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‘Age no bar for knee replacement surgery’
Total knee replacement may not add years to life but has the potential to add life to years. At 86, Kailash Devi witnessed this coming alive when her family convinced her to undergo knee surgery to address the fracture that occurred while walking at the terrace.
Having suffered from long standing arthritis and deformity in her right leg often made Kailash lose balance. She was usually very careful while walking but that day she lost her balance and tripped. The fall caused fracture just below the knee and involved crucial support structure of the knee joint. Investigations revealed that surgery was crucial to avoid long term immobility.
He was anxious of surgery at age was a big factor. “How much am I going to live in any case? I don’t want to undergo surgery,” she said. After a thoughtful discussion with her family and surgeon, she finally agreed. The surgery was performed in less than one hour and patient was mobilised the next day. In less than 4 days, she was discharged and decided walk down till her car in the parking.
Commenting on the appropriate age of knee surgery, Dr Sanjai K Srivastava, director and chief joint replacement surgeon, Radius Joint Surgery Hospital explains, “With increasing longevity, more patients older than 90 years now are becoming candidates for total knee replacement.
Some physicians may be hesitant to recomm-end the elective surgery to patients of this age. But, age is not a barrier for replacem-ent surgeries provided it is done with the right expertise and care. Studies internation-ally have shown that surgery is reliable, durable, and safe in patients older than 80 or even 90 years of age. Decision for surgery should be taken based on patient’s medical condition and comorbid conditions rather than only the age. It is important to be aware that primary and revision total knee replacement can be done safely and effectively for patients 90 years and older and it has resulted result in years of marked pain relief for those patients.”
Elaborating on knee replacement surgery in older group of patients, Dr Pankaj Bajaj, medical director and chief orthopedic surgeon, Cygnus Orthocare Hospital, New Delhi said, “Arthritis in patients with advances disease causes debilitating pain and impacts mobility. In such cases non-invasive treatments, such as medications and physical therapy, have limited value. As life expectancy increases, more number of patients who reach the tenth decade of life are likely to require TKR.”
Dr Bajaj further adds, “These patients may require an extra cover of care from specialities including surgical skills, anaesthesia team, ICU back up, physiotherapy and rehabilitation. But those who have the risk of long term mobility, knee replacement surgery is likely to be the most viable option. High end knee implants such as Single radius knee (SRK) is designed to provide a stable fixation with high quadriceps efficiency. As SRK is designed to mimic the natural human knee, its design features enable faster recovery and reduced postoperative pain.”