Best Knee Replacement Surgery in Hyderabad, India

Knee replacement surgeries are classified according to the extent of the knee joint that are involved and the type of prosthesis utilized. Below are the primary types:

Types of knee replacement operation

Different types of knee replacement surgery based on the extent of the knee joints that are involved comprise the following: 

• Total knee replacement (TKA): This is the most common type of knee replacement, which replaces both joint surfaces (tibiofemoral joint). Artificial components are placed in place to replace the femur (thigh bone) and tibia (shin bone). Most total knee replacement surgeries retain the patellofemoral joint (kneecap). If there is arthritis at the back of the kneecap, the surgeon may also choose to resurface and replace it.
• Partial knee replacement or partial knee arthroplasty (PKA): If arthritis affects only one compartment and the other compartments are normal, the surgeon may recommend a uni-compartmental replacement. This involves replacing only the affected compartment. 
• Total knee replacement with kneecap – patellofemoral arthroplasty: The patellofemoral joint that joins the kneecap to the thigh bone can be resurfaced and replaced. This type of knee replacement is less common and only needed if the back of the kneecap is worn off. If necessary, this can be done during a total knee replacement.
• Complex or revision knee replacement: If a patient has had a knee replacement for a long time or is experiencing difficulties, the surgeon may consider revising the joint. This is where the existing components are removed and replaced with a new second joint. For complex knee replacements, surgeons may employ a longer component in the bone to ensure correct implantation.

Types of knee replacement prostheses

Total knee replacement surgery can involve different prostheses. The most suitable form will depend on parameters such as ligament stability, bone and muscle condition, and any misalignments (bowlegs or knock knees):

• Non-constrained prostheses: The upper and lower parts of the prostheses are not joined. For this type of implant to function, the medial and lateral ligaments (and, in certain cases, the posterior cruciate ligament) must be stable enough to coordinate the movements of the knee, such as bending, straightening, and rotating it properly. Most prostheses require the anterior cruciate ligament to be removed before implantation.
• Semi-constrained prostheses: These prostheses are used when the posterior cruciate ligament is unstable and needs to be removed. In these prostheses, a type of hinge connects the two components, providing stability in place of the cruciate ligaments. The hinge determines how far the knee implant can bend and straighten.
• Constrained (or "hinged") prostheses: A hinged mechanism connects the upper and lower leg components, which are then joined to the bone on each side by a long stem. Constrained prostheses are utilized when the medial and lateral ligaments are insufficiently secure. Other causes include poor bone health and significant misalignments (knock knees or bowlegs).
  

Indications for Knee Replacement Surgery

Knee replacement operation, mainly total knee arthroplasty (TKA), is recommended for a variety of health conditions, including severe knee pain and functional impairment. Below are the main indications for knee replacement surgery: 

• Osteoarthritis: Advanced osteoarthritis, which causes significant joint degeneration and pain that interferes with everyday activities, is the most prevalent indication for knee replacement.

• Chronic knee pain: Patients with continuous knee pain, either intermittent or constant, for at least 3 to 6 months that is not relieved by conservative treatments (e.g., medicines, physical therapy) are suitable candidates for a total knee arthroplasty (TKA).

• Failed conservative treatments: Patients should have received adequate conservative treatment without experiencing significant symptom relief. This includes pharmacologic treatment and non-pharmacologic interventions for at least three to six months.

• Radiological evidence: Imaging tests are required to demonstrate structural damage to the knee joint, such as joint space narrowing or other symptoms of osteoarthritis or osteonecrosis.

• Severe deformity or instability: Conditions that cause severe knee deformity or instability may also suggest the need for knee replacement surgery.

• Age and overall health: Though age is not a precise criterion, elderly patients with severe symptoms and radiographic evidence of osteoarthritis are generally regarded as suitable candidates for total knee arthroplasty (TKA). However, younger patients may be assessed depending on their specific problems.

• Functional limitations: Functional limitations, like difficulties with walking, climbing stairs, or completing everyday activities, have a significant influence on the patient's quality of life. This supports the need for surgery.

Contraindications for Total Knee Replacement

Knee replacement surgery is frequently performed to decrease pain and restore function in people with significant knee joint degeneration. However, certain absolute and relative contraindications need to be considered for patient safety and to optimize outcomes. These contraindications indicate situations where surgery is risky or necessitates careful consideration before proceeding. They include the following: 

Absolute contraindications for knee replacement surgery

• Active or latent (less than 1 year) knee sepsis: Infection in the knee joint can cause serious complications, such as prosthesis failure and systemic infection, making surgery risky.

• Medically unstable patient: Patients with uncontrolled systemic diseases, such as heart failure, face considerable perioperative risks that outweigh the advantages of surgery.

