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.
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.
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.
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.