16 January 2018
Total Knee Replacement (Knee Arthroplasty) improves the quality of life of patients helping them with better knee movement as compared to what they had before the knee replacement. Sharing results of data analysis of his patients done by him and his team, Dr. Ramesh K Sen, Director – Joint Replacement & Orthopaedics, Fortis Hospital Mohali, said there appears to be rapid and substantial improvement in the patients’ pain, ability to work and overall quality of life in about 90% of them.
Dr. Sen, an Orthopaedic Surgeon with over 30 years of experience including 20 years as Faculty at PGIMER, added that this is probably the first time in India that such an outcome data has been recorded and documented for Indian patients.
The data pertains to a few of Dr. Sen’s patients – a small group of 153 wherein 22 had single knee replacement surgery and 133 had both knees replaced. A total of 288 joint replacement surgeries were done. “Except 5 knees joints, all other 283 achieved more than 90 degrees range of motion, with is compatible with our walking. One-third achieved significant improvement with the ability to sit on the ground (normal knee range), one-third had very well (more than 100 degrees movement) and one-third had more than the essential range of movement (> 90 degrees). We observed for their ability to use their operated knee as per Knee Society scores being used in the USA. As per observations of our patients, except 3 patients, all other had more than 80% knee function like normal. One-third of them had a good function as normal knee (>95%). These are very encouraging statistics and tell us that we’re on the right track,” said Dr. Sen.
These observations have been documented in Fortis Hospital Mohali. “We have been performing Knee Arthroplasty as a routine surgery. As a center dedicated to patient care and outcomes, we have been evaluating the results and the subsequent working of these operated joints using standard international scores used in the USA and Europe. We implement international standard criteria for assessment of changing the quality of life after getting the surgery of Total Knee Replacement. This is probably the first time in India that such an outcome data has been recorded and documented for Indian patients. The social habits and customs are different in our country than the people in the western world. So, there was a big need to define whether our patients also achieve similar results or are less happy,” said the renowned surgeon, who also has to his credit the patent for a new pelvic plate for reconstruction of acetabulum fractures, apart from 3 other patents.
Dr. Sen added that they also evaluated whether good scores for knee movement also resulted in good scores for quality of life. “We used WHO Quality of Life Scores that are already validated for Indian patients for other diseases. These scores evaluate patients on the basis of their ability to carry out their activities as per Indian standards. Except 5, all other 148 patients scored more than 80% in the outcomes. This shows that with a change in the painful and disabling joint by replacement, a normal life can very well be expected in our population,” he said.
Dr. Sen said, “As per observations, our patients have been able to achieve a better quality of knee working ability as well as better quality of life after Arthroplasty or Total Replacement. Technical factors in performing surgery also influence both the short and long-term success rate.”
The surgeon said there was the consensus regarding the following perioperative interventions that improve outcomes of Total Knee Replacement: systemic antibiotic prophylaxis, aggressive postoperative pain management, perioperative risk assessment and management of medical conditions, and educating the patients before the surgery.