Ramesh Pawar was an active 52-year old farmer living in a small village in Maharashtra. His day began well before sunrise and throughout the day he worked hard in the fields with his two sons. At the end of the day, he relaxed by playing with his grandchildren in the backyard of his house. Life was hectic but enjoyable. So when he was diagnosed with diabetes and high blood pressure, Mr.Pawar was surprised. He took his medicines whenever he could and had no time to brood over minor aches and pains.
Over the years, the minor aches and pains worsened. He was exhausted most of the times. His knees were bent and he was in severe pain. Sitting on his haunches was excruciating, so he could no longer work on his farm. Worse, he couldn’t even go to the toilet without help. He spent most of his time lying on his bed and depended on others for the simple tasks that a healthy person takes for granted. By the time Mr.Pawar came to Sahyadri Speciality Hospital and consulted joint replacement specialist Dr. Sushrut Badve, he was just a shell of his former self.
The first thing that was done was a general physical checkup. Mr.Pawar’s sugar was out of control, his blood pressure was very high and he had a heart condition. Like most busy people, he had ignored his own health because ‘he had very little time for himself’. He was immediately put on medication to bring his sugar, BP and heart condition under control. His knees were severely arthritic and deformed. “The knee is made up of the lower end of the thighbone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). Articular cartilage covers the ends of these bones where they touch and provides a lubricated gliding surface for the smooth movement of the knee. When this cartilage begins to wear away, it causes pain and stiffness. When it wears away completely, the bones rub directly on each other and cause persistent pain and reduced mobility,” explains Dr.Badve. This type of osteoarthritis is common in patients who are 50 or older. But it is also seen in people with a family history of arthritis or who are in professions which put pressure on the knee joint, such as sports persons. The cartilage can also wear away in patients suffering from rheumatoid arthritis or as a result of traumatic arthritis caused by serious knee injuries.
“For patients whose knees are severely arthritic, the pain is debilitating. Performing even routine activities like walking or climbing stairs becomes nearly impossible,” says Dr.Badve. In such cases, total knee replacement (TKR) can provide complete relief from pain, correct any deformities and help resume normal activities. In TKR, the damaged part of the joint is removed from the surface of the bones. Then the surfaces are shaped to hold the metal or plastic implant. The implant is attached to the thigh bone, shin and knee cap either with cement or a special material. The attached parts fit together to form the artificial joint. It is supported by the surrounding muscles and ligaments just like a normal knee joint.
“The use of good quality implants adds to the cost of the procedure but TKR is one of the most effective surgeries. The results are predictable and reproducible. It dramatically improves the quality of the patient’s life, that too for many years,” says Dr.Badve.
The now 57 year old Ramesh Pawar should know more about that. He can now easily walk from his house to the farm, and once again plays with his grandchildren. He says, “I went from being an active person to relying on others even to get up from the chair. With knee replacement, I have once again become a fit, productive person and regained not just my active life but also my confidence and dignity.”