Health Talk

All you Wanted to Know about Fast Track Knee Replacement Surgery


Knee Replacement is one of the most successful Orthospaedic procedures. It has been practiced for over 30 years now. In modern times, there has been a huge improvement in terms of technology, surgical technique and understanding of biomechanics of the knee joint. Post-operative pain management and painless physiotherapy has brought about a lot of change in recovery. The prevalence of knee osteoarthritis is around 42% in women and 21% in men above 60 years. The number of knee replacements surgeries performed in India are around 1 lakh per year at present and it is expected to grow by 20% annually. 

The fast track knee replacement is a new philosophy followed at Apollo Hospitals, Chennai. The main objective of this philosophy is to make the knee replacement procedure less painful, ensure faster recovery, painless physio and deliver trusted results. We follow a multi-modal approach for knee replacement with less surgical time, early mobilization, discharge and recovery. 

The concept of fast track knee replacement starts as an outpatient by doing all the investigations and pre anaesthetic check-up as an OPD and patient getting admission just the night before surgery.

Surgery starts with single shot spinal anaesthesia without any additives which decreases the duration of spinal anaesthesia and patient regains his leg power within 2 to 3 hours. No tourniquet is used during the surgery, hence the release of anoxic and pain causing metabolites, which routinely happens after tourniquet release, doesn't happen here and hence post-operative pain is less.

Next part is minimally invasive surgery. This involves small skin incision, minimal tissue dissection and less blood loss. This decreases post-operative pain and in turn helps in early mobilization and recovery. As a part of fast track knee replacement no surgical wound drain and no urinary catheter is used. This decreases the chance of post-operative infection.

All our knee replacement surgeries are cruciate retaining method. Post operatively this particular technique helps to gain proprioceptive function and stair climbing, especially, is more natural. Ten days after the surgery, the patient can walk without any support. All our knee replacement surgeries are protocol driven.   

Post-operative pain management involves multi modal techniques with femoral nerve block and no intra venous analgesics. There is no use of OPIODS in this technique which reduces drowsiness, vomiting and rarely respiratory depression. 

The patient is made to walk 3 hours after the surgery with the help of support. By second day, the patient is able to walk to the wash room by himself and is independent. By the end of 10 days patient will be walking without help of any walking aid.

The Fast track knee replacement has the following advantages:

n Fast relief

n Minimal (or) no pain

n Trusted results

n Zero infection rate

n No painful physiotherapy

n Early discharge from the hospital

n Patient can resume social and recreational activities.

n Is cost effective

(Dr. Madan Mohan Reddy is Senior Consultant, Joint Replacement Surgery, Apollo Hospitals, Chennai. He is also the recipient of International Healthcare Awards 2016 by Time CyberMedia.)

Q. Madam, I am a girl of 18 years and studying in Standard 11. I recently broke up with my boyfriend. I have moved on in my life. But my boyfriend says that he wants me back in his life. I told him that it's not possible but he is forcing me to accept him again. Please advise me what to do. 
(Name withheld) 
Ans: My girl! No one in this world can force you to do something against your will. Unless you allow that to do so! You have moved on with your life and that's that. If someone else is having a problem because of that, it's their problem. Not yours. Stay busy with your studies and other extracurricular activities. Don't allow anyone else to rule over your life.
Q. I am a 20 year-old male. In my childhood, I was sexually abused by 3 persons, one of whom was my relative. After growing up, I am trying to evolve from such a shock and trying to develop myself like any other general boy. But the problem is that sometimes I feel an interest towards boys instead of girls. There is no doubt that I want to have relation with girls and not with boys. But I don't know why I am attracted to guys. I am in a dilemma. Please help. 
(Name Withheld)
Ans: It is extremely unfortunate what you have had to go through as a child. Childhood is a time of innocence and discovery. What you went through is sad. There are lot of sick persons in our society who derive pleasure from such activities. Please remember that whatever happened to you as a child it is not your fault. Please seek professional counselling at the earliest. It will help deal with all your unresolved feelings and issues. Take care. 
Q. Hello madam, I am in the 8th standard. There is a boy who disturbs me along with his friends. If I pass by them, he and his friends always pass bad comments at me. I feel scared to pass by them. It is affecting my studies a lot. I keep thinking about it all the time. How do I get rid of this? Please help. 
(Name withheld)
Ans: What you state is a serious matter. This should not be taken lightly. Please inform your parents at the earliest. They will deal with it in the appropriate manner. Do not engage in any kind of quarrel with this boy. Let the elders deal with it. If possible for a while do not move around alone. Take care.
Ms.Gariasi Dutta, MSW (TISS) is Psychological Counsellor with Down Town Hospital, Guwahati. She can be contacted at 98640-55560 or [email protected]