Knee:

1. Arthritis

Arthritis is an inflammation of the joints. It can affect one joint or multiple joints. There are more than 100 different types of arthritis, with different causes and treatment methods. Two of the most common types are osteoarthritis (OA) and rheumatoid arthritis (RA).
The symptoms of arthritis usually develop over time, but they may also appear suddenly. Arthritis is most commonly seen in adults over the age of 65, but it can also develop in children, teens, and younger adults. Arthritis is more common in women than men and in people who are overweight.

2. Joint Preservation – Regenerative Therapy:

Regenerative cells are special types of cells with the ability to multiply and self-renew. They also have the potential to replicate into specialized cell types forming potentially any tissue in your body. In other words, they can become a cartilage cell
The human body has a tremendous capacity to differentiate and form different tissues, so that’s the thought behind regenerating cartilage, regenerating nerve cells and healing any injured tissues
There are multiple sources of adult regenerative cells found in your body, including bone marrow or fat.

Regenerative cell for knees treatment

The usual job of joint cartilage is to promote smooth movement of joint surfaces and protect bones from friction. This process allows for shock absorption of up to 20 times the weight of the body. It’s essential to physical movement, especially in athletics.
Osteoarthritis is one of the most common chronic degenerative disorders and it very often affects the knee, causing deterioration of its joint cartilage over time.
Osteoarthritis can also begin as a result of a knee injury, such as a ligament tear, tendon damage, or a fracture. In the face of damage, the joint becomes unstable and this wears down the articular cartilage. From there, the bone can suffer damage as well, in addition to the synovial joint lining, tendons, ligaments, and muscles.
Stem cell therapy for knees is minimally invasive. It’s a procedure that can decrease inflammation, slow and repair all these forms of damage from arthritis, and delay or prevent knee replacement surgery.

Regenerative cell knee injections

Adult regenerative cells can be extracted from bone marrow or fat through simple methods. It’s then concentrated and injected into the knee with image guidance, usually too successful results.
In one study, patients experienced improvement in both knees even though only one knee was injected. Although natural deterioration of the knee continues, at five years, those knees that are injected with regenerative cells are in better shape than they were before the injections.
Researchers believe that regenerative cell therapy for the knee works by developing into essential cartilage cells, thwarting the inflammation that can worsen arthritis and releasing proteins called cytokines that slow degeneration of cartilage and reduce pain
Ongoing research is striving to determine which regenerative cell knee therapy techniques, cell choices, and dosages yield the most effective and consistent results.
While some seem more potent than others and overall results are promising, more research is needed.

3. Partial Knee replacement

A partial knee replacement is an alternative to total knee replacement for some patients with osteoarthritis of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee.
In the past, partial knee replacement was reserved for older patients who were involved in few activities. Now, partial knee replacement is often preferred in the younger population as their recovery is quicker and often with much less pain. About 5% to 6% of patients with arthritic knees are estimated to be eligible for partial knee replacement.

Which patient require partial knee replacement?

Patients with medial, or lateral, knee osteoarthritis can be considered for partial knee replacement. “Medial” refers to the inside compartment of the joint, which is the compartment nearest the opposite knee, while “lateral” refers to the outside compartment farthest from the opposite knee. Medial knee joint degeneration is the most common deformity of arthritis.

Advantages of Partial Knee Replacement

Multiple studies show that a majority of patients who are appropriate candidates for the procedure have good results with unicompartmental knee replacement.
Also, because the bone, cartilage, and ligaments in the healthy parts of the knee are kept, many patients report that a unicompartmental knee replacement feels more natural than a total knee replacement. A unicompartmental knee may also bend better.
The advantages of partial knee replacement over total knee replacement include:

• Quicker recovery

• Less blood loss

• Less pain after surgery

4. Total Knee replacement

Knee replacement surgery is one of the most common bone surgeries in the country. Whether you need the surgery is a decision that you and your doctor, an orthopaedic surgeon, carefully make together. More than 90% of people who have had their knees replaced see a huge improvement in pain and their ability to get around.
Known as arthroplasty, knee replacement surgery replaces the damaged parts of your knee with artificial parts. Several million Indians live with such implants.

