There are multiple factors to concern about Total Knee Replacement. Most of the surgeons concern about 3 factors.
- The first one is safety.
- The second is outcome, because the patient’s expectation is higher than in the past. Most of the patients expect no pain, correct deformities because most of the patients have deformities before surgery, come back to straight as normal knee, the function come back almost as normal knee function, and also the longevity of the new knee after surgery.
- The last one is patient’s satisfaction, different patients expect different things. Some patients expect longevity after surgery and most of the patients expect faster recovery that means now we are going to develop many things like surgical technics or technology to improve the outcome.
The Total Knee Arthroplasty is more than 50 years now when it first started, but in the past 10 years it improves really fast. There are several factors included in the development.
First, surgical technics which makes fewer traumas of the soft tissues that we call “Minimally Invasive Surgery” to make smaller incision and fewer traumas of the muscles and soft tissues which lead to faster recovery and less pain.
Second, is the technology to improve the outcome in which now we use the Computer – Assisted Surgery started in Thailand in the year 2004 now it has been more than 10 years. It is very precise and accurate compared to conventional technique. Conventional means normal surgery that every hospital or public hospital uses. We already prove that in conventional technique it is only 60 – 70 percent accurate even the surgeon prefer best outcome, but with Computer – Assisted Surgery it increases up to 90 – 95 percent accuracy that means much different and it benefit for patients and not only increases longevity, but also improve knee function, almost normal knee function much better than conventional, that is technology, to prevent possibility of human error during operation.
For TKA surgery, normally we will recommend to
– choose the surgeon first, because the most important factor is the experience of the surgeon. Patients have to search and choose any surgeons in the hospital that the patient available to go, which doctor is the best for that kind of surgery.
– Second, choose the hospital atmosphere because we concern about the complications, the most serious one is infection.
– The third one, choose what type of prosthesis, because there are a lot of type now in the market and the price is different, choose the best one match to the budget, because if you choose too low quality it may save cost now, but may need second or third or fourth operation in the future and that is not good outcome. The best quality of prosthesis is expected 35 years, but that does not mean that every patient needs the best one. If the patient is 75 years, maybe moderate quality is good enough.
In the present, we are able to operate both knees at the same time because of simultaneous bilateral total knee replacement within 2 hours of period, shorter time because doctor have more experiences. For hospital stay, one knee maybe 3 days. Bilateral at the same time, maybe 5 days which is really short period of hospital stay. This saves cost and provides good outcome to the patients.