Total Knee Replacement : Restoring and Quality of Life

Total Knee Replacement (TKR), also known as total knee arthroplasty, is a surgical procedure that has transformed the lives of millions of people around the world. It is a medical marvel that offers a second chance at mobility and pain-free living for those suffering from severe knee joint damage. In this blog, we will delve into what TKR is, why it is needed, the benefits it offers, and its significance in improving the quality of life for individuals.

What is Total Knee Replacement (TKR)?

Total Knee Replacement (TKR) is a surgical procedure in which a damaged or diseased knee joint is replaced with a prosthetic implant. This implant mimics the functions of a healthy knee joint, allowing patients to regain lost mobility and alleviate pain. The surgery is typically performed under general or regional anesthesia, and it involves removing damaged cartilage and bone from the knee joint and replacing them with artificial components made of metal and plastic.

Why It is Needed?

TKR is needed when a person’s knee joint becomes severely damaged or diseased, often due to conditions such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. These conditions can cause the knee joint to deteriorate over time, resulting in excruciating pain, limited range of motion, and a significant reduction in the quality of life.

Here are some common reasons why TKR may be necessary-

•  Chronic Pain: Persistent knee pain that limits daily activities and disrupts the individual’s overall quality of life.

• Loss of Mobility: Severe joint damage can lead to a loss of mobility, making it difficult to perform basic functions such as walking or climbing stairs.

• Decreased Quality of Life: When knee pain and limited mobility impact a person’s ability to enjoy life, participate in physical activities, or engage in social interactions.

• Failed Non-Surgical Treatments: When conservative treatments like physical therapy, medications, and lifestyle changes no longer provide relief.

Benefits of Total Knee Replacement (TKR)

Total Knee Replacement offers a multitude of benefits for individuals suffering from knee joint problems-

• Pain Relief: One of the most immediate and significant benefits is the relief from chronic knee pain, allowing individuals to enjoy an improved quality of life.

• Improved Mobility: TKR restores mobility, enabling patients to walk, climb stairs, and engage in physical activities they may have avoided for years.

• Enhanced Functionality: Patients regain the ability to perform daily tasks independently, such as bending, kneeling, and squatting.

• Increased Quality of Life: TKR often leads to an overall improvement in the patient’s well-being, including increased social interaction and a return to hobbies and activities they enjoy.

• Long-term Durability: Modern TKR implants are designed to last for many years, providing lasting relief and functionality.

• Better Joint Stability: The prosthetic components provide better joint stability, reducing the risk of falls and injuries.

Conclusion

Total Knee Replacement (TKR) is a life-changing procedure that offers hope and relief to individuals suffering from debilitating knee joint conditions. It is a remarkable medical advancement that not only alleviates pain but also restores mobility and enhances the overall quality of life. While TKR is a major surgery, the benefits far outweigh the risks for many patients, allowing them to regain their independence and enjoy a more active and fulfilling life. If you or a loved one is facing severe knee joint problems, consult with a healthcare professional to explore whether TKR could be the right solution for you.

Jinkushal Cardiac Care & Superspeciality Hospital is your trusted destination for top-tier healthcare. Our team comprises highly experienced and eminent Joint Replacement Surgeons who specialize in cutting-edge procedures. We pride ourselves on performing the most advanced joint replacement surgeries, ensuring optimal outcomes for our patients. If you or a family member is grappling with the debilitating effects of knee pain, hindering your daily life, it’s time to pay us a visit. Our world-class orthopedic treatments and expert advice can pave the way for a pain-free, active, and happy life. Don’t compromise on your well-being; seek guidance from the best Joint Replacement Surgeons in Thane at Jinkushal Cardiac Care & Superspeciality Hospital. Your journey to a healthier and more fulfilling life begins here

Post Angioplasty care

Angioplasty is one of the most common and successful treatment options for heart disease. It is a procedure in which blocked blood vessels are opened to supply blood to heart muscles.
Angioplasty in heart attack treatment saves valuable lives. Generally cardiologist performs Angioplasty immediately after heart attack. Angioplasty is not only relieves chest pain but also reduces the chance of another heart attack. Post angioplasty care is basically divided into three parts:
• Immediate care
• Diet
• Exercises

Immediate Self Care after Angioplasty Surgery

• 1. In general, people who have angioplasty can walk around within 24 hours after the procedure. Complete recovery takes a week or less. Keep the area where catheter was inserted dry for 24- 48 hours.

