Moving away from hip and knee pain

Total Knee Replacement Surgery with walking ability within 24 hours

If you have experienced severe pain in your knees while walking, climbing stairs or getting in and out of chairs, or suffer from knee deformities or chronic knee inflammation that fails to respond to anti-inflammatory medications and injections, it might indicate osteoarthritis of the knee.

Besides advanced age, other risk factors for knee osteoarthritis include heredity, gender and history of trauma. Although there is no cure for osteoarthritis of the knee, lifestyle changes can slow disease progression and reduce its severity. Osteoarthritis of knee can largely impair daily abilities and quality of life. However, a number of people live in fear of having a knee operation. Some do not know that total knee replacement surgery is one of the most effective ways to bring patients back to their normal activities in no time.

"Knee surgery appears to be frightening to some patients since they doubt the curability and fear inability to walk afterwards. To eliminate this anxiety, total knee replacement surgery combined with a pain intervention technique using radiofrequency ablation and nerve block results in no or less pain, less muscle damage and a faster recovery, regaining walking ability within 24 hours after surgery."

To eliminate suspicion of incurability, a Digital Template Computer Program is used for individual surgical planning. The program allows the surgeons to customise the size and determine the position of the prosthesis for each individual patient. This, in turn, reduces the possibility of traumatic damage to surrounding areas and prolongs the lifespan of the implants.  

The patient's concern of inability to walk after surgery is dispelled by the fast rehabilitation and recovery program. Patients can usually start walking and restoring full muscle function within 24 hours of surgery.

Direct Anterior Approach – An advanced hip replacement surgery technique

Hip osteoarthritis often appears in people aged over 40. Genetic abnormality of hip joints, the autoimmune disease of Systemic Lupus Erythematosus (SLE), kidney disease, rheumatoid arthritis or long-term steroid use are major contributing factors. In late stages, patients often experience chronic hip pain that might radiate to the legs and pain killer drugs might not work anymore. Hip pain is usually aggravated when the patient moves or climbs stairs. If pain is intensifying, it can disrupt sleeping at night and result in limited mobility and poor quality of life.

In the past, patients often avoided traditional hip replacement surgery which involves making a large incision (6 -to 8- inches long) on the side of the hip (lateral approach) or the back of the hip (posterior approach). Both techniques require muscle and tendon detachment from the hip in order to replace the damaged joint. Detachment of these muscles can potentially result in increased pain after surgery and can prolong the time to get a full recovery by months or even years. Failure of these muscles to heal properly after surgery may increase the risk of hip dislocation which is the leading cause of hip replacement failure. Undesirable postoperative outcomes also include the risk of unequal length in legs, leading to poor posture and other complications.  Nowadays, advanced technology in orthopaedic surgery allows less invasive procedures with improved surgical results and patient satisfaction.

The Direct Anterior Approach (DAA) Cosmetic Incision Hip Replacement Surgery has gained increasing popularity in the USA, Canada and Europe as well as Thailand. DAA hip replacement surgery is considered a minimally invasive surgery that involves a smaller incision (3- to 4-inches long) hidden at the groin beneath the bikini line. This small incision on the front of the hip allows the joint to be replaced by moving muscles aside along their natural tissue planes, without detaching any tendons.

"Due to the advancements of the navigation system, called JointPoint™, new generations of prosthesis and a less invasive surgical technique, the DAA hip replacement surgery requires a smaller incision, no requirement for muscle detachment and so less pain, less blood loss and lower post-operative complications as well as faster recovery time and improved mobility with reduced chance of hip dislocation. Besides superior cosmetic effects, patients are not instructed to follow hip precautions after surgery. In short, the surgery brings back their daily life and reboots their bounce.

Dr. Phonthakorn Panichkul
Joint Reconstruction and Arthroplasty Surgeon, Hip and Knee Center, Bangkok International Hospital.