at an earlier age. In such a condition, there is a chance that they will require a knee replacement again. This procedure called revision Knee replacement Is done very successfully even today. However, this event is at least 15-20 years from now, and if such a surgery is required then by that time I expect a lot of revolutionary changes and technological advances which will make the follow-up procedure easier safer, and even longer-lasting. The advantage is that the patient can lead an active life rather than that of an old person starting today.

Usually, if you get operated on a single side then you are discharged 3rd -4th day after surgery. Doing Both knees together, people usually go home 5-6 th day.

On the day of the surgery, by evening you can sit in bed and are encouraged to move your knees and ankles. The next day, You will stand and take a few steps. On the third day, all the Intravenous medicines and catheters are removed and you can start walking with a walker. Depending on your age and activity level, you will need a stick or a walker for a few days.

Special pneumatic pumps will be applied to your legs in the recovery room and will be kept in place for several days. They massage your calves every forty-five seconds. Most patients find them very comfortable. You may also wear special stockings. The pedaling exercise, the pumps, and the stockings all help to prevent blood clots from forming in your legs. 

By the time you leave the hospital, we like you to have at least 90 degrees of knee motion and good control of muscles about your knee. Most patients by the second or third day after surgery no longer have an IV and are feeling quite well. 

You will be allowed to go home when your temperature is normal and you are able to get in and out of bed by yourself and go to the bathroom by yourself. Some patients reach this goal within 3 days.

Patients with these conditions can safely undergo knee replacement. These conditions need to be well-controlled prior to the surgery.

The recovery after surgery differs from patient to patient. Most people can fully recover in 1 month. 

A knee replacement surgery allows you to be as active as you would have been if you had natural knees. All the activities that you love doing but you cannot do now due to knee pain are possible. I would like you to meet Mrs. Natalia Menezes Who has been operated on both knees 5 years back she is now 68 yrs old. She regularly travels in local trains in the rush hours from Virar to churchgate carrying with her fruits and vegetables grown at her farmhouse in Virar. She is a regular participant in the senior citizens run for the Mumbai marathon and has done parasailing, and motor scootering on the visit to Bangkok. She loves climbing mountains and is an amazing woman.

The limp in a patient with knee pain is due to loose ligaments and pain while walking. After the surgery, both are corrected, and The limp vanishes. 

Replacement surgery does not weaken bone. So If you fall, then the chances of developing a fracture is the same and depends on the severity of the fall.

Knee replacement techniques and Implants have changed for the better and this is a continuous process. Modern techniques and Implants allow a normal knee movement and can bend their knee fully within 2 mths of surgery. A lot of my patients can bend their artificial knees more than my natural knee. You have to remember that the knee replacement Implant is manmade and cannot compare to a natural knee. So you have to use it carefully.

The Indian Custom of sitting on the ground and using of Indian commode places a lot of strain on the implant and is best avoided. You can sit cross-legged on a couch but not on the ground. Having said that, sitting on the ground rarely for an occasion is acceptable.

As with any surgery, the chances of infections are 1%. Infection control starts before the surgery. We will do certain tests to localize the site of infection that is present in skin, urine, or teeth. Longstanding infection in these areas has to be eliminated. If any dental/ urinary surgery is required is performed or delayed for 6 months till after knee replacement.

I am a great believer in physiotherapy. The physiotherapist is a paramedical professional who does a lot of essential activities. He/she plays the following roles. 

• Motivates the patients and encourages activity
• Answers questions the patient may have about the procedure and post-operative period
• Develops a friendly and approachable relationship with the patient
• Looks for red flag signs suggestive of problems and notifies the doctor
• Dressing changes and removal of stitches
• Shows patient stairs climbing other activities of daily use
• Accompanies patient on roads till they regain confidence
• Co-ordinates with a doctor for medicines and informs recovery of the patient

Usually, a patient will require 7 sessions of physiotherapy once a day after surgery, then 7 sessions on alternate days to recover from this surgery.