Lifestyle-conscious young Indians seek early knee replacements

New Delhi, July 22: Vaishali, 32, was suffering from rheumatoid arthritis (an autoimmune disease that attacks the joints) that affected both her knees, leaving her with no movement at all. Recently operated with the bilateral Total Knee Replacement (TKR) surgery at Nanavati Super Speciality Hospital in Mumbai, she now has near normal movement. A healthy and active life is awaiting her.

Preeti Tyagi, 43, recently underwent knee replacement surgery at Atlanta Hospital in Ghaziabad. Suffering from rheumatoid arthritis, she was not even able to walk for 100 metres. After the knee surgery, she is now able to climb stairs without any pain and can soon resume other physical activities as well.

Knee pain

Not long ago, knee replacement was considered a necessity for the elderly suffering from the persistent keen pain. Not any more.

Increasingly, young Indians are going under the knife for joint replacements so that they can maintain active lifestyles rather than wait for their knees to pack up.

"The knee replacement surgeries have emerged as a lifestyle choice for many people in their forties who do not want to hang up on jogging, cycling, driving, yoga, climbing stairs or playing their favourite sports," say the country's leading orthopedics and knee replacement experts.

An improved implant technology with positive outcomes is driving young people to opt for surgery at an earlier age.

"Earlier, we hardly had patients seeking joint replacement in their forties or fifties. Most waited till the knees lost all mobility and pain became unbearable. Today, young people are seeking joint replacements earlier so that they can return to their dynamic lifestyles," Dr Rajeev K Sharma, senior consultant (joint replacement surgeon) at Indraprastha Apollo Hospitals in New Delhi told IANS.

The latest techniques like gold knee and oxinium implants are proving much better than previous ones, ensuring a long-lasting positive effect on knees.

"The newer materials like fourth-generation ceramics, alloys and finishes like oxinium and highly cross-linked polyethylene (plastics) last much longer. Hence, the eight-10 years of implants' life is now extrapolated to 20-25 years," explains Dr Sanjay Agarwala, head (orthopedics and traumatology) at PD Hinduja National Hospital in Mumbai.

The outcomes are invariably better in patients who are relatively younger as arthritis has not yet completely decimated their original knee joint with ligaments and cartilage supporting it.

The muscles supporting the knee joint are also relatively stronger and can recover faster from the surgery than in older patients.

"Partial knee replacements are also possible in younger patients because a part of the knee, which is less damaged, can be retained in them. This includes some original nerves, tendons, ligaments and sensors," Dr Sharma adds.

Like the west, knee replacement in India is now becoming popular among the younger population.

"Joint replacement effectively aims at relieving pain, correcting alignment and achieving mobility and stability of knee joint. It can last up to 25 years with modern bearing surfaces," says Dr Pradeep B Bhosale, director (arthritis and joint replacement surgery) at Nanavati Super Speciality Hospital in Mumbai.

Dr Bhonsle, who performed the surgery on Vaishali, has also operated upon people as young as age 20 when the cartilage was either destroyed by arthritis or because of post-traumatic conditions.

"Knee replacement is a life-changing procedure for those suffering from arthritis. With the new implant technology, the durability is no more an issue," notes Dr Ishwar Bohra, senior consultant (orthopedics department) at BLK Super Speciality Hospital in New Delhi.

By having a functioning knee again, the patients may also reduce the risk of several diseases whose onset is accelerated by the lack of physical activity like hypertension, diabetes and cardiovascular diseases.

According to Dr A.B. Goragaonkar, head of orthopaedics at L.T.M. Medical College and Hospital in Sion, Mumbai, total knee replacement surgeries do well when performed timely.

"Delayed total knee replacement surgeries take longer rehabilitation time but eventually do well. The earlier, the better," advises Goragaonkar who recently performed a knee replacement surgery on a 42-year-old school teacher who is now doing fine.

"New implants are more anatomical and compatible which not only consumes less time in surgery but also increases the span of joints," explains Dr Amit Tyagi, medical director and orthopaedic surgeon at Atlanta Hospital who operated on Preeti.

According to the premier health website, in 2014, nearly 70,000 people underwent total knee replacement surgery in India as compared to 6,000 people who underwent a hip replacement.

Are there risks involved in conducting knee surgeries in younger patients?

"There is no such risk, but the surgery should only be done when it is genuinely required. If the person can walk easily or is in early stage of osteoarthritis, then surgery is not required," emphasises Dr Tyagi.

Surgical risk is less in young arthritic patients in comparison to the elderly.

"As they are active and their cardiac activity and muscle strength is better, the rehabilitation is faster and results are better," he stresses.

Although, a word of caution for those who have gone in for an early knee surgery.

"A certain degree of restraint must be exercised while resuming physical activities. You would not eat 'supari' with artificial teeth, would you?," advises Dr Agarwala.


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