• Presence of active infection elsewhere in the body: Active infections in other areas of the body raise the risk of spreading infection to the surgical site, affecting recovery.

• Extensor mechanism dysfunction: Quadriceps or patellar tendon dysfunction impairs knee stability and function, decreasing the chances of a positive outcome.

Relative contraindications for knee replacement surgery

• Poor overlying skin condition: Compromised skin integrity raises the likelihood of wound healing problems and infections after surgery.

• Neuropathic joint: Nerve injury can cause instability and deformity in neuropathic joints, potentially leading to poor surgical outcomes.

• Noncompliance due to major psychiatric disorder, alcohol, or drug abuse: Failure to comply with postoperative care and rehabilitation can severely impede healing and lead to complications.

• Morbid obesity: Obesity causes additional stress on the prosthetic joint, raising the risk of implant loosening and failure over time.

• Poor patient motivation or unrealistic expectations: Dissatisfaction and inadequate recovery can occur due to a lack of motivation for rehabilitation or excessive expectations about surgery outcomes.

• Severe peripheral vascular disease: Reduced blood flow caused by vascular disease hinders wound healing and raises the risk of infection and ischemia after surgery.

• Insufficient bone stock for reconstruction: Low bone quality or insufficient bone stock can affect implant fixation and long-term stability.
  

Knee replacement surgery has several benefits for individuals with significant knee pain and mobility difficulties. Below are the important benefits of knee replacement surgery:

• Pain relief: The primary advantage of knee replacement surgery or knee arthroplasty is significant pain reduction. Many patients find a considerable drop in pain levels after surgery, allowing them to participate in everyday activities without discomfort.



• Improved mobility: Knee replacement may improve mobility, allowing patients to do movements that were previously challenging (difficult) or impossible because of arthritis or degeneration of the joint.

• Improved physical activity: Postoperative mobility improvements frequently result in more involvement in physical activities, such as walking and low-impact sports, that are important for overall well-being.

• Greater independence: Patients usually regain the capacity to conduct daily tasks independently, like climbing stairs and walking without assistance. This leads to a sense of independence.

• Better quality of life: The majority of patients report high satisfaction reviews after knee replacement surgery, highlighting improvements in their overall quality of life.

• Cost-effectiveness: While knee replacement surgery can be expensive at first, studies show that it can result in significant long-term savings by decreasing the need for continuous pain management medications and enhancing functional capacity.

• Psychological benefits: As patients regain movement and independence, they frequently report increased emotional well-being, less worry, and greater social connections in addition to physical improvements.
  

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Knee replacement surgery steps include the following:

Before the knee replacement procedure

• In addition to a thorough medical history, the doctor usually performs a complete physical examination to ensure patients' good health before going through the surgical procedure, which may include blood tests or additional diagnostic tests.
• Patients need to inform the doctor / knee replacement surgeon if they are sensitive to or allergic to any medications, tape, latex, or anesthetic agents (local and general).
• Patients must inform their doctor if they have a history of bleeding disorders or are using any anticoagulant (blood-thinning) medications, aspirin, or other blood-clotting inhibitors. Certain medications may be required to be discontinued prior to the surgery.
• Patients need to inform the doctor about every medication (prescription and over-the-counter) and herbal supplements they are taking.
• Patients who are pregnant or suspect they are pregnant need to inform their doctor.
• The doctor will explain the procedure clearly to the patient and allow them to ask any questions they may have.
• The patients will have to do a signature on a consent form authorizing the doctors to perform the surgery. Patients should carefully read the form; if there are any questions, they can ask the doctors.
• Patients are informed not to drink or eat anything from the night before their procedure.
• Patients need to look and arrange for someone to assist them around the house for a week or two once they are discharged from the hospital.

During the knee replacement procedure

• Knee replacement surgery is usually performed while patients are asleep under general anaesthesia. The anaesthesiologist will discuss this with the patients earlier.
• Patients are asked to take off their garments and provided a gown to wear.
• An intravenous (IV) line can be started in the patient's arm or hand.
• Patients are positioned on the operating table, and a urinary catheter is inserted.
• In case of excessive hair at the surgical site, it may be trimmed.
• The anaesthesiologist will monitor the blood pressure, heart rate, and other vital signs during the procedure.
• The skin around the surgery site will be cleaned with an antiseptic solution.
• The doctor will create an incision in the knee area.
• The doctor will remove the damaged surfaces of the knee joint and resurface it with the prosthesis. The knee prosthesis is composed of metal and plastic. The most common type of artificial knee prosthesis is the cemented prosthesis. Uncemented prostheses are no longer routinely used. A cemented prosthesis is secured to the bone with surgical cement. An uncemented prosthesis has a porous surface that allows the bone to develop and connect to the prosthesis. Sometimes, both types are used to replace a knee.
• The incision will be closed using stitches or surgical staples. 
• A drain may be inserted into the incision site to remove fluid. A sterile bandage or dressing will be done.

