Best Knee Replacement Surgeon in Hyderabad – Dr. K. Sudhir Reddy

That's a very good question because it is a major surgery, big surgery, expensive surgery. According to Swedish orthoplasty registry, the surgery is overwhelmingly successful in the initial period. More than 99 percent are successful. Even after 20 years of surgery, more than 93 94 percent of them are still surviving. It is considered probably the most successful medical intervention ever.

Most of the patients are very anxious and very fearful of a major surgery when it is not a life-threatening disease. When you go to doctors, many of them tell you that it is a very successful surgery, but there is always an apprehension on the patient that the opinion advise is biased.

Orthoplasty registries are the repository of a data collected over a long period of time. The entire data needs to be collected and analyzed so that we understand whether it is really working, what are the success rates, what are the problems and how are we going to get better results.

There are several kinds of implants that are produced and sold. Individual doctors experience and opinion is not that important. More important is the collective data and actual evidence of what is happening in the real world.

According to all this, knee replacement is a highly successful surgery and it will last. At least more than 90 percent of the people, it will last more than 20 years. There is no other surgery or medication that will give you that kind of result which lasts that long. By many, it is considered as a surgery or procedure of the century and the most successful surgery ever invented.

That's a good question because total knee replacement is a major surgery and there could potentially be serious complications and it has a lot of financial implications and implications on the recovery, post-operative pain on the patient and the patient's family itself. You should be very judicious in choosing when to undergo total knee replacement surgery. Generally, we say when the pain is severe and so severe that it affects day-to-day function, be it social functions or personal life or professional life is being affected by this pain and is not able to complete worker jobs. Or pain is so severe that he is requiring regular painkillers or analgesics to control the symptoms, regular medication. Or pain is so severe that he is having to give up his hobbies or lifestyle. Or when the rest pain, that means sleep is also getting affected.

Arthritis is a spectrum of disease. It will start from very mild disease and gradually over the years it can progress to severe arthritis. In radiological terms, we divide into four categories: grade one, two, three, and four. Grade one is mild, grade two is moderate, grade three is severe, grade four is severe with secondary deformity. Usually, in grade three and grade four you undergo knee replacement.

Overall this is a surgery that is a quality of life surgery. It is not an essential surgery where if you don't do this surgery your life is at risk. No, your life is not at risk, but your quality of life is at risk. So it is entirely a patient's choice when he or she needs to undergo a knee replacement surgery.

The x-ray findings come secondary. Primary is the patient's severity of pain and how much his quality of life is affected.

An adequate amount of conservative management must be attempted. At least six months of physiotherapy, some medication must be attempted before we say this is not working and you will benefit with total knee replacement surgery.

Dr. K. Sudhir Reddy, Best Knee Replacement Surgeon in Hyderabad, advises that for preventing knee pain, patients must strictly focus on weight control, performing regular exercise, and consuming nutritious food.

Yes. Dr. K. Sudhir Reddy, Best Knee Replacement Surgeon in Hyderabad, states there is scientific evidence proving that weight has a direct relation to knee pain. Excess weight directly impacts the knees, so weight control is necessary to protect the knee cartilage.

According to Dr. Sudhir Reddy, scientific evidence shows that consuming Aloe Vera plant juice helps the knee cartilage and can be beneficial for managing knee pain.

In arthritis, the hyaline cartilage covering the knee joint gets damaged and wears out. Without this cartilage, the joint loses its smooth movement, resulting in severe knee pain.

The Knee Replacement Surgeon uses an X-ray to check the gap inside the knee joint. If the cartilage is worn out, the gap disappears. When the cartilage is completely damaged and there is no gap left, it is identified as Grade 3 or Grade 4 arthritis.

Knee replacement is suggested when a patient reaches Grade 3 or Grade 4 arthritis and the severe pain begins to ruin their quality of life. If the pain disturbs your sleep, stops you from walking, and makes day-to-day life difficult, the surgery is recommended.

Age is not a strict condition for this surgery. While it is common in older patients, it can also be done for younger patients (even at 25 or 30 years of age). If the knee is completely damaged, the patient is healthy enough for a major operation, and their day-to-day life is severely affected, the surgery can be done at any age.

In general, an implant rarely causes more bending or less infection. Implants mainly have a difference in durability and success rate based on the implant shape. From hundreds of implants in the market, surgeons select three or four proven products from good companies like Johnson & Johnson, Zimmer, Smith & Nephew, Stryker, and Aesculap.

Implants are selected based on existing evidence from the last 20 years. We look at data from Arthroplasty Registers, such as the Swedish Arthroplasty Registry, Australian Arthroplasty Registry, and the National Joint Registry (UK and Wales). We study this data to see which implant has more durability, less failure rate, less loosening rate, and higher success with patella and cement.

