Knee replacement surgery, or knee arthroplasty, relieves pain and restores function in severely diseased knee joints by replacing damaged bone and cartilage with a prosthesis made of metal alloys, high-grade plastics, and polymers.

When It’s Needed

• Severe pain, swelling, or stiffness reducing mobility
• Pain interfering with sleep or quality of life
• Difficulty with daily activities (e.g., getting out of bed)
• Depression due to pain and limited mobility
• Failure of non-surgical treatments (medications, physiotherapy, intra-articular injections)

Conditions necessitating surgery include osteoarthritis, rheumatoid arthritis, knee trauma (distal femur/proximal tibia fractures), haemophilia, gout, avascular necrosis, knee deformity, neuropathic joint, or sequelae of septic arthritis.

Types

• Total Knee Replacement (TKR): Both knee compartments replaced
• Partial Knee Replacement (UKR): One compartment replaced

Technique

• Spinal anesthesia, no tourniquet, smaller incisions
• Minimal soft tissue handling, mechanical axis alignment, ligament balancing
• Implant trial (15-20 min), implanting (10 min), wound closure (15-20 min)
• No drain, early mobilization (walking within 3-4 hours, stairs next day)
• Discharge: 3rd day (unilateral), 5th day (bilateral)

Standardized, high-volume procedures reduce surgical time, complications, and infection rates (<1%).

Recovery

Hospital stay: 3-5 days. Patients use crutches initially, stop walking aids around 4 weeks, and drive after 6-8 weeks. Full recovery takes 2-3 months, with rare persistent pain after 6 months.

Risks

• Superficial or deep infection
• Ligament, vascular, or nerve damage
• Deep vein thrombosis (DVT)
• Aseptic or septic loosening
• Persistent pain, instability, stiffness, or fractures

Hip replacement surgery replaces a damaged hip joint with an artificial one, significantly reducing pain and improving mobility. Modern implants last at least 20 years.

When It’s Needed

• Severe pain and reduced mobility affecting sleep or quality of life
• Difficulty with daily activities
• Depression due to limited social or work life
• Failure of non-surgical treatments (medications, physiotherapy)

Conditions include avascular necrosis, degenerative osteoarthritis, rheumatoid arthritis, hip fractures (femoral head, acetabulum, inter-trochanteric), septic arthritis, ankylosing spondylitis, bone dysplasias, DDH, Perthes, or SCFE sequelae.

Risks

• Hip dislocation or instability
• Superficial or deep infection
• Deep vein thrombosis (DVT)
• Vascular or nerve injuries
• Intra-operative or post-operative fractures
• Leg length discrepancy
• Aseptic or septic loosening
• Heterotopic ossification

Shoulder replacement replaces the humerus head and glenoid with artificial surfaces, reducing pain and improving range of motion. The procedure takes approximately 2 hours, with implants lasting 10-15 years.

When It’s Needed

Offered to low-demand or elderly patients when other treatments (NSAIDs, physiotherapy, steroid injections, arthroscopy) fail. Conditions include trauma, degenerative osteoarthritis, rheumatoid arthritis, or septic arthritis.

Risks

• Superficial or deep infection
• Excessive bleeding
• Instability or dislocation
• Stiffness
• Vascular or nerve injury
• Aseptic or septic loosening
• Fractures during or after surgery
• Thrombosis or blood clots