Knee
Total Knee Replacement
A knee replacement resurfaces a joint that arthritis has worn through. The damaged ends of the thigh bone and shin bone are removed and replaced with metal and plastic components, so the joint moves on a smooth surface again instead of bone grinding on bone.
By appointment only, at Kharar (Mohali) or Solan. Your confirmation says which.
When it is worth considering
Knee replacement is an operation for pain, not for an X-ray. Plenty of people have badly arthritic-looking knees and manage well; others have moderate changes and cannot get through a night. What usually tips the balance is pain that has stopped responding to the simpler things and has started deciding how you live.
In practice the conversation tends to start when several of these are true:
- Pain at rest or at night, not just when you walk
- Physiotherapy, weight management, painkillers and injections have been genuinely tried
- Stairs, squatting or getting up from a chair have become the limiting factor
- The leg has begun to bow inwards or outwards
- You are giving up things you want to do because of the knee
If those do not yet describe you, the honest answer is usually to wait and treat it without surgery. That answer gets given a lot in this clinic.
What the operation involves
The procedure takes roughly one to two hours. Most knee replacements in India are done under spinal anaesthesia, so you are numb from the waist down and sedated rather than fully asleep, which tends to mean less nausea afterwards and easier pain control early on.
The worn surfaces are removed and the implant is sized and positioned so the leg lines up straight and the ligaments are balanced through the full range of movement. Getting that alignment right is most of the operation, and it is where navigation and robotic assistance help most, particularly in knees with a severe bow.
Dr. Khanna trained in hip and knee arthroplasty at Lilavati, Sir HN Reliance and Breach Candy Hospitals in Mumbai and at Max Superspeciality Hospital, Mohali, has experience with both navigation-assisted and robot-assisted technique, and has published research on post-operative pain protocols in knee replacement.
Recovery, week by week
These are typical ranges. Age, general health, how stiff the knee was beforehand and how consistently you do the exercises all move them.
- Day 0 to 1. You stand and take your first steps with a walker, usually the same day or the next morning.
- Week 1 to 2. Hospital stay is generally two to four days. Walking indoors with support, working on straightening the knee fully and bending it past 90 degrees. Stitches or clips come out around day 12 to 14.
- Week 3 to 6. Most people move from a walker to a stick, manage stairs, and return to desk work if they have it. Swelling is still normal at this stage.
- Week 6 to 12. Walking unaided, driving again once you can brake safely, back to routine daily activity.
- 3 to 12 months. Strength and stamina keep improving. Some swelling and a warm feeling around the knee can persist for the better part of a year, which is expected rather than a problem.
The physiotherapy is not optional and is not something to start later. What you do in the first six weeks largely sets the range of movement you keep.
What it will not do
A replaced knee is a very good knee, not a young one. Kneeling is often uncomfortable and sometimes never fully comfortable. Deep squatting and sitting cross-legged on the floor are usually limited. Running and jumping sports are not advised, because they wear the implant.
Modern implants commonly last fifteen to twenty years or more, but they do not last forever, and a younger, heavier or more active patient will use one up faster. That is a real part of the timing decision.
Risks worth knowing about
Serious complications are uncommon, but no operation is free of them. Infection, blood clots in the leg or lung, stiffness needing further treatment, ongoing pain, injury to nerves or vessels, and loosening or wear of the implant over the years are the ones that matter most. Blood thinners, antibiotics and early walking are all used specifically to reduce these risks.
You will be told which of these apply more to you before anything is decided. Your own general health, diabetes control, weight and smoking all change the numbers.
Common questions
How long will I be in hospital?
Usually two to four days, depending on how quickly you are walking safely and managing stairs. Patients who live alone or have no one at home to help sometimes stay slightly longer.
Can both knees be done at once?
Sometimes. Doing both in one sitting means one anaesthetic and one recovery, but it is more demanding on the body and needs good general health and a strong support system at home. It is a decision made case by case, not a default.
When can I drive again?
Typically six to eight weeks for a right knee and a little sooner for a left one with an automatic car. The test is whether you can perform an emergency stop without hesitating, not how the knee feels sitting still.
Will I set off airport metal detectors?
Occasionally. It is not a problem, and there is no need for a special card or certificate, telling the security staff is enough.
How long do I need physiotherapy?
Supervised physiotherapy usually runs six to twelve weeks, and a home exercise programme continues well beyond that. The exercises matter more than any other single factor in the result.
Not sure whether you need this?
That is the right question to bring to a consultation. Second opinions on surgery already advised elsewhere are a routine part of the practice. Bring your imaging and any plan you have been given.
Not sure this is your problem?
These start from the symptom rather than the operation, and cover what else can cause it and what gets tried first.