• If the catheter was in through groin
  a. Walking short distance on a flat surface is okay.
  b. Limit going up and down on stairs to around 2 times a day for first 2-3 days.
  c. Do not strain yourself by doing any hard work, driving or exercising heavily until your doctor allows you to do so.
  d. Avoid any sexual activities for 2-5 days. Ask your doctor when will it be okay to resume.

• If the catheter was in through arms or wrist
  a. Do not lift anything heavy with that arm
  b. Avoid any heavy pushing, pulling or twisting with that arm.

• You will have to take care of your puncture site
  a. Your doctor will tell you how often you need to change the dressing
  b. If your site bleeds or swells up, lie down and put pressure on it for 30 minutes and please consult your doctor regarding the same.

Healthy Diet

“There is no single diet that is right for everyone”. Your health diet should include:
1. Lots of fruits(avoid fruit juice) fresh vegetables, whole grains, sprouts oats, beans( for diabetic consult your diabetologist but in general you must avoid banana, litchi, grapes, mango, custard-apple, chiku, potato and arbi )
2. Nuts such as almond (4-5/ day), walnuts 2-3/day and peanuts handful of without oil, butter and salt.
3. Eat less oily food.
4. If using oil in food preparation use oils which are healthy for heart like peanut or groundnut oil, olive oil, ricebran oil, etc these oil have more MUFA content which helps to lower bad cholesterol.
5. Do not add extra salt when food on table.
6. Eat small portions and in between meals have salad or fresh fruits whenever hungry.
7. Avoid sugar, sweets and artificial sweetners ( splenda, equal, stevia, sugar free these are equally harmful).
8. Avoid refined flour (maida) and its products like white bread, pasta, pizaa, etc.
9. Avoid packaged foods like wafers, namkeens.
10. Avoid bakery products like biscuits, cakes, pastries.
11. Avoid processed red meats and poultry.
12. Avoid canned and jar food.
13. Avoid aerated drinks like cocacola, pepsi instead consume fresh lime water, butter milk, coconut water.
14. Eggs can be taken without deep frying and without the yolk.
15. Home made food is the best food
16. Taking your dinner at least 3 hours before sleeping.
17. Eat food, not too much, mostly prefer plants.

Exercises

Exercising Immediately After an Angioplasty:

1. Rest for a minimum of one to two days after your procedure. This means no heavy lifting, no aerobic activity, or any activity that would require you to raise your heart rate significantly.
Normal, day-to-day activities are appropriate for the most part Angioplasty. Be careful with activities like carrying in heavy groceries, cleaning, gardening, etc. that would be of a higher intensity.
2. Start with lifestyle activity after 2-3 days of rest
Lifestyle activities (or baseline activities) are those exercises that are a part of your normal daily routine. These are the activities that get you “up and moving.”
For example, taking the stairs, parking farther away, grocery shopping, gardening, etc are all activities that will get you up, moving and increase your heart rate. Limiting yourself to daily normal activity instead of starting structured exercise will help you build endurance for later long term exercise regime

Safe Exercises Routine for Long-Term

1. Aim for 150 minutes of aerobic exercises every week. As long as you’re cleared by your doctor, you should be aiming for this amount after your angioplasty as well.
150 minutes is not a goal that you need to meet immediately. Angioplasty You may only be able to meet this goal after a few weeks or months of daily/ lifestyle activity
2. Include two to three days of weight training. After you’ve gotten comfortable with aerobic exercise, start thinking about including some weight training. This will complement your cardiovascular training. Do not weight train the same muscles two days in a row.
Aim to workout for about 20 minutes total in length. Include a series of exercises so that each major muscle group is worked.
Avoid carrying weight more than 10 Kg if your heart function is low.
Note that if you do have some chest pains or did previously, overhead exercises (like shoulder presses) may make you have some chest pains or feelings of tightness. Avoid these if they are bothersome or produce symptoms.
3. Be mindful of more extreme weather conditions. Although most exercises in general will be safe for you after your angioplasty, some physicians recommend staying indoors when there is more extreme weather.
Some weather conditions, like overly hot, humid or very cold days can produce symptoms like chest pain, difficulty breathing or chest tightness.
It’s recommended to workout or exercise indoors if the temperature is below 20°F (-6°C).
Also stay indoors if the humidity is above 75% or the temperature in general is above 80°F (26.6°C).
Keep an eye on the weather. Note which days have very hot or cold temperatures and make plans to be safe and stay indoors instead.
4. Be mindful of side effects or symptoms during activity. Usually, an angioplasty will help relieve cardiac-related symptoms (like chest pain); however, you still need to be mindful of how you’re feeling during and after activity.

