Knee Replacement in Iran

How knee replacement surgery is done?

The knee replacement surgery is a 2 to 4-hour procedure. It starts with putting you under general anesthesia. The orthopedic surgeon will first make a 5 to 8-inch incision. Next, he/she prepares the bone and cartilage by removing the damaged surfaces of the femur and tibia (two bones located between the knee and ankle) as well as some extent of the surrounding bone. Implants (metal or plastic components) are then cemented or press-fitted into the bone; they recreate the joint surface and restore the knee function and alignment. Depending on the case, the surgeon may or may not resurface the kneecap (patella). Lastly, he/she will insert a medical-grade plastic spacer between the metal components; this adds a smooth gliding surface.

Total Knee Replacement (TKR) surgery involves replacing the whole knee joint. Whereas in Partial Knee Replacement (PKR) surgery, only one damaged part of the knee (medial or lateral) will be replaced. Partial knee replacement surgery is minimally invasive and requires less recovery period. The pre-op evaluations will help the surgeon decide which approach suits you the best. 

When the procedure is over, you are expected to stay at the hospital for 3-5 days. Rehabilitation starts right away with the help of a therapist.

What can knee replacement surgery fix?

First and foremost, knee replacement surgery is an effective treatment for osteoarthritis. The condition causes severe pain in the knee joint to the extent that the person might experience pain or stiffness walking, getting in and out of the seated position, or even at rest.

Knee deformity is another condition that can be successfully treated by knee replacement surgery. By helping the knee alignment, it is considered as one of the most effective treatment options for bowlegs.

Some forms of knee inflammation and swelling cannot be easily treated using medications. Knee replacement surgery, however, can considerably subside the symptoms. 

Also, any deformity or abnormality of the lower limb can have additional effects such as back pain. By treating the knee joint problem causing the back pain, a knee replacement surgery can relieve the pain and discomfort in the back. 

Knee replacement alternatives

Knee replacement surgery is a definite and low-risk procedure. But it can be followed by pain and discomfort for a month or two. Most people go on with getting a knee replacement surgery after they try less effective but more convenient alternatives:

• Lifestyle modification: Losing weight and replacing strenuous activities with low impact exercises might possibly reduce the pain or stiffness.
• Anti-inflammatory medications: Some forms of arthritis caused by inflammation can provide temporary relief.
• Glucosamine/chondroitin medications: These medications can improve mobility and reduce the pain associated with knee arthritis.
• Knee injection: Some physicians decide using injections can help treat knee pain. Injectable options include Hyaluronic acid, Corticosteroid, or Placental tissue matrix.
• Stem cell: This cutting-edge therapy includes using hipbone marrow stem cells to help regenerate knee cartilage tissue. It is most beneficial when used after knee replacement surgery for better knee repair and pain relief (source).

Which knee replacement implant is the best

Suitable knee replacement implants are biocompatible, durable, tough, and last for more than 15 to 20 years. Implant components are mostly made of titanium, cobalt-chromium alloys, or a titanium and cobalt mixed metal. 

In some cases, gender-specific knee implants are used for an optimal outcome. As opposed to traditional "average" size implants, gender-specific implants are developed to fulfill the expectations of men and women equally.

Knee replacement implant brands used in Iran are mostly from Germany. Manufacurers such as Aesculap and Implantae are trusted by many Iranian surgeons for their high-quality and non-allergic materials. Other implants found in Iran include:

• Valdin
• Zimmer
• Gruppo
• Waldemar
• Biomet

By choosing the right clinic and the appropriate medical team, you can make sure your surgeon uses suitable implants that meet your every need. You can ask the surgeon about the type of knee joint implant he or she uses in the consultation session.

Should I have a knee replacement operation?

Most patients of total knee replacement surgery are elderly people between 50 to 80 years old. However, knee replacement surgery can be successfully performed on people of any age. In other words, an orthopedic surgeon determines the candidacy of an individual based on his or her pain and disability rather than age. 

After a knee replacement operation, you should avoid high-impact activities such as running, jogging, or jumping; you should also try to maintain a healthy weight. The newly replaced implants will function as if they are your original joints. However, knee replacements can wear out gradually with normal activity. Some lifestyles like being overweight and doing excessive activities can speed up this process. 

Arthroplasty surgery can be quite difficult. You should make sure no other alternative can fix your problem. You can do so by hitting us up and having a free consultation session with medical experts.

