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It’s all in the joint

With better implants and advanced computer-aided navigation for surgery now available in India, people suffering from Arthritis can hope to regain a normal lifestyle within days of surgery, writes Sidhartha Roy.Mind those bends
Hindustan Times | By Sidhartha Roy
UPDATED ON JUL 05, 2008 11:41 PM IST

Every third Indian over the age of 60 spends sleepless nights due to knee pain caused by arthritis. Arthritis, which affects joints, makes performing simple activities like walking, climbing stairs or just lying down very painful. Painkillers are the mainstay of treatment, and when they stop working, knee replacement surgery can help you reclaim your normal lifestyle.

Knee pain caused by arthritis is one of the most common diseases in India, afflicting people in the age group of 40 to 65. Indian lifestyle is a big contributor — sitting on the floor, squatting, bending and climbing stairs — are known triggers for knee pain caused by the gradual wear and tear of the joint. The pain and deformity occurs when the smooth surface cartilage gets worn out and the bone starts rubbing against bone.

The first signs are pain and stiffness in the knee or hips, swelling and early signs of deformity.

Though there is not much you can do to prevent arthritis, doctors suggest lifestyle changes to reduce stress on the knee joints such as losing weight, avoiding sitting on the floor, climbing stairs or jogging. Gentle exercise lowers weight and decreases pressure on the joint while strengthening muscles that support them. Medications include oral anti-inflammatory drugs and some injections into the knee.

Many suffer the pain in silence because of lack of awareness about the treatment options available in India. “Patients feel undergoing a knee replacement surgery would worsen their condition. Also, we in India have an inherent fear of going under the knife and of anaesthesia,” said Dr S.K.S. Marya, Director, Orthopaedics and Institute of Joint Replacement Surgery, Max Healthcare.

Marya, one of India’s best-known joint replacement surgeons, said that the success rate of a knee replacement surgery is about 97 per cent. “The success of the surgery varies and the risks involved are infections and blood clots. However, there is no risk to life,” he said.

Doctors advise patients to undergo surgery when the pain starts affecting movement or if deformity begins. Knee replacement surgery involves removing the surface of the knee joint and replacing it with metal and plastic surfaces.

With better implants and advanced computer-aided navigation for surgery now available in India, people can hope to regain a normal lifestyle within days of surgery. “Patients start walking with the help of walkers within three days of surgery and can perform all activities by three months,” said Dr Marya.

While a fixed bearing implant costs between Rs 65,000 and Rs 75,000, a high flexion knee implant that allows more movement costs up to Rs 85,000. The cost of surgery, including the price of the implant, varies between Rs 1.6 lakh to 2.5 lakh in a private hospital. A high flexion knee allows a patient not only to bend the knee but also complete rotating movements, which was not possible with implants available earlier. Unlike implants available earlier that had a life of maximum 10 years, the new implants can function perfectly for 15 to 20 years.

In the West, people opt for surgery as soon as the pain starts hindering normal activity. “Though India has some of the best knee surgeons, people don’t consult doctors till it is very late,” said Dr Rhys Williams, a UK-based surgeon. “I advice a knee replacement surgery when you are strong and fit enough to recover quickly after the surgery and not when deformity has already set in,” he said.

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