After the knee replacement procedure

• Following surgery, patients are brought to the recovery room for observation. Patients will be moved to their hospital room once their blood pressure, pulse, and respiration have stabilized, and they are alert. A few day's stay in the hospital is normally required for knee replacement surgery.
• Following surgery, it is essential to start moving the new joint. A physical therapist will visit with patients shortly after surgery to plan an exercise program for them.
• Physical therapy may begin with the use of a continuous passive motion (CPM) machine. While patients are lying in bed, this machine moves the new knee joint through its full range of motion.
• Pain is managed with medicines so that patients can participate in the activity. Patients will be provided with an exercise schedule to follow while in the hospital and after discharge.
• Patients are discharged and sent home or to a rehabilitation facility. In any instance, the knee replacement doctor will arrange for continued physical therapy until patients regain muscular strength and range of motion.
  

A knee replacement is a common and safe surgical procedure. Though, there are risks associated with each procedure. Most knee replacement patients do not have any problems. If there are any, they are generally small and treatable. The risk of developing complications varies with age and overall health. Below are the knee joint replacement surgery complications: 

• DVT (deep vein thrombosis) or blood clots: Because of the way blood flows and clots after surgery, blood clots or DVT (deep vein thrombosis) are possible following a knee replacement. This is usually not a serious condition. A blood clot in the leg can occasionally go to the lungs (pulmonary embolism). This can lead to major consequences.

• Damage to nerves or tissue: During surgery, a blood vessel, nerve, or ligament near the knee joint may be injured. This is uncommon and can be fixed after surgery or heal later.

• Wound infection: There is a slight chance that the knee wound may get infected after surgery. Antibiotics are generally used to treat these infections. Patients may require additional surgery if the infection spreads deeper into the knee joint.

• Bleeding: Excessive (more) bleeding during or after surgery may occur, necessitating blood transfusions or further additional procedures.

• Joint stiffness: Many individuals feel stiffness following surgery, which can impede mobility and require physical therapy to overcome it.

• Persistent pain: Some people may not get the desired pain reduction after surgery and may experience continuous discomfort.

• Prosthesis loosening: Over time, the prosthetic joint (artificial joint) may become loose, causing pain and instability, needing revision surgery.
  

Recovery after knee joint replacement surgery in Hyderabad usually takes around 12 weeks, with most patients able to resume daily activities, such as walking without assistive devices, within 3-6 weeks. Complete recovery, including restoring maximum strength and mobility, might take 6 months to a year. Adherence to physical therapy and rehabilitation strategies is essential for successful outcomes and long-term joint health.

Questions that the patients can ask the healthcare team about knee replacement surgery?

• When can I go home?
• When do I need to see my doctor again?
• What kind of pain can I expect?
• When can I go back to my regular activities?
• What is the expected recovery time?
• What precautions should I take?
• What problems can occur after knee replacement surgery?
• Will I require physical therapy after surgery, and for how long? 
• How do I expect my knee to look over time?
• How long will my recovery take, and what kind of assistance will I require throughout that time?
• Are there any specific exercises I should avoid while recovering?
• Do I need any further treatment?

Knee resurfacing vs Knee replacement

Two distinct surgical methods for treating damage to the knee joint, primarily from arthritis, are knee replacement and knee resurfacing. The parameters that aid in differentiating knee replacement and knee resurfacing are shown in the table below:

Difference Between Total Knee Replacement (TKR) and Partial Knee Replacement (PKR)

The knee replacement surgery cost in Hyderabad, India ranges varies from ₹90,000 to ₹3,25,000 (US$1,050 to US$3,798). However, the actual knee replacement cost may vary depending on several factors such as:

• Type of Surgery: Partial vs. Total Knee Replacement
• Unilateral vs. Bilateral Surgery: Single knee vs. both knees
• Implant Quality: Standard vs. premium imported prosthetics
• Hospital Stay & Room Category: General, semi-private, or private rooms
• Surgeon's Expertise: Fees vary based on experience and reputation
• Insurance & Cashless Facilities: Coverage through health insurance or corporate tie-ups

Breakdown of Knee Joint Replacement Surgery Cost in Hyderabad, India

💠 Unilateral (Single Knee) Replacement:

• Total Knee Replacement (TKR): ₹90,000 – ₹1,75,000 (US$1,050 – US$2,040)
• Partial Knee Replacement (PKR): ₹80,000 – ₹1,50,000 (US$935 – US$1,748)

💠 Bilateral (Both Knees) Replacement:

• Total Knee Replacement (TKR): ₹2,90,000 – ₹3,50,000 (US$3,380 – US$4,078)
• Partial Knee Replacement (PKR): ₹2,20,000 – ₹3,00,000 (US$2,564 – US$3,495)

At PACE Hospitals, we provide advanced knee replacement treatment in Hyderabad, Telangana, India, with cutting-edge technology, expert orthopedic surgeons, and affordable pricing. We also offer insurance and cashless payment options for a hassle-free experience.