Stop exercising and see your doctor if you experience

• Chest pain

• Chest tightness

• Shortness of breath or difficulty breathing

• Wheezing

• Dizziness or light-headedness

• Palpitations

• Discomfort in your jaw, arm, shoulder, back or stomach

• Nausea

• Check in with your doctor regularly. After your angioplasty, it’ll be recommended that you follow up.

Incorporating Safe Exercises After an Angioplasty

AMOUNT OF EXERCISE ALLOWED VARIES DEPENDING ON YOUR HEART FUNCTION.

PLEASE CONSULT YOUR CARDIOLOGIST FOR EXACT AMOUNT OF EXERCISE ALLOWED.
1. Incorporate a 30 minute walk most days. One very safe and frequently recommended exercise is a 30 minute brisk walk. This is a great exercise for most angioplasty patients to start with.
2. Try other aerobic exercises like jogging, biking or swimming. If you’ve got the 30 minute walk down and want to try other types of aerobic activity, try some of the following:
Jogging. While this might sound like an exercise that raises your heart rate too high, it is a type of cardio exercise that you can work towards over time. Jogging burns more calories than running and works your heart harder. This helps build better aerobic fitness.
Swimming. This is another great cardio exercise. Angioplasty It involves your full body, but is easy on the joints and you can make it low intensity as needed. Plus, the water keeps your body cooler which keeps your heart rate lower.
Cycling.. Like swimming, it’s low impact and you can make the intensity lower if needed.
3. Do yoga and meditation. Since strength training is a good type of exercise to include along with cardio, you need to find ways to include this. Yoga is a great low impact exercise that can help strengthen without raising your heart rate high.
Yoga is a great exercise to get into after any health issue, but especially after a cardiac procedure like an angioplasty.
The great thing about yoga is that it can be good for strength training, but also trains your breathing and can help relax and de-stress which might be useful after having a cardiac procedure like an angioplasty.

General tips

1. Wait for at least 90 minutes after eating to start with your exercise
2. Take 5 minutes to warm up before aerobic activity
3. Start slowly and increase your activity level gradually
4. Stay hydrated and dress according to weather
5. Don’t sit down immediately after exercise; take 5 minutes to cool down you may feel light headed or have heart palpitations.

When can you join work?

If you had a planned (non-emergency coronary angioplasty, you should be able to return to work after a week if you work is not very energy demanding( heavy weight lifting or straneous)
If you had an emergency angioplasty following a heart attack it may take longer to recover fully and return to work.

“Best person to guide you is your doctor”

SPECIAL INSTRUCTIONS

• DO NOT STOP ANY MEDICINE WITHOUT ASKING YOUR DOCTOR ESPECIALLY ASPIRIN AND OTHER ANTIPLATELETS LIKE CLOPIDOGREL, PRASUGREL AND TICAGRELOL. STOPPING THESE DRUGS CAN LEAD TO STENT THROMBOSIS AND HEART ATTACK.
• DO NOT IGNORE ANY KIND OF CHEST PAIN – SEE YOUR DOCTOR IMMEDIALTELY AND GET AN ECG.
• AVOID STRAINING FOR STOOLS. THIS MAY PRECIPITAE HEART FAILURE. PLEASE TAKE SYP DUPHALAC 30 CC STAT IF YOU ARE HAVING CONSTIPATION AND SEE YOUR DOCTOR.
• DO NOT SMOKE. THE RISK DECREASES ONLY AFTER YOU QUIT SMOKING FOR MORE THAN A YEAR.
• AVOID ALCOHOL.
• 6 HOURS OF SOUND SLEEP IS A MUST.
• THE AMOUNT OF EXERCISE ALLOWED VARIES FROM PATIENT TO PATIENT. GENERALLY AT FIRST POST ANGIOPLASTY VISIT AT 7 DAYS THE DOCTOR WILL ADVICE YOU THE AMOUNT OF EXERCISE. ROUTINE ANGIOPLASTY PATIENT IS SUPPOSED TO BRISK WALK FOR 30 MIN OR MORE AFTER FIRST 7 DAYS.

