knee care

Dr Vinay JoshiMS,DNB,FCPS,D’ORTH,FRCS,FRCS (ORTH)

Consultant Orthopaedic SurgeonKDAH

Taking good care of your knees

Knee Anatomy

Maintain a Healthy Weight

• Excess weight puts undue stress on your joints and speed up the deterioration of joint cartilage.

• For those who have OA, excess weight can exacerbate the symptoms.

• Losing weight has been proven to reduce pain in legs and hips.

Exercise • Exercise is essential to slowing and preventing

osteoarthritis.

• It maintains healthy joints, relieves stiffness, reduces pain and fatigue, and increases muscle and bone strength.

• Arthritis experts recommend low-impact exercises that involve aerobic activity, strength training, and stretching

Diet

• A diet low in saturated fat and high in fiber-rich food.

• whole grains, Fresh fruits, and vegetables will optimize nutrition and help you avoid excess weight.

• Avoid processed and fried food.

Rest

• While exercise can help develop healthy joints and muscles, excessive overuse of joints can increase the risk of developing OA.

• The key is balance. Also, for those who have OA, fatigue has been shown to increase pain.

• Make sure you get eight to 10 hours of sleep every night.

Stages of Osteoarthritis

Progression of Osteoarthritis

Non Surgical management of knee arthritis

• Reduction of weight.• Use of cane• Limitation of activity• Intraarticular cortisone injection.• Swimming / bicycle.• Knee cap / braces.• NSAIDs.• Physiotherapy and SWD.

When to consider a Total knee replacement

• Only patient can make a informed decision.

• Constant pain / wheelchair bound – Needs TKR.

• Responding to non operative treatment and can walk long distance without a stick – Do not need a TKR.

SOME FACTS ABOUT KNEE ARTHRITIS

• Grade 4 arthritis will never get better or remains same but will gradually get worse.

• Gradually star affecting other knee and lower back.

• Delay of surgery may start affecting other side.• Longer you sit around with arthritis softer

your bones and weaker your muscles.• Total knee replacement has 96% success rate.

Metal used is Cobalt Chromium.

High Density Polythelene in the middle.

MIS ( Minimally Invasive Surgery) knee

• Small Skin Insertion• Minimal disruption of

extensor mechanism• Shorter hospital stay• Early mobilisation and quick

recovery• Less blood loss

High Flex TKR

Specifically designed to safely accommodate Flexion upto 155.

Why a woman’s knee? Gender Total Knee

•Orthopaedic surgeons have reported anatomical differences in women’s and men’s knees for years.

Orthopaedic surgeons often have to consider intraoperative adjustments during knee surgery to accommodate women’s anatomical differences.

Women account for nearly two-thirds of knee arthroplasties performed annually . Women are three times more likely to need knee arthroplasty.

• CT data documents distinctive shape differences in female and male distal femurs.12,13

Female femurs are:

• More trapezoidal-shaped.

Narrower in the M/L dimension when compared to a male femur of the same A/P dimension

MIS ( Minimally Invasive Surgery)

Unicondylar Knee Replacements

Localised Knee arthritis

Preservation of uninvolved tissues and bone.

With appropriate patient selection, careful surgical technique, and proper implant design long term excellent results.

Patellofemoral Replacement

Severe isolated patellofemoral arthritis

A PFR is a much smaller operation than a total knee replacement. The incision is much smaller and all knee ligaments are preserved. The recovery from a PFR is the quickest of all partial knee replacements.

Computer Navigation in TKR

Mechanical Axis • The use of computer navigation in total knee replacement (TKR) has resulted in consistently accurate alignment of prosthetic components.

• Helps surgeon in soft tissue balancing in difficult TKR

Computer Navigation in TKR

THANK YOU