Bilateral Total Knee Replacement

A 72 year old man visited Aster Hospital, Mankhool in the month of November 2017 complaining of severe pain in both knee for the past one year. He was under treatment for chronic renal disease, DM, HTN, cardiac stent and was on medication for pain since the last 2 years.

The patient was walking with bilateral limping gait with support. He used walking aids for walking and was in severe pain while sitting and standing. He had been advised surgery 2 years back but the patient was reluctant and wanted medication for pain relief.

After much counselling, an x-ray was taken which showed grade 4 osteoarthritis of both knees. Upon detailed discussion regarding the treatment plan for both knees, the patient agreed for bilateral Total Knee Replacement.

After appropriate investigation and planning, the patient was posted for surgery on 13th Jan 2018. Considering the high risk of comorbid conditions, patient was further explained in detail the treatment plan. Prior to the surgery the patients consent was taken and we began planning and preparing for surgery.

Working closely with Dr. Ranjith Narayan, Specialist Orthopedic Surgeon, we chose to use Zimmer Persona Total Knee implants and began the surgery for both knee under combined epidural spinal anesthesia.

The surgery was successfully completed as planned with good joint alignment and good soft tissue balancing. Post operatively, the patient was in the ICU for 2 days for post op care, all his blood parameters were normal with not much blood loss. Physiotherapy was started from 2nd post op day and he was mobilized out of bed on 5th post op day.

The patient is now under physiotherapy and has started to mobilize with the walker.

He is advised to walk weight bearing with walker while continuing physiotherapy to strengthen his muscles and mobilize his joints. He will be on regular follow up to see his recovery and to mobilize him without the walker after seeing him on consecutive follow up for muscle strength and make him independent.