TAVI – A Non Surgical Procedure Alternative to Aortic Valve Replacement Surgery

The Aortic Valve Replacement is a successful procedure to treat the condition known as aortic stenosis. In this condition the aortic valve fails to fully open, thereby restricting blood flow through the body. However, open heart may not be possible over 60 years old due to comorbidities. Because of this, TAVI (Transcatheter Aortic Valve Implantation) and TAVR (Transcatheter Aortic Valve Replacement ) and has been gaining popularity with doctors over the last decade. So much so that now it is also approved in patients with mild and intermediate risk for surgical valve replacement.

In This Blog, we will cover the following Topics

• What is TAVI or TAVR?

• What happens when you undergo Transcatheter Aortic Valve Implantation?

• What happens when you undergo Transcatheter Aortic Valve Implantation?

• Which medical condition is treated with this treatment?

• What are the advantages of TAVI/TAVR?

• Who should undergo this procedure?

• What are the most important elements that are considered prior to make a decision on whether a patient is suitable for TAVI/TAVR.

• What test will the patient have to go through in order to undergo this procedure?

• Post TAVI Management ?

• TIPS for patients who have undergone TAVI Procedure for faster recovery.

• Risk Involved during TAVI Procedure?

• Cost For TAVI (Transcatheter Aortic Valve Implantation) In Thane Mumbai

What is TAVI or What is TAVR?

The most ingenuous treatments that are being used in the present can be described as the Transcatheter Aortic Valve Replacement (TAVR) can also be called TAVI, TAVI Full Form is Transcatheter aortic Valve Implantation

Until recently, Valve replacement through open heart surgery was the onlythe option to patients with severely Aortic Stenosis. However, many patients are not able to avail this option due to advanced age, a malfunctioning of the left ventricle and other comorbidities.

Thanks to the development of TAVI or TAVR treatment in Mumbai for these patients is now also feasible. TAVI and TAVR both are same and are highly beneficial option for patients suffering from severe Aortic Stenosis symptoms that are not suitable for traditional Valve Replacement Surgery.

It is a minimally-invasive Cardiac Surgical procedure that heals the valve but does not do away with the damaged, old valve. In addition to this, it inserts a replacement valve inside the aortic valve’s location.

Similar to the placement of a stent into an artery. The TAVI/TAVR procedure delivers a compact replacement valve into the location with the aid of an instrument. After the stent has been expanded, the valve is deployed at the desired location.

What happens when you undergo Transcatheter Aortic Valve Implantation?

Aortic valve diseases are rising in the population of the globe. In normal circumstances, the valve opens as blood flows from the heart to other organs. But, there are times when the valve is unable to open properly, and blood flow gets impeded because the valve gets stiff. This is known as the aortic stenosis. It is evident that when this occurs there is an increase in pressure on the heart as blood is circulated through a small valve. giddiness, swelling of the ankles, breathing problems, chest pain and blackouts in a few instances, are just a few of the symptoms. In most cases, such as this, open heart valve surgery is usually recommended. However, this procedure may not be appropriate for all patients. People who are elderly, are sick or with a variety of medical conditions may not be able to undergo open-heart valve surgery since it’s too risky for the patients. Transcatheter aortic valve placement (TAVI) can be the procedure used to treat in such cases.

Who should undergo for TAVI Procedure?

• Elderly patients with aortic stenosis but suffer from other medical issues whichmakes open heart surgeries extremely risky.

• Patient with failure of previous prosthetic valve in aortic or mitral position.

• For whom can this method be highly beneficial?

• This is an amazing technology that allows surgeons and doctors to fix an indication of a severely narrowed and problematic Aortic Valve (Aortic Stenosis) without opening the chest of the patient.

