Monday, February 11, 2019

Squatting after Unicondylar Knee Replacement

Knee Replacement is a revolutionary surgery. It gives patients a miraculous cure from severe knee pain and deformity. Patients achieve a lasting and complete relief from pain. It is a boon for patients handicapped by knee arthritis. It is one of the most successful surgeries in all of medicine.
In an effort to continuously improve, science makes breakthroughs all the time. The knee is made of 3 compartments. Arthritis damages these compartments but often not uniformly.  When we as surgeons are doing total knee replacement, we often find that one compartment is badly damaged whereas the other compartments are well preserved. In total knee replacement, we replace all the compartments irrespective of the damage. The knee also has two important ligaments called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). These ligaments are removed in a total knee replacement. Replacing all compartments leads to much bone loss and bleeding. In order to do a good knee replacement, we need to take a big incision (cut) in the skin and the muscle. Big cuts result in more pain and slower recovery. Patients need supervised physiotherapy to regain knee function. After total knee replacement patients can walk freely and comfortably, however the absence of ligaments doesn't allow them to sit on the floor or squat easily.
Scientific research has led to the evolution of Unicondylar Knee Replacement (UKA) to solve these issues. The principle of UKA is to replace only the damaged compartment. Only one of the three knee compartments is replaced. There is minimum cutting of bone and less blood loss. Patients feel much less pain and recover quickly. No painful physiotherapy is required after surgery. My UKA patients are walking comfortably just a few hours after surgery. They hardly feel postoperative pain. The surgery is done through a small cut in the skin using special instruments with a minimally invasive technique. Both ACL and PCL are preserved. After UKA patients are able to easily squat in a toilet and sit on the floor. UKA feels like a natural knee. The long term results of UKA are comparable to total knee replacement. UKA is just as durable and will give a patient many years of pain-free knees.
Not all patients are eligible for UKA. It cannot be done in very advanced arthritis where all compartments are damaged. It also cannot be done in patients who have damaged ACL or PCL ligaments. Even so a large number of arthritis  patients can benefit from this modern surgery. Your doctor is the best judge of whether you are eligible for UKA.
UKA is a bone, muscle and ligament preserving surgery done through a minimally invasive technique with advantages of fast recovery, less pain and better function. It is a spectacular gift of modern scientific research.