The most important point is the surgeon, the surgeon's quality, and the surgeon's interest. It is better to leave the choice to the surgeon because they will suggest the proven products they use regularly and have higher success with. If the patient is of younger age, surgeons suggest implants with hope for more durability. Ultimately, the choice is yours, but it is better to decide based on the surgeon's knowledge and suggestion.

In simple terms, arthritis is nothing but wear and tear of any joint.

A joint is the meeting point between the two bones.

The knee is the commonest joint that is affected with arthritis.

In the joint, the end of the bone is covered with a whitish, thick material called cartilage.

Cartilage does not have a nerve supply, sensory feeling, or sensation. It is very smooth with very little friction, so movement does not cause any pain.

The cartilage starts falling off, and the bone starts getting exposed. When this happens, it becomes very painful because the bone is a very painful surface. Any movement will become very painful.

You will have a lot of pain, swelling in the knee because of the pain, and it will become stiffer and stiffer. Because of more wear and tear, it can be deformed and bent also.

Eventually, it affects day-to-day life, where your activities of daily living also become very, very difficult.

The guiding principle is surgery is offered to a patient only when all other conservative management with medication is exhausted and when it is likely to benefit him a lot .

All information is given so the patient is aware of what risks , financial implications , and recovery terms are before proceeding with surgery .

No surgeries are without any pain , but with state-of-the-art pain management teams , pain is much less and better tolerated .

Patients are able to walk independently without any support within two days of surgery .

Success rates will amount to more than 99% . We have been doing knee replacements for more than 10 years without any failure .

In actual fact, arthritis is probably the most common health problem in the entire world. Even in young people, a recent national survey showed that the commonest health problem in young people (less than 30 years old) is arthritis, with a 3% incidence among young people.

Genetics is one factor, although it is not very strongly associated. With everyday use, depending on the kind of use—either we overuse it or underuse it—both are detrimental to your joint. Optimal amount of exercise and use is important.

There are certain risk factors like:

• Obesity
• Some kind of injury to the knee (if your joint is injured, it will start wear and tear)
• Excessive heavy exercise
• Sedentary lifestyle (when there is not enough movement in the knee, not enough liquid is produced)
• Smoking
• Malnutrition

Sometimes, if you are bent with slightly malaligned legs, bow knees, or knock knees, because of uneven pressures in the joint, it can lead to arthritis as well.

Most people, if they live long enough (maybe 100 years), are likely to get arthritis in the majority of the joints that move well. Despite all factors being present, sometimes if we live long enough, most of us are likely to get wear and tear towards the end of our lives. So, arthritis is a common problem affecting most people, but some people are more prone because of the above-mentioned risk factors.

The main symptoms of arthritis are pain. Pain is a main and a major symptom of arthritis, and that is also the initial symptom or first symptom of arthritis. Any joint that is developing arthritis will start becoming painful, unless somebody is a diabetic where sensation is limited.

These are the main symptoms of arthritis in any patient, also they can differ depending on the site of arthritis. In any patient, in any arthritis, you have pain, swelling, stiffness, and gradually deformity.

A spine arthritis is called spondylitis. It's mostly pain and stiffness and difficulty in bending forward. These are the usual symptoms.

In the beginning, when there is early arthritis, the patient may not identify it because they may not get any symptoms. They may not get any pain. It is very occasionally when they walk long distances, climb a lot of stairs, lift heavy weights, or drive long distances they may feel a little bit of pain, which will again go away within maybe a couple of days. Most of the patients do not realize they may be suffering from arthritis because they can do their most activities pretty well.

Gradually, these attacks start becoming more and more frequent and longer and longer in duration. Any significant distance or any stairs they will not be able to climb. Gradually they will start developing stiffness when they cannot get up from sitting posture, they take a long time to change position. Even day-to-day activities at home looking after themselves, going to office, or going to meet friends and social functions will be becoming more and more difficult. They gradually start cutting down all these things.

Because all these things happen very, very gradually, they do not realize the severity of the problem till it becomes very late, when they are not able to take care of themselves and when they are becoming dependent on somebody else. That is when most of these patients seek treatment.

If they seek treatment in early stages itself, it may be more useful because you can actually try and prevent the progress of the disease before it becomes serious.

In general, women are more prone to arthritis than men. Dr. K Sudhir Reddy, Chief Orthopedic & Joint Replacement Surgeon, Landmark Hospitals, says this is because of a sedentary lifestyle or high BMI. Obese people are more prone to arthritis, and people involved in heavy manual labor are more prone to arthritis.

The role of medication in arthritis is twofold. One is to prevent the progression of the disease. The other one is to treat the symptoms of the disease which is pain, stiffness, and swelling of the knee.

