Knee Replacement Surgery in Thailand: 10 Things You Need To Know
1. HOW DO I KNOW I NEED A KNEE REPLACEMENT SURGEY?
The determination for the need for knee surgery is based upon a number of factors, primarily:
- Chronic pain
- Loss of function
- Lack of response to other less invasive procedures
- Physical findings (presence of significant deterioration of the joints and swelling)
- Presence of complicating health issues (patients with some chronic health issues may be at a high risk for surgery and therefore not suitable for an operation)
The determination is made by you and your physician. Unless you feel 100% confident in the opinion of your doctor, you may want to seek a second opinion.
2. CAN I AVOID KNEE REPLACEMENT SURGERY?
Surgery should almost always be looked at as the treatment of last resort. There are a number of things you can do to reduce your risk of needing knee surgery one day, including:
- Get Well: If you are overweight, lose some.
- Get Fit: If you are unfit, get fit.
- Focus on nutrition: Accelerated aging (degeneration) can oftentimes be altered through improving nutrition through both dietary and nutritional supplements.
- Focus on reducing inflammation naturally: Ask your doctor about nutritional supplements specifically to reduce inflammation, including fish oils, curcumin, glucosamine/chondroitan, anti-oxidants, phytonutrients, etc.
- Medical anti-inflammatory medicines: your doctor may recommend oral or injectable medicines designed to reduce inflammation in and around the joints.
If any or all of these measures fail to alleviate your condition, then surgery may be the best option for you. Given the tremendous advances in surgical technique and in post-operative recovery and rehabilitation, the probability that you will have a positive outcome have never been higher.
3. CAN YOU EXPLAIN WHAT HAPPENS DURING KNEE REPLACEMENT SURGERY?
Once you are in the operating room and unconscious from anaesthesia, your surgeon will make an incision from the top of the knee to just below the knee. The actual length of the incision depends upon the specific technique used by the surgeon. Once the knee joint is exposed he/she will remove the damaged area, usually the cartilage and endplates of the upper leg bone (the femur) and the lower leg bone (the tibia) and may also need to remove part of the knee cap. The newly exposed surfaces will next be capped with synthetic joint materials.
Here is an easy to understand video from WebMD depicting the operation: Knee Replacement(http://www.webmd.com/pain-management/video/knee-replacement)
4. CAN YOU TELL ME SOMETHING ABOUT THE KNEE IMPLANT ITSELF?
Knee implants are made of basically two kinds of materials, metal and plastic. Since these materials are foreign to the body they must be attached to existing structures (tissues like bone and or cartilage) and therefore require special procedures to make sure they stay in place. One method uses a special type of bone cement and the other achieves uses joint replacement materials that are porous that allow for the bone tissue to “grow into” the joint replacement in such a way to create a strong bond. Some surgeons use both methods on the same patient.
We found a good article explaining the different kinds of knee implants at the American Academy of Orthopedic Surgeons website here (http://orthoinfo.aaos.org/topic.cfm?topic=a00221).
5. HOW BIG OF A RISK IS ANAESTHESIA?
Every surgery involving anaesthesia presents a risk. Fortunately that risk is quantifiable and very low. There are a number of different types of anaesthesia that can be used for this operation, each presents with slightly different risks. Much of the risk of anaesthesia is actually due to your state of health at the time of the surgery. Therefore if you are in good health your risk of anaesthesia are very low.
Here (http://orthoinfo.aaos.org/topic.cfm?topic=a00372) is a link a an informative article at the website for American Academy of Orthopedic Surgeons.
6. HOW LONG WILL I FEEL PAIN AFTER THE SURGERY?
The length and intensity of the pain a patient may experience after surgery differs tremendously from person to person. Most patients notice a rapid drop off of the pain within 4 or 5 days. Your surgeon will make a determination about what kind and how much pain relief medication is needed immediately following surgery. The medicine is most often administered intravenously at first before transitioning to oral medication. Upon release from the hospital, your pain levels should decrease with time, but some level of discomfort may remain for some time. In a small percentage of patients the pain can persist for up to a full year after the surgery, depending to great extent on how well you engaged in active physical rehabilitation.
7. WHAT CAN I EXPECT IMMEDIATELY AFTER SURGERY?
As you awaken from being under the anaesthesia, you will slowly become aware of where you are. You will notice that your knee is elevated and covered with bandages and there will likely be a tube exiting your knee to drain off fluids that have built up shortly after the surgery. Most surgeons now also use a device that creates something called “Continuous Passive Motion” or CPM that moves your knee slowly flexes and extends your knee slowly to accelerate healing. Some surgeons also have a catheter inserted into your urinary tract to minimize your need to use the toilet immediately after the surgery. If you are an increased risk for clot formation, your doctor may have also placed a special bandage on your lower leg to offset that risk. Your doctor will administer antibiotics intravenously and you may also receive low dose anticoagulants (blood thinners) to reduce the risks of a clot.
You’ll likely remain in the hospital for several days before being released. Once you are released you’ll need to start physical rehabilitation.
8. CAN I DO REHAB IN THAILAND?
Rehabilitation of your knee will take some time. Some people traveling from abroad for knee surgery choose to initiate their rehabilitation while they are in Thailand.
9. HOW LONG WILL MY KNEE IMPLANT LAST?
There are variety of knee replacement models. Each has it’s pros and cons. Research demonstrates that for the overwhelming majority of recipients (85%) of the knee replacements, they will last 20 years or more. Younger recipients, due to the greater wear and tear, may need to have theirs replaced after 10 years.
10. HOW SOON CAN I TRAVEL AFTER THE OPERATION?
Because knee surgery disrupts a lot of tissue in the lower leg, orthopedic surgeons generally recommend the patient not fly long distances for approximately 4-6 weeks. The risk of blood clotting in anyone flying long distances increases, but in those having just had surgery of the knee the risk is even higher. This is one of the reasons patients sought rehabilitating their knee in Thailand and turning it into a holiday at the same time.