Lifestyle aspects to sustain joint replacement surgeries!

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Dr. Akhilesh Yadav

The prevalence of joint pain is not new and uncommon these days as a higher proportion of the young and middle-aged population have been spotted in this limelight. While COVID has been a major threat to overall health, yet people affected with the infection have been immobilized for long either due to home quarantine or hospitalization. Further the ill-effects of the virus have also triggered weakness in the muscles and joints.

Clouding myths pertaining to the post-surgical quality of life of knee replacement have kept many patients with chronic knee pain in the dark. While there is a dire need to raise awareness among masses about the advancements in technology in the field of joint replacement surgeries, also a minor effort from those undergoing such surgeries to adapt to a healthy lifestyle can also turn out the outcomes to be more fruitful.

Attributed by a plethora of reasons including family history, age related degeneration, obesity, physical inactivity, acquired infections like rheumatoid Arthritis, osteoporosis and other inflammatory ailments, in association with the COVID complications are the triggering factors for the onset of joint pain. Nutrition deficiency including Vitamin D3 and B12 are the major contributing factors to have severely impacted the bones and cartilage that provide strength to the joints.

During a primary knee replacement surgery, the knee joint is replaced with an implant, which is in most of the cases successful. But sometimes due to loosening of the implants or wear out, a revision procedure may be required. Depending upon the condition, the revision surgeries may include replacement of partial components of the implants, Unicompartmental joint replacement or complete replacement.

According to the recent data provided by Joint registry (ISHKS), over 35,000 total knee replacements (TKR) have been performed in India last year and there is an upsurge in these procedures in the last five years. As per an estimate around 20 crore Indians (especially above the age of 50 years) suffer from some form of knee related problems. The major reasons attributable includes degenerative arthritis like osteoarthritis, Rheumatoid Arthritis, Unicompartmental arthritis among many others. Among such majority of population atleast 20% of them are having a poor quality of life and are suggested for an immediate knee replacement procedure.

Advanced knee replacement procedures are sustainable

Though most of the TKR are sustainable in more than 90% of the cases and have a life of around 15-20 years, but over time if the knee replacement fails due to variety of reasons. In such cases patients may require to undergo a Revision TKR (RTKR) due to the increased swelling and painful knee joints. The patients may also feel stiffness, instability that may hinder in their day-to-day activities.

In some of the cases due to trauma or an injury to the bone may make it harder for the surgeon to use standardized implants during a revision surgery, where specially designed implants are required.

Avoiding such complications of injury to the joints or adjacent areas and taking certain precautionary measures can ensure an enhanced lifespan of the implants and avoids the need for a revision knee replacement surgery.

Maintain an optimal Body Mass Index (BMI) – Poor eating habits and a sedentary lifestyle often post surgery ends up in unwanted weight gain. It is thus advised to eat a healthy and balanced diet along with regular mild exercises to maintain the BMI.

Physical activity and regular exercise – regular exercise is a must, and always consults the treating doctor for the moderation, before taking up heavy workouts. It is usually advised for brisk walking, basic physical exercise like aerobics for atleast 5 days a week. This will not only help in strengthening the muscles but also helps in proper settling and adjustment of the implants. Regular exercise will also benefit the patient for a prolonged life of the implant.

Avoid cross legged sitting immediately after surgery- Adopting to a table chair lifestyle for initial few months post a knee replacement will reduce the wear and tear allowing the implants to settle better as per the curvature of the actual bone. Consult the surgeon when to involve in such activities.

Regular walk- To decrease the chances of re-do surgery, it is important to increase the pace of walking pace and distance after few months of surgery.  Walking is purely an individual capacity. At the end of 2 months, one should be able to walk 1-1.5 km per day which can be increased to 250 meters by the end of 3-4 months, till 3 km per day mark is achieved.

Yearly check-ups- TKR patients must visit the surgeons yearly to keep a check on loosening in the joint which can be dealt with time.

Patients with lifestyle ailments such as diabetes and hypertension should regular measure and monitor the same. Diabetic patients are at elevated risk of developing infections even months after the surgery and hence the blood sugar should be monitored regularly.

If these measures are properly addressed then the lifespan of knee replacement surgeries may result to long term benefits.  In case of any problem at any point, it is important to get information from the concerned surgeon.

The writer is Associate Director & Unit Head Orthopaedic, Max Hospital Vaishali

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