• It’s extremely helpful to those at high risk of undergoing open heart surgery.

What are the advantages of TAVI/TAVR?

• It is a minimally-invasive surgery that can greatly ease the suffering of patients

• Rapid recovery

• Very low failure rate

• Small incisions, which means less blood loss.

• Lower risk of contracting infections

• Can be used in patients who aren’t qualified for open heart surgery

• Better quality of life.

• Fewer complications.

Which medical condition is treated with this treatment?

• Severe aortic stenosis with AVA < 1 cm 2

• Degeneratead previously placed surgical aortic valve leading to severe stenosis or leakage (regurgitation)

• Bicuspid aortic valve with stenosis.

• The most typical reason for Aortic Stenosis is degenerative and is caused by the accumulation of calcium in old age.Other causes are congenital, such as Bicuspid Aortic Valve, an affected heart valve, or Rheumatic heart disease.

What are the most important elements that are considered prior to making a decision on whether a patient is suitable for TAVI/TAVR.

• The patient’s age

• Comorbidities

• Medical background

• Risk scores like EURO and STS score.

• Heart condition of the patient

• If the patient has undergone surgery like bypass procedure.

• If you have a has a history is present, it could be Coronary Artery Disease (CAD) or chronic or Obstructive Pulmonary Disease.

• If the patient is suffering from Cardiac Arrhythmias

What test will the patient have to go through in order to undergo this procedure?

• ECG

• 2D ECHO / sos TEE

• Chest X-ray

• PFT (Pulmonary Function Test)

• Angiogram

• CT Scan (Computed Tomography) with TAVI protocol

• TEE (Transesophageal Echocardiogram) if required.

Post TAVI Management?

Following the procedure the patient is transferred in the intensive treatment unit at the hospital, so they can be watched continuously throughout recovery. The hospital stay is expected to last for a couple of days. But normal meals can returned quickly.

When the patient is at back at home, which can happen within a few days dependent on the speed of recovery they must adhere to all prescriptions for medicines, diet activities, pain control and treatment of wounds. Keep track of all scheduled follow-up appointments.

It may take few days to fully recover.

Tips for patients who undergone tavi procedure for faster recovery.

• Following the procedure of TAVI doctor has recommended an anticoagulant medication to stop blood clots. To make sure you’re receiving the correct dose, you should be sure to check your blood frequently.

• Be sure to take recommended walk as prescribed.

• Avoid lifting anything that is heavy, however you are able to perform other activities as normal.

• Request permission from your physician regarding when you are able to take part in hard work or driving, as well as any other type of sexual or sexual activity.

• Tell the doctor right away If you notice any type of bleeding, pain the shortness or even fever.

• Monitor the groin area for signs of swelling, redness or bleeding.

• Maintain an appropriate weight.

• Eat a heart-healthy diet.

• Do not smoke.

Risk Involved during TAVI Procedure?

A growing number of cardiologists are becoming familiar using TAVI and the risk related to it are declining. But, TAVI is a major procedure that requires general anesthesia is necessary and very few TAVI Specialist Cardiologist in Thane Mumbai who do regular TAVI Procedures . The most common risks that are frequently connected to TAVI are the following:

• Bleeding

• Blood vessel damage

• Heart attack

• Stroke due to a decreased blood flow to the brain.

• Kidney failure

• Repair valve failure leading to emergency AVR.

• Complete heart block requiring a pacemaker.

• Heart failure

There could be other risk factors in addition to the risk based on your medical condition. Before you undergo the procedure, you should have a thorough discussion with your Cardiologist in Thane or Mumbai about the subject.

When it is handled by a reputable Interventional Cardiologist in Thane and the proper follow-up of the instructions, patients who have undergone TAVI recover rapidly.

WHAT IS TAVR

A Transcatheter Aortic Valve Replacement is a full form of TAVR also Called Transcatheter Aortic Valve Implantation TAVI and it is done to treat aortic valve stenosis. Aortic valve stenosis is a condition where the aortic valve is narrowed and fails to open properly. The Transcatheter Aortic Valve Replacement (tarv) is a minimally invasive heart procedure done to replace the transcatheter aortic valve.