Arthroplasty in Iran

Arthroplasty in Iran is performed not only with the best quality but also at the most affordable price. The cost of knee replacement in the US is $49500. Even in so-called cheap countries such as India, knee replacement surgery will cost you more than $4000. In Iran, however, exceptional Iranian hospitals such as Moheb Mehr Hospital offer knee replacement surgery at only about $1800. 

What you need to do before getting knee replacement surgery

Pre-op Evaluations include an overall physical examination of your knees, X-rays, medical history (including the medications you are currently taking). You might also be advised to take some tests such as blood tests or MRI. The state of your physical health plays a huge part in the procedure and the recovery period. Your orthopedic surgeon might ask you to schedule a complete physical examination several weeks before the operation. 

Arrange for somebody to stay with you for several weeks before the surgery. Although you will be able to walk using crutches or a walker as soon as the surgery is over, you may still need someone to help you with doing the house chores for 2-3 weeks. Activities like cooking, shopping, and doing the laundry can be difficult and need excess energy during the recovery period.

In the weeks leading to the operation, spend 30 minutes each day doing exercises to build up strength in the knee muscles. You can do exercises such as straight leg raises, knee bending, sitting kicks, or chair pushups. You should also try to get in better shape before the surgery, losing some weight can help lighten the stress on your knees.

Quit smoking for at least 2 weeks before the surgery. Smoking slows the recovery process and can increase the risk of infection. You should also avoid alcohol for a week before the procedure. 

Avoid blood-thinning medications including ibuprofen and anti-inflammation. In the consultation session with the doctor, remember to mention any medication you routinely take. Nutritional supplements and herbal medications can also be considered as blood-thinners.

Post operation recovery and exercises

After a knee replacement surgery, you should follow instructions about wound care and exercises. You should also watch out for any symptom of infection. In 3 to 6 weeks you can resume your normal daily activities and house chores. Pain is considered normal; particularly at night and with some activities. It will decrease in several weeks. 

• Within a day after surgery, the knee exercises will begin. A physical therapist will show you how to do the movements. You should continue physical therapy at home regularly. Most physicians advise you to do exercises like ankle pumps or knee straitening. Gradually, you should start walking as part of your daily routine.
• Your wound will be covered with sutures and staples for several weeks after the surgery. You can continue wearing the bandage after the stitches are removed to avoid irritation. You should care for the wound before after the sutures are removed. Avoid soaking the wound in water until it is completely dried and sealed.
• You may experience a loss of appetite for some weeks after surgery. A balanced diet, rich in iron, is recommended by most orthopedic surgeons. Being on a diet can also help with maintaining a healthy weight and reducing the stress on knee joints.
• Take medications prescribed by your surgeon. They may include antibiotics to avoid infection and pain killers to manage pain and discomfort. The surgeon may also recommend that you take blood thinners to prevent blood clots formation.
• A majority of patients can resume driving within 4 to 6 weeks. To ensure you have recovered, make sure you can bend your knee enough to sit comfortably in the car.
• Try to steer clear from hazards like stairs. Falling during the initial weeks after the surgery can be extremely damaging to your new knees. Until you feel your balance and strength is improved, use a cane or walker or have somebody help you while walking or climbing stairs.

Risks and side effects

Knee replacement surgery is a major surgical procedure that can have some risks and side effects of its own. Aside from basic surgical risks such as reaction to anesthesia, infection, and blood clots, other possible side effects may include: 

• Nerve damage
• Artificial joint failure (worn out, loose, or dislocated)
• A slight length difference between legs
• Allergic reaction to the implant components or bone cement

FAQ

Does knee replacement surgery hurt?

After the surgery, you are likely to experience some discomfort and pain that will subside in three to six months. The benefits of knee replacement surgery can totally outweigh the pain.

Can knee replacement fail?

Knee replacement failure can occur in some rare cases. When it does, it is most frequently associated with infection or dislocated prosthesis. A failed knee joint implant can successfully be treated and a new joint can replace the previous one.

Do knee replacements last forever?

Like any artificial body part, knee replacement implants have a limited life span. However, the durability of most implant components means you can have them for up to 20 years. 

Can knee replacement make you taller?

Yes, most people feel they are slightly taller after knee replacement surgery. Most arthritis conditions can lead to cartilage worn down and as a result a reduction in height. A newly replaced joint can undoubtedly make changes.

Can knee replacements be rejected?

Allergic reactions can make your body reject the implant component or bone cement. Expert surgeons will ask about your history of allergic reactions and probably take some tests to make sure the rejection won't happen.