Collagen peptides are a newer class of nutriceuticals or nutritional supplements which provide the basic building blocks which are required for collagen synthesis. When we increase the synthesis of collagen it will imbibe more water so it will obviously become more stronger and so the further wear and tear will be reduced.

The third category of medication is injectable medications. These will stimulate the cartilage to synthesize more collagen and also will lubricate the joint more. So the cartilage quality will become better and the friction will become less.

The medication for symptomatic treatment are essentially either simple analgesics or pain killers or anti-inflammatory medication. These are both painkillers as well as reduce inflammation which means swelling, redness, and stiffness.

Paracetamol is one of the safest and probably the first and probably also the mildest. Then we have medication such as non-steroidal anti-inflammatory drugs which are ibuprofen, diclofenac, naproxen, and ketorolac. All this medication will reduce the pain, swelling, and stiffness on the joints so that there is a good symptomatic pain relief.

While none of these will actually regenerate the cartilage that is lost, these will give good relief and can also stop the progression—not completely stop, but slow down the progression of the disease.

Are there any diets or any special foods that will reduce arthritis or prevent arthritis? Answer: In actual fact, no food itself has a direct effect on arthritis, either caused, progression, or improvement of the disease. The effect of food on arthritis is indirect.

Are there some kinds of food thought to improve the condition and lubrication of the joints?

Although there are some kinds of food like avocado and aloe vera that are thought to improve the condition and the lubrication of the joint, there is not much scientific evidence to support that.

Does excessive weight or obesity cause damage to your joints?

Excessive weight or obesity is going to cause a lot of damage to your joints. It is body weight or body mass index that has more effect on arthritis.

Should diet be in such a way that you maintain an appropriate body weight?

Your diet should be in such a way that you maintain an appropriate body weight or body mass index, so that excessive load is not imparted onto your joints. This is so wear and tear does not happen so quickly; it's an indirect effect rather than a direct mechanism on the arthritis.

The answer should be no, although there is some connection. In families where parents or elders get severe arthritis early, the children also are likely to get arthritis slightly early or more severe. This is when we are talking about osteoarthritis, but there is no direct link.

The so-called genetic effect is probably more due to other factors which are indirectly influenced in a family system. If obesity is more in your parents, children are likely to be more obese because of their dietary habits, exercise habits, and life habits. That can cause an increased risk of arthritis. It is more of an indirect effect rather than a direct genetic transmission of the disease.

Having said so, there is another category of arthritis called rheumatoid arthritis or inflammatory arthritis which has a definite genetic link. For somebody who had rheumatoid arthritis, their offspring or children are much more likely to have rheumatoid arthritis than other general people. There's almost a 25% chance that if your parents have rheumatoid arthritis, you may get rheumatoid arthritis.

Yes. The sitting posture causes a good effect on your spine. Long sitting hours, especially improper sitting hours, are very high risk factors for causing spondylitis and back pain.

Yes. In the spine, arthritis is called spondylitis. Spondylitis starts with damage to the intervertebral discs.

Your spine is made of bones which are called vertebrae and there are discs which are like a sponge material or a balloon between the two bones. It takes shock absorption so that you can bend forward and backward.

Yes. When we sit in an improper posture, the pressure on the discs is uneven. On one side it can get more pressure, on the other side it will start bulging. Eventually, the discs will start stretching or breaking out, so the discs will eventually get damaged.

Yes. Damaged discs will lead to wear and tear in the intervertebral area and excessive bone formation attempt to repair from the vertebra. Eventually, it leads to spondylitis.

Knee pain has many causes. Commonly, it comes from two ways: stress and actual damage.

When we walk or exercise, pressure falls on the cartilage and ligaments. Overuse, increased body weight, and sitting down a lot put stress on the knee cap. This causes pain in the front of the knee. It usually decreases with rest and some medicines.

Actual damage always comes from knee wear and tear. A common type in old age is osteoarthritis, which increases slowly and gradually.

Treatment is taking precautions early, not increasing weight, regular walking, and taking medicines given by doctors. Taking them prevents future problems.

In five percent of people, knee pain comes from inflammatory arthritis diseases. It can be rheumatoid arthritis, gout, infection, or psoriasis.

Treatment is specific and various medicines must be used. Neglecting them causes serious damage. You must consult a doctor, get tests done, find out the type of arthritis based on the results, and get the specific treatment.

The main development discussed is the recent technology advances in knee replacement surgery and how they improve the experience for patients.

The advances utilize the best quality materials designed to provide a completely natural feel and natural movement for the knee joint.

This new technology and the advanced materials significantly improve and reduce the patient's recovery time, allowing them to regain movement faster.

A partial knee replacement is where we replace only a small part of the knee or one compartment of the knee. Only one part of the thigh bone, one part of the leg bone. The other compartment between the knee cap and the knee groove, both of them are not resurfaced at all, not replaced at all.

