Interview with Knee Replacement Surgeon Dr. Bakul Arora by Hopeland Medical Tourism
Question: Why patients delay the surgery? Is it because of surgical pain?
Ans: ( Dr. Bakul Arora) , YES “ because of fear of surgical pain, i come across many patients who are afraid of undergoing knee replacement surgery in spite of having significantly knee problem. They restrict their activities in order to avoid pain. This sets in a chain of reactions. They don’t move out of the house leading to dullness of mind and depression. They don’t exercise much due to pain which leads to aggravation of blood sugars and blood pressure. The knee joint starts deforming and becomes stiff leading to increase in pain.
Hence its important to undergo surgery at the right time when your physical and mental health is sound. Total knee replacement offers a magical solution of all knee related problems. However many patients fear the surgery related pain and doubt if their recovery would match the expectations as promised.
Question: What is old technique of doing Knee Replacement Surgery, and How it is more painful?
Ans: The muscles are the walls around the knee joint. During conventional surgery the muscles of the knee joint are cut in order to change the knee joint that means the wall of the room is broken and then repaired. This makes the muscles red angry and swollen. Of course with time, the inflammation settles down, but the initial period after surgery becomes extremely painful which in turn delays the recovery. Sometimes patient start walking only after 2 weeks.
Question: Painless Knee Replacement Surgery! is it possible?
Ans: Yes, but No surgery can be painless. But our efforts are oriented to achieve an almost painless technique and faster recovery. That is to start walking on the SAME DAY of surgery, WITHOUT PAIN. Patient can also go for hip replacement surgery with minivasive technique.
Question: How do you achieve (painless surgery) this?
Ans: I operate using a very innovative approach where the muscles around the knee are NOT CUT. As the muscles are not cut, there is almost NO PAIN. Your new knee feels comfortable just like at home. This approach doesnt incite the inflammation as much as the conventional technique. Hence the recovery is quick. Most patients begin walking within 3 to 6 hours after surgery, start stairs climbing on the next day and are ready for discharge the day following.
Question: You also said that you don’t use few surgical equipments / machineries during surgery likes TOURNIQUET, CAUTERY, SUCTION, DRAIN? What is its benefit to patient?
Ans: Use of Tourniquet and Cautery damages the nerves and muscles of knee, which causes more pain and more blood loss. Using of this machine also increasing the chance of complication like deep thrombosis.
Let me explain you benefit of not using those machines / equipments……
• Less blood loss
• Less local tissue trauma to nerves and muscles.
• Less post-operative pain.
• Less risk of complications like deep vein thrombosis, infection or blood clots, etc.
• Easier & early rehabilitation.
• Less post operative stiffness.
Question: What are other advantages to patients of Mini Invasive (Painless) Knee Replacement Surgery?
Ans: In Mini Invasive Technique of Knee Replacement Surgery recovery is very fast. Most patients begin walking within 3 to 6 hours after surgery, start stairs climbing on the next day and are ready for discharge the day following.
Other Advantages to Patients.
· Fast Recovery
· Walking after 4–5 hrs of surgery and staircase climbing from next day of surgery.
· Short hospital stay 2 to 4 days.
· Minimal blood loss during the surgery
· No blood Transfusion.
· Less Physiotherapy.
· Less Antibiotic.
· Stitch less Surgery.
Question: When operated patients can walk without support ?
Ans: Under normal circumstances, patients are able to walk without support after 1 weeks in single knee replacement surgery. In both knee replacement surgery, they take approximately 3–4 weeks, but at the same time walking without support is also depend on patients leg / hip/ spine strength , age and other factors .
Question: What activities patients can perform after surgery?
Ans: Patients are allowed normal activity after surgery. However, they should avoid high impact sports, running, squatting, cross leg sitting, kneeling. Patients are comfortable to perform walking, swimming, and cycling after surgery.
Question: do you have any better options for younger patients for Knee Replacement Surgery?
Ans: Yes, Years ago, knee replacement surgery was reserved for elderly patients due to a high complication rate and lack of implant durability. Modern techniques have allowed orthopedic surgeons to base surgical decisions on a patient’s pain and disability, and not necessarily chronological age. Most patients who undergo knee replacement are between the ages of 50 and 80, but surgeons evaluate patients individually and primarily on their physiologic age and demands.
Question? How long will be a Knee Replacement last?
The average life of knee replacement is 15 to 20 years.
Advanced surface Implants are now available with better biocompatibility and longevity of 30 to 40 years. These implants are made of Ceramic-Gold alloys or have Oxidized Zirconium as their bearing surface.
Question: Do you want to say something to patients?
Ans: “My idea is to help patients to confront their fears and eliminate them”.
Thank you .
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