The procedure involves replacing the damaged aortic valve with animal heart tissue. It is also called a biological tissue valve. In some cases, this biological tissue valve may be placed into an existing biological tissue valve that is no longer working.

When Is TAVR Done?

A TAVR surgery is opted when the patient is not eligible to go through open-heart surgery to treat aortic stenosis. Aortic valve stenosis is a serious heart condition that occurs when the heart’s aortic valve thickens and is unable to open completely. This limits the blood flow from the heart to the rest of the body. This can cause symptoms like chest pain, fainting, fatigue, leg swelling and shortness of breath. The extreme conditions may also lead to heart failure and sudden cardiac death.

Advantages Of TAVR

• The TAVR is a minimally invasive procedure. It causes fewer complications than traditional surgery where the entire chest wall is opened to expose the heart.

• The procedure involves making smaller incisions of a few mm and thus less blood loss.

• A minimally invasive procedure allows a shorter healing period and faster recovery

• A shorter stay in TAVR hospital in thane is needed for recovery and scar healing

TAVR Procedure

Whether a patient needs an open-heart surgical procedure or a TAVR depends upon various conditions. It is important to evaluate the risk factors that may affect the procedure. Once the TAVR procedure is finalized, the doctors can go ahead with the surgery.

The procedure is performed under local or short general anesthesia. A tiny incision is made in the groin to access the heart through a blood vessel. A catheter is then inserted and the catheter is guided towards the heart into the aortic valve. The new valve is then positioned at the appropriate place and the catheter is then removed.

The patient is kept under observation for few days in intensive care. Medications for pain relief and to prevent infection along with others are typically administered. Regular follow-ups and checkups are must after the discharge to look up if the new valve is functioning as expected.

Certain precautions and lifestyle changes are suggested after the surgery by a TAVR Specialist Cardiologist . These include excellent dental hygiene to help prevent these infections, a heart-healthy diet, exercising regularly, maintaining a healthy weight and avoiding smoking.

In conclusion, the TAVR procedure in Thane could be opted for patients in all risk categories. TAVR is a relatively new technique that could prove to be effective in improving the quality of life of patients who otherwise have no or restricted options for aortic valve treatment.

CARDIAC REHABILITATION

A Cardiac rehabilitation is a customized outpatient program to be taken up by patients after a heart attack or other heart disease or surgery. The goal of Cardiac rehabilitation is to help improve the patient’s health and help them recover from the heart conditions after surgery.

The program includes exercise training, educating the patient about lifestyle and behavioral changes to reduce heart problems. These programs are known to reduce the risk of death from heart disease and prevent future heart problems. Still the Cardiac rehabilitation is not only for heart patients. It is in general a program designed to benefit any patient to adapt to a better lifestyle for a healthy heart.

The people with the below conditions could consider it:

• Those suffering from Coronary artery disease

• Who have had a Heart attack or Heart failure

• People suffering from Peripheral artery disease

• Have had any heart surgeries like valve replacement, angioplasty or stents

• Having heart diseases run in the family

• Patients with conditions affecting the heart like diabetes and high blood pressure

The cardiac rehabilitation program could last for months and the duration may vary from patient to patient. The program is guided by a team of health care professionals including cardiologists, nutritionists, mental health specialists and other required therapists.

Here Are The Most Common Inclusions In The Program:

Medical evaluation: Medical evaluations are done regularly to track the results and make changes if required e.g. BMI.

Physical Activity: An important part of the program includes exercises. The level of physical activity again depends on patients and may change during the program.

Lifestyle instruction: Lifestyle changes including healthy eating, quitting smoking and drinking, stress management and others are instructed to be followed.

Emotional and behavioral support: Since many find it difficult to cope with the changes, behavioral support is also included in the program. People who feel depressed or unmotivated are provided emotional support and counseling.

The patients should also find regularity and acceptance to the new lifestyle and have better understanding of the heart conditions.

Life after the Cardiac Rehabilitation

The Cardiac rehabilitation program benefits the most to those who continue the lifestyle learned in the program. With the improved lifestyle one should expect better weight and stress management capability. The physiological and behavioral inclusions in the program should help develop ability to control over habits like smoking and drinking and help them being more emotional stable.