Total Knee Replacement (TKR), Total Hip Replacement (THR)

Total knee replacement and total hip replacement surgeries are both very important and also common medical procedures, which help to restore the optimal functionality of the concerned joint. Both procedures are extremely safe and have shown effective results for patients with severely ailing joints – hip and knee.

Total Knee Replacement (TKR)

A total knee replacement surgery, also medically known as total knee arthroplasty, is a safe surgical procedure that helps to relieve pain and restore normal functioning of the concerned knee joint. The surgery involves separating the affected bone and cartilage from the thighbone, shinbone and kneecap, and replacing it with an artificial joint made of plastic and metal – called prosthesis.

A total knee replacement surgery is advisable for patients whose knees have been damaged or weakened due to injury, trauma or arthritis. These affected knee joints tend to cause immense pain and also restrict the functioning of the knee. A knee replacement surgery is best suited for people who tend to experience extreme knee pain due to weakening, wear-tear, injury, trauma, etc. of the bone and cartilage forming the knee joint. A knee replacement surgery becomes the need for patients in such conditions since the compromised knee joint causes difficulty in the movement including climbing stairs, walking, sitting or lying down. However, a knee replacement surgery is advisable only in conditions when other alternative courses of treatment – such as medication, physical therapy or mobility aids (walkers, sticks, crutches, etc.) – have failed to restore the normal functionality and ease knee pain. The surgery is safe, has minimum complications and aims to correct a problematic knee joint and leg deformity.

However, the suitability of the knee replacement surgery will depend per case. The orthopaedic surgeon will conduct a physical examination (to know the ability, stability, strength, flexibility, structure, etc. of the knee joint) understand symptoms, and also perform several tests such as X-rays to evaluate the damage and current condition; blood and urine test; and an electrocardiogram to be aware of any heart problems beforehand. Also, other critical factors such as age, health, weight, physical activeness, etc. will be considered while deciding the surgical method and the choice of prosthetics.

Total Hip Replacement (THR)

Total hip replacement surgery or also medically referred to as total hip arthroplasty is one of the most successful surgeries in all of medicine. In a total hip replacement surgery, the damaged bone or cartilage is removed and prosthetics are put in place to improve functionality and ease the pain. The surgical procedure aims to replace the damaged or worn surfaces of the hip joint.

In general, our hip is a ball-and-socket joint; the ball (femoral head) and socket (acetabulum) are covered with articular cartilage – a soft and compressible substance, which enables the hip joint to function optimally. When the articular cartilage wears away, the underlying bone of the hip is exposed. This leads to roughening and distortion of the hip joint, causing sore and restricted movement. Gradually, with more wear-and-tear, a limp will be formed causing the leg to become weak and shortened. This is caused due to multiple factors such as osteoarthritis, rheumatoid arthritis, injury, osteonecrosis, childhood hip problem, and others.

In a total hip replacement surgery, the compromised femoral head (the ball) is removed and is substituted with a metal stem. This metal stem is put into the hollow centre of the femur, either cemented or ‘press fit’ per the bone. Then a ball made of metal or ceramic is put on the top part of the stem, to replicate the functioning of the femoral head. Once through, the damaged cartilage of the socket is swapped for a metal socket, held with screws or cement. At last, the surgeon places a spacer – made of plastic, ceramic or metal – between the replaced ball and socket to ensure flexibility and smooth functionality of the joint. This new joint helps to ease pain, improve walking ability, reduce stiffness, treat the limp, and in many cases, restore the actual length of the affected leg.

Though safe, yet it is always advisable to consider all precautions and recovery requirements before going for the surgery. The best candidates for total hip surgery are the ones that either faces immense pain limiting daily activities, hip pain that causes a problem in resting or stiffness in hip limiting ability to move. Hip surgery is recommended when all other courses of treatment such as medications, mobility aids, physical therapy, etc. have failed to provide any positive results.

In all, although both surgeries are extremely safe surgical procedures, there are still some common risks associated with them, these include:

  • Blood clotting in legs or lungs
  • Stroke
  • Heart attack or heart damage
  • Infection
  • Nerve or blood vessel damage
  • Infection
  • Implant problems
  • Continued pain after surgery

However, two important complications that can arise post the surgery include:

  • Infection after the surgery characterised by high fever, chills, swelling, leakage from the surgical area, tenderness, extensive joint pain, and redness.
  • Exhaustion and wear down of the imitation joint that was placed in the knee or hip to replace the original joint. This complication or problem does not arise immediately but occurs over a period of time due to wear-tear of the joint majorly because of rigorous physical activities, such as weight lifting and others.

That said, a total knee replacement and total hip replacement surgeries are one of the safest medical procedures in the world. The risks involved are minimal and the recovery period, although slow, is very effective. However, the methods, surgical procedures, complications, risks, recovery – should be considered and thoughtfully discussed with the surgeon before going ahead with the surgery.