Number of reasons to opt for a surgery:

• Nagging knee pain bothers you while resting, possibly keeping you from sleeping well.

• Severe pain and stiffness makes it hard for you to walk, climb stairs, or get out of a chair.

• Physical therapy and medication haven’t helped.

• Your knee is often swollen.

• Your knee is bowed or has other defects.

Preparing for Surgery

Before you have surgery, your surgeon will take your medical history and do a physical exam that includes X-rays and possibly blood tests. Your doctor will use those X-rays to figure out what the damage inside your knee looks like. The doctor will also want to see how strong the muscle support around your knee is, and how well you can move the joint.
As with all surgeries, tell your doctor what medications you are on, including blood thinners, aspirin, or other drugs. They’ll also need to know if you have a history of infections, bleeding, or blood clots. You also shouldn’t eat for 8 hours before the surgery.

During the Surgery

Knee replacement surgery has become more advanced. If you are healthy, it can be done as an outpatient procedure without a hospital stay. If done in the hospital, expect to stay in the hospital for at least 1 to 4 days. Just before surgery, nurses might insert an intravenous line (IV) into a vein in your arm or hand to give you fluids and medicines. They also have to shave your skin where the doctor will make the cut.
You might get general anaesthesia to put you in a deep sleep during the surgery. Your doctor may decide instead to give you a spinal/epidural anaesthesia, which will numb you below the waist but keep you awake. Most people will have general anaesthesia.
Surgery can take 1 to 2 hours. Your doctor can do it a couple of ways. They might make an 8- to 10-inch cut in the front of the knee. Then they’ll take out the damaged part of the joint and the surfaces of the thigh bone and shin next to the joint. Once that is done, the surgeon will implant the artificial knee.
You might get what’s called “minimally invasive” surgery. In this case, the surgeon will make a shorter cut, around 4 to 6 inches. This will result in less damage to muscle and tendon. A person who is thin, young, and healthy is usually a good candidate for this technique.

After the Surgery

You can expect to be up on your feet within a day. That might be hard to do on your own at first. So you may need parallel bars, crutches, a walker, or a cane for a while to get up.
Usually, you can expect a big improvement in flexibility and much less pain within a month. It’s important to exercise your knee often, to keep down swelling and to strengthen your muscles.
You might need help from a physical therapist, who will go through a series of exercises to strengthen your repaired knee. How long you’ll need physical therapy depends on your health and how motivated you are to recover from your surgery.

5. Revision Knee replacement

The revision surgery is often required when a knee replacement no longer functions correctly. During this procedure, a surgeon replaces the old device with a new one. Although today’s implants are designed to last many years, it’s possible that at some point in the future — typically 15 to 20 years or more — your prosthetic will break or wear out. If you’re overweight or you engage in high-impact activities such as running or court sports, the device may fail sooner.
Surgery is performed under sterile conditions in the operating room under spinal or general anaesthesia. The Patient is positioned on the operating table and the leg prepped and draped. A tourniquet is applied to the upper thigh and the leg is prepared for the surgery with a sterilizing solution. An incision around 7cm is made to expose the knee joint. The bone ends of the femur and tibia are prepared using a saw or a burr. Trial components are then inserted to make sure they fit properly. The real components (Femoral & Tibial) are then put into place with or without cement. The knee is then carefully closed and drains usually inserted, and the knee dressed and bandaged.

Rehabilitation

Post-surgery rehabilitation is essential to avoid further complications such as reduction in the range of motion, muscle weakness and recurrence. Physical therapy may be initiated immediately after surgery and may be continued for up to three months. Physical therapy includes uses of crutches or walker along with strengthening and mobilization exercises to regain the strength and mobility of the join.