Frequently Asked Questions

A joint is formed by the junction of two bones. The function of a joint is to allow movement. Tissues and muscles around the joint give support to it and help to direct its movements. A joint becomes painful when it gets diseased and degenerates. This can be caused by a number of reasons: old age, injury, infection, rheumatoid arthritis, gout, and others. The most common cause is wear and tear because of old age. A diseased joint gets swollen and red. There is pain on movement and weight-bearing with the stiffness of joints. There would be difficulty in carrying out day to day activities.

The ends of bones are covered with smooth, white, cartilage. This allows free and smooth movement of the joint. When a joint gets diseased, this smooth cartilage is lost. This leads to raw ends of the bones being rubbed against each other.

Rubbing of raw bone ends causes severe pain and restriction of movements. Initially, medicines and exercises help. But, joint damage will progress over time. Pain which occurs at night and disturbs sleep is an indication of serious joint damage which would need surgery. To date, there is no method of regeneration of cartilage. So, the cartilage is replaced with a new, smooth plastic and metal surface (joint replacement surgery).

The worn-out cartilage and frayed bone ends are replaced with a smooth metal and plastic surface. So, movements become easier. Pain on movement and weight-bearing goes away. Muscle strength improves and there is less difficulty in carrying out day to day activities. The pain of surgery decreases in two to three weeks time. Thus, surgery improves the quality of life.

Joint replacement surgery is one the most successful surgeries in modern medical history. There are routine risks of surgery just like in any other operation such as allergy of anesthesia drugs, infection, displacement of knee cap, deep vein thrombosis etc.

The surgery normally lasts less than one hour. The time for preparation of surgery is about one to one and half hours. The time for dressings, cleaning up and X-rays after surgery is roughly one hour. So, relatives can expect to see their loved ones back afterthree hours.

Usually, the patient is made to stand up and walk on the evening of the surgery itself, i.e., day one, with the help of a walker. Occasionally, it may take a day or two depending on the patient’s medical condition. Exercises are started from the first day itself under the instructions of the physiotherapist. The patients normally go home in their own cars and can climb up and down the stairs by the time of discharge which is usually after four to five days from the day of surgery.

The medicines are usually required for the first two to three weeks. After that, usually medicines for bone strengthening in the form of calcium, proteins or vitamins may be continued.

It takes around two to three weeks for the major part of the swelling to go down. Some patients do feel some numbness around the knee for some time, which usually recovers by six weeks.

Stitches are usually removed after three weeks. Patients can take a bath much earlier after using waterproof dressings from the third day of surgery.

For the initial two to three weeks, medicines should be taken as prescribed and the exercise program followed religiously. Most patients do not need a visiting physiotherapist but exercising at home must be continued. Walker should be used for the first one to two weeks followed by a stick for another one to two weeks. The patient should not sit cross-legged or squat or run speedily for the first three weeks.

Until full movements are regained and unless recommended otherwise, they should use the western-style toilet. Aged patients do get salt depleted (hyponatremia) after surgery, so high salt intake is recommended under a physician’s guidance. Good diet is the key to early return to good health.