21 Feb TOP 5 MODIFIABLE PATIENT FACTORS FOR GOOD OUTCOME OF TOTAL KNEE REPLACEMENT SURGERY

“It takes two hands to clap “ goes an unknown or Zen saying .It is very true for knee replacement. By this I mean if one hand is the surgeon the other hand is the patient. Patient equally has to be a part of the process in getting good outcome out of the surgery. We call it modifiable patient factors. It could be said as the way of life is getting ready for surgery and post-surgery just like preparing oneself say a 10/km Marathon.

      The 5^th in the list would be the nutritional status. The better the nutritional status of the patient better the outcome. We have pre-surgical tests done routinely which give a guideline about the Nutritional Status of the patient, for example, Serum Albumin gives a better understanding of the general fitness for the surgery.

    The 4^TH in the list in assessing a better way of life for surgery would be Quit Smoking. When it comes to health, smokers do not do well at all, and this is equally good for surgery too. If someone is smoking more than 1 PPD( Pack Per Day) it has to be brought down to less than half pack per day and make them quitting smoking. We require patients to quit smoking 6weeks prior to (TKR) Total knee replacement & monitor this with a blood test.

             The 3^rd important modifiable factor is having blood sugar under control. The prevalence of diabetes is rising all over the world due to population growth, aging, sedentary lifestyle, increase in body weight. International diabetes federation (IDF) estimates that the total number of people in India with diabetes to be around 87 million by 2030 so this is one of the important factors. We work closely with the physicians for all our diabetic patients. Follow up of patients happens with HBA1C. This should be less than 8 for knee replacement surgery.

        The 2^nd important modifiable  factor is the body weight .Patients  need to bring down their BMI ( Body Mass Index) to less than 40kg/m² .Though obese patients are the major suffers  of the knee pain it is equally important to reduce  body weight before knee replacement as chances of infection and other complications are high with morbidly obese patients.

        The 1^st important modifiable factor is anemia. India has the highest prevalence of anemia at 40% though there are several causes for anemia. Iron deficiency anemia is the most common. That too, it is more common in women who are the predominant sufferers of knee arthritis. This one factor is simplest and easily correctable factor. We work with physician who takes care of our patient’s pre surgery and correct hemoglobin. The order of the above factors may vary according to the geography, disease pattern and the surgeon’s preferences. It can be even said all the factors are equally important for Total knee replacement surgery. It is essential to manage all the above factors before an elective knee replacement procedure.

    We at Alpha Ortho Clinic strive continuously to make sure your knee replacement Surgery goes as smooth as possible.