In a majority of patients, by the time they come to surgery, all the three compartments are usually severely affected and require something called totally replacement where we change the entire compartment, all the three compartments.

Patients who have only one compartment severely affected, usually the medial compartment, while the other compartments are generally in a good state. Not everybody is suitable for unicondylar arthroplasty, but in those patients who are suitable, especially if they are young, you only replace this part because it is unnecessary to change all three compartments.

By virtue of working on a small area, it is much less damaging to the patient. The complications are expected to be lower, the pain is expected to be much lower. Patients recover much faster and because most of the natural tissues are preserved, patients feel like it is more naturally theirs. They can get better function and be more active.

After 20 years when this fails, it is very easy to convert this into a total knee replacement. In a selected group of patients, it is less damaging, has a quicker recovery, better function, and also it can postpone total replacement by many years.

Do you require physiotherapy after total knee replacement surgery?

There is no straight answer to this. With the present-day techniques, especially the subvastus muscle-sparing minimally invasive approach, and pain-relieving techniques, the post-operative recovery is fairly quick, the pain is fairly manageable, and the recovery is much faster. Depending on their own motivation and willingness to do exercises, many patients don't require any formal physiotherapy by an external physiotherapist at all. Patients are advocated and taught to do their own exercise, and for the majority of them, that will suffice.

Which patients will certainly require physiotherapy?

Some patients who may have had severe deformities before the surgery, very stiffening before the surgery, or very sensitive patients who are not able to exercise themselves will certainly require physiotherapy.

How to assess how long the therapy is required?

It is important in the first couple of months after surgery to regularly be in touch with your doctor, who will be able to assess whether you require formal physiotherapy by a therapist or how long the therapy is required based on your progress and advise you accordingly.

Total knee arthroplasty is basically a surgery performed for severe arthritis of the knee joint when there is complete damage to the cartilage, complete loss of cartilage resulting in severe pain and difficulty in day-to-day activities.

If you look at your normal knee joint, the ends of the bones are covered with cartilage. The cartilage is a white avascular structure, it does not have blood supply, it does not have nerve supply, so it is painless and it is very smooth, frictionless. But eventually when the cartilage wears off your knee becomes very very painful, it becomes very stiff, swollen and your day-to-day function becomes very very difficult.

What is done is we remove any remaining damaged cartilage and shape the ends of the bone using special instrumentation to accept a prosthetic joint. The worn-out cartilage or damaged cartilage is removed and then an artificial or prosthetic joint is fixed to the end of the bone using something called bone cement which acts like a grout. Once this is fixed with bone cement this is completely fixed, it doesn't come off easily, it doesn't move at all.

These prosthetic joints are made with special alloys or are a mixture of metals, the various combinations of these. So they come in different parts and different different sizes. There is a central part called polyethylene insert.

Because now the articulation is between metal and the plastic, again there will be no pain, no friction because the coefficient of friction between these two materials is very low and usually this will last very long. Because there is no pain, no friction, patient again becomes very symptom-free, mobility becomes better, function becomes better.

We also have the knee caps. Sometimes we replace the two. It is not always essential to replace this but in most of the patient, we do replace that. The combination of the three parts that are being replaced are in usual terms when they are replaced, it is called total knee replacement surgery.

You must visit the doctor as soon as you suspect arthritis, irrespective of what stage it is. It may be a very early stage or Grade 1, it may be a very severe stage. Whenever you realize or you suspect that you have arthritis, you should visit because there are benefits of treatment at any stage.

If you go at a very early stage, the doctor can give you advice, good enough advice and medication which can at least slow down the further progression of the disease and which will make your symptoms much better and functionality better.

If you go at an advanced stage, he will still offer you a lot of solutions which can get you out of that pain, which will increase your functionality.

Broadly speaking, the treatment of arthritis you can divide into conservative management and surgical management.

Conservative management means methods other than surgery which includes change of lifestyle, exercises, formal physiotherapy, some medication which includes dietary supplements, medications such as non-steroidal anti-inflammatory drugs, sometimes injections.

In the initial and moderate phase of arthritis they will be successful.

We have keyhole surgeries, realignment surgeries called osteotomies, partial knee replacements which are very good in certain groups of patients, then we have total knee replacement which is a complete change of joint.

All these are more useful for severe arthritis of the knee.

Gradually, these attacks start becoming more and more frequent and longer and longer in duration. Any significant distance or any stairs, they will not be able to climb. Gradually, they will start developing stiffness when they cannot get up from sitting posture, they take a long time to change position. Day-to-day activities at home, looking after themselves, or going to office, or going to meet friends, social function, all this will become more and more difficult.

If they seek treatment in early stages of itself, it may be more useful because you can actually try and prevent the progress of the disease before it becomes serious.