Knee

Dr Sanjeev Gupta specialises in treating knee pain and knee injuries. He has particular expertise in knee surgery including knee arthroscopy, knee replacement and revision knee replacement procedures.

He understands how debilitating knee injuries and arthritic conditions can be, and is particular focused on enhanced recovery paths.

Dr Gupta is a high volume joint replacement surgeon, performing complex primary knee replacement surgery, bilateral knee replacement surgery and revision knee replacement surgery.

Dr Gupta is very involved in exploring all conservative options prior to considering surgery. He aims to provide the best patient care to every patient, with a commitment to providing a trusted evidence based approach to treatment recommendations for the best outcome.

When is Total Knee Replacement surgery recommended?

Surgery is recommended when non-surgical treatments no longer work in controlling your pain.

Arthritis is a condition which causes wearing of the smooth cartilage lining a joint, resulting in a painful joint. This leads to inflammation, swelling and pain. As a result, the knee becomes painful, tender, may lock up and become stiff. As a consequence, mobility might be difficult.

There are several non-surgical treatments to try prior to surgery. These include:

  • Non-impact loading exercises, such as swimming and cycling.
  • Weight loss reduces the pressure across the knee joint, which usually results in less pain
  • Simple pain medications (Panadol-Osteo)
  • Anti-inflammatories
  • Steroid injections may help many patients, however the results can be varied
  • Physiotherapy

Surgery is recommended when other treatments are no longer effective, and the pain is affecting quality of life. The aim of surgery is to correct the deformity, and allow pain free motion, and to allow you to gain mobility again.

What is involved in a Total Knee Replacement?

Prior to surgery, you will require a medical check-up, including blood tests, ECG and X-rays. You will be required to attend a pre-admission clinic, where you will be reviewed by the Anaesthetist who will determine your suitability for surgery. The type of Anaesthetic will be discussed with you.

The surgery generally takes 60-90 minutes. The knee joint is exposed via an incision to the front of the knee (approximately 12cm), the tendons are moved to the side to allow access to the knee joint itself and any damaged cartilage is removed and the joint surfaces are prepared. The surgery is performed with computer navigation to improve accuracy.

What happens after the procedure?

A knee replacement procedure normally involves a hospital stay of 3-5 days. Most patients are encouraged to get out of bed and walk around for short periods on the same day of surgery, with supervision by the physiotherapists. Patients are given a set of exercises to follow which will help strengthen the knee joint and restore a good range of motion over time.

It is not uncommon to experience discomfort for several weeks following surgery, even with pain medications.

General daily activities can normally be resumed 3 - 6 weeks after the procedure. Most patients can drive after 6 weeks, often sooner. This will depend upon your progress, and your need for pain medications. You should not drive if you are taking medications that affect your ability to drive.

Any heavier physical activity, such as sport, will need to wait a little longer. We generally recommend to avoid contact sports, although we encourage you to maintain your health with other activities. Sports including bowls, golf, skiing and tennis are all encouraged. Dr Gupta will advise you on this.

Expect continual improvement in strength and stamina for several months following surgery. 

What are the success rates for Total Knee Replacement surgery?

Nine out of ten patients see a great reduction in pain and much increased mobility and many are able to take up physical activity again. The chance of any further surgery within the first 10 years is less than 5%.

What are the risks of Total Knee Replacement surgery?

In general terms very few patients suffer complications in total knee replacement surgery, however there are several potential risks with this procedure. This includes general risks of any operation, in addition to specific risks of total knee replacement.

The risks of total knee replacement include:

a. Infection
b. Blood clots (deep vein thrombosis and pulmonary embolism)
c. Pain / Tendonitis
d. Numbness in front of knee
f.  Loosening / Fracture
g. Damage to nerves and/or blood vessels
g. Revision surgery

In general, most of these complications are uncommon, and will be discussed with you during the consultation.

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