Total Joint Replacement has become quite common these days but still there are lot of doubts that a common man an average patient has about the procedure and its related problems. Whenever we talk about any surgery there is a lot of questions that are raised in the mind of the average patient. Dr. Sachin Bhat is Consultant Trauma & Joint Replacement Surgeon at the SRV Group of Hospitals having its hospitals at Goregaon, Chembur & Dombivli. He has over 15 years of experience and has carried out many Complex Fracture and Complex Joint Replacement surgeries.

• What is Osteoarthritis of the knee ?
  Osteoarthritis is a degenerative disease of the knee where the cartilage that covers the bone of both the thigh and the leg which form the joint dries off. The synovial fluid dries off and the cartilage cracks to expose bony surfaces. The bones start rubbing into each other and which causes pain. This usually occurs after the age of 45.
• What are the factors that cause arthritis ?
  Many factors that increase the incidence are obesity or increased weight, lack of exercises, lack of walking, and muscle weakness. Many other immunological diseases like Rheumatoid and Ankylosing Arthropathy also cause this.
• What happens in arthritis of Knee ?
  Patient starts having pain in the knees it can be in 3 stages Mild, Moderate & Severe. Mild stage is when patient has pain only while sitting on the floor or while getting up from floor. Moderate stage is when pain is during climbing of stairs and severe is when there is pain while walking and also at night while sleeping.
• What is the right time for surgery ?
  The right time for surgery is when you have pain from walking a few meters or if the knee deformity has started, don’t wait too long once the knee starts to getting deformed or deshaped the more you wait the more will be the morbidity after surgery and you will require more physiotherapy. The right age usually is after the age of 50.
• What are the newer techniques that you follow ?
  I follow an early discharge model where the patient gets admitted on the morning of surgery and is operated on. He is made to stand and walk in the evening. The next day the knee bending and sitting on a chair is started and the patient is sent home on the 3rd day. But this can be done in select patients who don’t have associated problems like diabetes and high blood pressure. All my patients walk on the same day of surgery.
• What are the preparations before going for TKR ?
  We have a patient education program where the patient is taught exercises which will have to be done after the surgery so the physiotherapy is started before the surgery. Many blood investigations and a complete body check up is done for the surgery as patient has to be fit to undergo the operation.
• How much pain will be there ?
  The surgery is carried out under spinal anesthesia and I give local injection to minimize the pain. Round the clock painkillers are given. There is less pain from the second day onward. As I give a small cut the pain is less.
• What is the post-operative exercise program ?
  Patient is made to walk on the same day and the knee bending is started on the 2nd day. He is made to sit on a chair. Stair case climbing is done on 3rd day and patient is sent home. The physiotherapy continues at home for a month. The walker is taken off the 3rd day so all my patients walk without walker after going home.
• When can I move around on my own ?
  Once the wound is healed the patient can go anywhere, he wishes and can travel by public transport as well. The wound heals usually by 20th day.
• What is the type of joint put ?
  Many types are available in the market but the best ones are the ones with Titanium and Cobalt Chromium. Oxynium is also good.
• What can I do after surgery dos and don’ts ?
  Patient can virtually do everything that he or she desires. They are advised not to sit on the floor as that increases the load on the joint.
• Do you do Total Hip Replacement ?
  Yes, I do Total Hip Replacement. In India we have few cases of Hip Osteoarthritis but we have Rheumatoid and Ankylosing arthritis where Hip Replacement is necessary, also in case of Avascular Necrosis of Hip where the blood supply to the ball of the hip is damaged and the ball of the hip becomes dead as a result only surgery is the way out.