Top 5 Mistakes to Avoid After Knee Replacement Surgery

How long does knee replacement surgery take?

Knee replacement surgery usually takes between 1 and 2 hours and about 1 hour for a partial knee replacement, depending on the complexity of the surgery and specific patient characteristics.

What is bilateral knee replacement surgery?

Bilateral knee replacement surgery involves replacing both knee joints with artificial implants to alleviate severe pain and restore mobility, often due to joint degeneration or arthritis. It can be performed in a single procedure under one anesthesia or as two separate surgeries scheduled months apart. The choice between these techniques depends on the patient's health, recovery goals, and risk factors.

For the best knee replacement in Hyderabad, Telangana, India, PACE Hospitals offers advanced surgical techniques, including robotic-assisted and minimally invasive knee replacement, ensuring faster recovery, reduced pain, and excellent long-term outcomes.

How much blood is lost during knee replacement surgery?

During knee replacement surgery, blood loss normally ranges between 300 and 500 milliliters, depending on the surgical approach and patient condition. Patients may require a blood transfusion in some circumstances, however contemporary procedures such as the administration of antifibrinolytics have considerably reduced this need.

Is knee replacement considered major surgery?

Yes, knee replacement surgery is regarded as major surgery because it includes removing weakened bone and cartilage from the knee joint and replacing it with artificial implants. It takes extensive recovery time and rehabilitation and is often advised only after other therapies fail to reduce severe pain or enhance mobility.

What to expect 5 weeks after knee replacement surgery?

Most patients report less pain and swelling, better mobility, and a wider range of motion 5 weeks following knee replacement. Many people can walk without using assistive equipments such as walkers or canes and resume light home tasks. Physical therapy is essential throughout this period to strengthen the knee and improve flexibility.

Is knee replacement surgery painful?

Knee replacement surgery is frequently associated with considerable pain in the early postoperative period, but the pain usually subsides over time. Most patients recover manageable pain levels within a few weeks, with many experiencing significant improvement from prior pain three to six weeks after surgery. However, some individuals may continue to have moderate to severe pain even a year after the treatment, which is frequently influenced by factors like preoperative pain levels and psychological conditions.

What are the signs of infection after knee replacement surgery?

Symptoms of infection following knee replacement surgery include: 

• Increased joint pain or stiffness, mainly if it develops with time.
• Swelling, warmth, and redness at the surgery site with cloudy or foul-smelling discharge. 
• Fever or chills, usually higher than 100°F (37.8°C), along with tiredness or night sweats.

These symptoms require urgent consultation with an orthopedic surgeon for further evaluation and necessary treatment.

What is revision knee replacement surgery?

Revision knee replacement surgery involves replacing old, loose, or infected components of a previous knee replacement with new prosthetic parts. It is more complicated than the initial surgery, frequently requiring specialized implants, bone grafts, or metal augments to treat bone loss and assure joint stability.

When are staples removed after knee replacement surgery?

Surgical staples are often removed 10-14 days after knee replacement surgery, based on how the incision heals. The exact timing may differ based on wound condition, patient health, and surgeon advice.

What is the difference between unilateral and bilateral knee replacement?

Unilateral knee replacement is a procedure that involves replacing the joint in one knee, usually for people who have serious injury to that knee. Bilateral knee replacement involves replacing both knees in one surgery or two consecutive surgeries. While unilateral surgery has a shorter recovery period, bilateral surgery can be more effective for people with severe arthritis in both knees, but it may require a longer rehabilitation and a higher risk of complications.

How do I manage swelling after knee replacement surgery?

Elevating the leg above heart level, using ice packs, and wearing compression stockings can all help reduce swelling. Patients also need to avoid long periods of sitting or standing without moving.

What is the success rate of knee replacement surgeries at PACE Hospitals?

How long does it take to recover from knee replacement surgery at PACE Hospitals?

What types of knee replacement surgeries are available at PACE Hospitals?

Do you provide free online doctor consultations in India for Knee Replacement Surgery?

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