Kick out the myths
By Deepshikha Punj
27th January 2013 12:00 AM
According to a new study by Virginia Commonwealth University, USA, patients who undergo knee replacement surgery may be at risk of gaining more weight than their peers who have not had the surgery. The five-year study led by Daniel Riddle, professor in the VCU Department of Physical Therapy in the School of Allied Health Professions, reviewed the medical records of nearly 1,000 knee replacement surgery patients to reach to this conclusion.
Indian experts, however, say that this could be true if there is lack of mobility which in turn leads to the myth and people refrain from a knee surgery. Dr Rajeev K Sharma, Senior Consultant Orthopedic and Joint Replacement Surgeon, Indraprastha Apollo Hospital, New Delhi, says, “For many reasons such as fear of the unknown, fear of surgery, fear of ‘losing’ a body part, fear of the post-op surgery pain, fear that they will end up worse than they started, deterioration of the joint, increased pain and lack of mobility, patients sometimes consciously delay their knee replacement surgery. This can lead to risk of deformities developing inside and outside the joint, risk of muscles, ligaments becoming weak and losing function or fear of increased pain. It can lead to increased disability or lack of mobility or difficulty with normal activities, and hence weight gain.” He adds weight gain, post surgery, can be busted through exercises.
Dr Biren Nadkarni, Senior Orthopedic and Joint Replacement Surgeon at Sitaram Bhartia Institute of Science and Research, says, “Knee replacement is done to replace the weight-bearing surfaces of the knee joint to relieve pain and disability on patients suffering from arthritis, mainly osteoarthritis, where the pain is unbearable. But, it is usually surrounded by several unreal myths.”
Nadkarni says that some of the most popular myths about knee surgery include age requirements, recovery period, procedure and longevity. “The one thing to remember is that the name ‘total knee replacement’ is a misnomer. In the ‘total knee replacement’ surgery, the knee is not replaced. It is only ‘resurfaced.’ The normal knee has an articular cartilage that covers the knee bones. In an arthritic knee, the cartilage covering the bone ends is destroyed, leading to the bone rubbing against bone. During surgery, only the surface of bone ends are shaved off in sequential manner and caps are put on top of damaged bone ends, one each on the femur, tibia and patella. The artificial smooth caps rub against each other,” he explains.
Another myth is that while our own knees are the best what nature has given us and one should manage with the original knees as far as possible, sometimes putting off surgery on a damaged knee can produce changes that may affect the success rates of the future knee replacement. The recent study also concurs. “Part of the explanation is that people may have spent years adapting to their circumstances by avoiding activities that could cause knee pain,” says lead author Riddle, a professor in the physical therapy department at Virginia Commonwealth University, as quoted in a university news release.
The researchers also found that weight loss before knee replacement surgery is a risk factor for weight gain after the procedure. Overweight and obese patients typically are encouraged to lose weight before undergoing knee replacement, to reduce the risk of complications and speed up their recovery.
Talking about the chronic health risks, like cardiovascular disease or diabetes, due to weight gain, Sharma says “Over 90 per cent of people, who have had total knee replacement, experienced an improvement in knee pain and function. So some myths should not hinder them from going ahead with this procedure.”
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