Painless Total Knee Replacement Why is it better than conventional Knee replacement surgery?

Painless & minimal-stitch Knee Replacement Surgery by the subvastus approach overcomes the potential drawbacks of conventional knee replacement surgeries. Knee replacement has proven time and again to be a highly successful and life changing surgery for elderly people who suffer from severe knee pain and for those who suffer from arthritis. However, despite the benefits offered by knee replacement surgery, patients are often skeptical as they are unsure if they will be able to walk pain free after the surgery or will the pain recur. Also, the complete recovery process after the surgery will be long and grueling, requiring a lot of orthopedic and physiotherapy visits.

Painless and minimal-stitch total knee replacement surgery overcomes these apprehensions as the surgery does not involve any muscle cut. KNE3WIZ aims to overcome all these challenges by leveraging technological advancements in imaging and visualization.

Its advanced algorithms make use of CT scan files to construct a highly detailed and precise 3D models of patient’s bones. This significantly improves the outcome of the surgery. Also, this surgery requires minimal-stitch as there is no cut in the muscle. Painless and minimal-stitch total knee replacement surgery employs the minimally invasive or no-cut in the muscle technique known as the Subvastus knee replacement. Whereas in the traditional approach to knee replacement an incision of 15-20 cm is made in the middle of the thigh muscle (the muscle just above the knee joint) to access the knee joint and perform the replacement is performed through this opening. Eventually the muscle is stitched back. This conventional technique where a cut in made on the muscle increases the recovery time as the time taken for the muscle is longer.

However, in the subvastus approach instead of cutting the quadriceps muscle from the centre, the muscle is shifted to the side to expose the knee joint and perform the replacement. Further, our 3D model helps the surgeon plan the most optimal fit and size of the implant and also helps select the right implant. Once the joint is replaced the muscle is moved back to its original place. As there is no muscle cut, the recovery time is significantly reduced allowing the patients to get back to work within days.

Is recovery much faster post painless and minimal-stitch knee surgery?
Recovery time varies from patient to patient based on their health. Those who have undergone painless & minimal-stitch Knee Replacement Surgery generally start walking within 5-6 hours of the surgery. They can start walking without support the next day itself.

*It is important to understand that recovery time varies from patient to patient.

Who can undergo painless & minimal-stitch knee surgery?
Almost all patients can benefit from painless and minimal-stitch knee replacement surgery. It completely depends on the expertise of the operating surgeon. Nonetheless, anyone who is a candidate for knee replacement surgery can undergo this surgery.

How much time does it take for the minimal-stitch knee surgery?
Painless and minimal-stitch Knee Replacement surgery performed at Shah Hospital with computer navigation does not take any longer than conventional surgery.

What is the principle of total knee replacement?
Knee replacement is a surgical procedure to resurface a knee damaged by arthritis or any external damage. A damaged cartilage can never repair itself except in the young with limited damage. The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments. This cartilage which is present of the surface of the bone ends is removed. The knee joint as a whole is never removed in total knee replacement. Natural bone and collateral ligaments are preserved. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery can be performed for someone who has arthritis or a severe knee injury.

What is the operative procedure?
The procedure starts from checking basic vitals like blood pressure, heart rate, body temperature, and oxygenation levels of the patient and then a mark is made on the knee undergoing surgery. Anesthesia is administered on the regional area or on the whole body. The surgeon makes a deep incision down the centre of the thigh, and then cuts through deeper tissue, including the quadriceps tendon, and flips over the kneecap to access the femur and tibia.

Alternatively, some surgeons make smaller incisions and use minimally invasive techniques for total knee replacement. The knee is bent to 90 degrees so there is a scope of accessibility for the surgeon. The surgeon uses a bone saw to remove the arthritically damaged areas at bottom of the femur and the top of the tibia. Surgeon may resurface the back of the kneecap, or patella, and attach an implant. A polyethylene component may be attached to facilitate the patella gliding against the new joint. Components are attached to the femur, tibia and the patella. A flexible cushion made of polyethylene is attached on top of the new tibia surfaces.

This spacer acts as a shock absorber between the two new prosthetic surfaces. The leg is flexed and extended to test the fit of the components and the range of motion of the new knee. The surgeon straightens the knee to allow the components, cement, and the bone to bond together. Because the bone cement is fast acting, this takes only about 10 minutes. The surgeon will repair any deep tissue that was cut during the surgery and then stitch the skin at the incision.

Quick Facts:
● Knee replacement is performed for Osteoarthritis, Rheumatoid Arthritis, Psoriatic Arthritis.
● Knee replacement can be partial or total.
● It requires a hospital stay of 2-3 days.

Computer navigation in Total Knee Replacement

The natural hip, knee and ankle joints are aligned in one single line. The joint replacements are also designed so that if hip, knee and ankle are well aligned, the joints would last much longer. Just as a GPS in the car can help navigate to reach the destination in the best possible manner, computer navigation in total knee replacement would help the surgeon achieve the perfect alignment. A good surgeon would be able to achieve perfect alignment in good number of cases, an excellent surgeon would be able to achieve perfect alignment in most of the cases but computer navigation would be able to achieve perfect alignment in ALL the cases.