What is Total Knee Replacement Surgery? (Arthroplasty)

Total knee replacement is an orthopaedic procedure that aims to replace a malfunctioning knee joint and restore normal range of motion. The damage usually occurs as a result of different types of arthritis, affecting a great deal of middle-aged and older people. If pain medications and other treatment options don’t manage to control the symptoms, the disease progresses. It can worsen to the point that it begins to affect one’s lifestyle and this creates the need for an operation.

Given the invasive nature of the procedure, general anesthesia is necessary. The patient might also be given a slight sedative beforehand to ensure that they are calm all the way through. The orthopedic surgeon has to make incisions into the knee area, remove the troubled tissue, bone, muscle and whatever gets in the way. Then they place metal-and-plastic artificial joints. The prosthesis serves to mimic the function of a healthy knee.

Once the surgery is over, normally after one to three hours, the patient is sent to the recovery room where their pulse, blood pressure, and breathing are monitored for as long as necessary. They can’t leave right away, that is, there is some in-hospital stay involved.

Who Needs Knee Replacement Surgery?

There are two things that can damage a joint beyond repair: 1) a severe knee injury; 2) any form of advanced arthritis. In the second case, surgery is reserved for when all other methods have been exhausted. Meaning the patient had tried various therapies to no avail. And it happens so that he or she still experiences severe pain, which sometimes interferes with his or her sleep. The procedure is also needed when one has degeneration or chronic inflammation that limit daily activities. In advanced forms of arthritis, mild knee deformity might be observed too. In all these cases, surgery is oftentimes the only way to go.

Although the early stages of the disease can be managed by medication, physical therapy, and lifestyle modifications, total knee replacement remains the only option when severe osteoarthritis is at play. The latter is characterised by considerable misalignment of the lower limbs or intractable pain and stiffness which failed to respond to conservative treatment.

How Does Arthroplasty Help You?

One of the main goals of total knee replacement surgery in Singapore is to restore the normal alignment of the lower limbs. Another objective is pain relief. The traditional techniques require a lot of visual judgement from the surgeons, which is prone to error and can lead to mal-alignment in up to 30% of the cases. This increases the risk of early implant failure as a result of accelerated wear and aseptic loosening. However, studies have shown that, if successful, the procedure creates long-lasting results (20 years and more), allowing the patients to participate in their everyday routines.

Advanced Medical Technology

So, thanks to advancing technology, we can now perform total knee replacement surgery in Singapore in a more refined manner. The use of computer navigations, 3D printing, and even a robotic arm (MAKOplasty) helps to improve surgical results without a significant increase in time.

Computer navigation has been implemented in various fields such as aviation, automobile and defence industries, and it’s finally being brought into the surgical fields. It involves inputting the “coordinates” of the lower limb – the anatomical landmarks of the ipsilateral hip joint centre, knee joint, and ankle joint – into the computer system. This brings about a real-time reflection of where the cutting instruments should be placed. To further enhance the accuracy, the cuts can be verified as well. In addition, the soft tissue balance is fine-tuned by studying the kinematics of the knee joint. This helps to achieve a well-functioning knee prosthesis.

3D Technology for Total Knee Replacement

3D printing technology has revolutionised the industrial world in the past decade and we can now use it in knee replacement surgery. Patients opting for this technique will undergo a preoperative MRI scan of the lower limb. It captures all the important data as well as pre-determines the size and alignment of the implants. What happens next is a 3D printer produces these Patient Specific Instruments (PSI). After proper sterilization, they will fit onto the patient’s knee joint anatomy and allow the specialists to perform the replacement in a quick and accurate fashion.

Robotic Surgery for Greater Success

Robotic surgery is the new dimension in the future of surgery. Take for instance MAKOplasty. It is a semi-automated robotic arm that will assist the surgeon in executing total knee replacement. Patients who want to use this technique should undergo a preoperative CT scan of the lower limb. After that, all the substantial parameters will be gathered and entered into the computer. Next up, these data will be merged with the real-life anatomical landmarks of the individual, once he or she is in the operating theatre. The specialist can now use the robotic arm to precisely perform the procedure. As an added bonus, there is a safety mechanism built into the device to minimise the risk of nerve or blood vessels injury.

Overall, these advanced technologies have greatly improved the accuracy and surgical results of both total and partial knee replacement in Singapore. Computer navigation, PSI, and MAKOplasty are perfect for two main scenarios. Number one is people with a previous injury to the same lower limb that has led to a deformed anatomy. Number two is patients who have variant anatomy, such as severe bowing of femurs.

There are other benefits to this, mainly related to the fact that no instrumentation goes near the bone’s medullary cavity. These include reduced blood loss and minimum risk of embolic events.

What Happens After Surgery?

On the day after you have your artificial knee in place, you will be encouraged to engage in mild physical activity. A physical therapist will create an exercise plan to be executed for weeks after surgery. The therapy might begin with a continuous passive motion machine. Its purpose is to move your affected leg within its range of motion all the while you are resting in bed. In order to participate in the exercise, you will receive medication to soothe the knee pain. You will also be encouraged to get out of bed and bear as much weight on the replaced knee joint as you can.

Once you leave the hospital, your physiotherapy will continue at home or at a rehabilitation centre.

How Much Does Knee Replacement Surgery Cost in Singapore

In Singapore private hospitals, knee replacement surgery can cost between the range of $19,000 to $$32,000. For public hospitals, knee replacements cost between $16,000 to $22,000. The high costs are due to the materials used for the implants such as ceramic, steel, titanium etc. Contact us to find out more about the costs of knee replacement surgery for your condition.

Before Total Knee Replacement Surgery

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    Transforming Orthopaedic care - NEW location, NEW doctor, and a continuous commitment to your well being

    Dr Nicholas Yeoh

    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Rd
    #06-37, Singapore 329563

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