Total knee replacement (TKR), also called total knee arthroplasty, is an operation in which all the worn surfaces of the knee joint are replaced with an implant made of metal and medical-grade plastic. It is advised for advanced arthritis affecting the whole knee, when pain, stiffness or deformity limit daily life and other treatments no longer help.
PMG Hospital (PMG Orthopedic Hospital), Gota, is an orthopedic hospital for total knee replacement in Ahmedabad, where the operation is performed using conventional and robotic-assisted techniques. This page explains what total knee replacement involves, how it differs from partial replacement, who may need it, the procedure, implant options, replacing both knees, recovery, risks and cost factors.
What Is Total Knee Replacement?
The knee has three compartments: the inner side (medial), the outer side (lateral) and the area behind the kneecap (patellofemoral). In total knee replacement, all three are resurfaced. The worn cartilage and a thin layer of bone are removed from the end of the thigh bone (femur) and the upper end of the shin bone (tibia). These are covered with metal components, and a plastic insert is placed between them so that the joint moves smoothly. The back of the kneecap (patella) may also be resurfaced.
The anterior cruciate ligament (ACL) is usually removed in total knee replacement. The posterior cruciate ligament (PCL) is either kept or its function is taken over by the implant, depending on the implant design.
Total vs Partial Knee Replacement
| Feature | Total knee replacement | Partial knee replacement |
|---|---|---|
| What is replaced | All three compartments | Only the one damaged compartment |
| Ligaments | ACL usually removed; PCL kept or replaced by the implant design | Cruciate ligaments usually kept |
| Usually suitable for | Arthritis in more than one compartment, deformity, or a damaged ACL | Arthritis limited to one compartment with healthy ligaments |
| Recovery | Usually takes longer | Often quicker in the early weeks |
| Chance of further surgery in the long term | Lower | Somewhat higher |
The choice depends on the pattern of arthritis, the ligaments, the alignment of the leg and the patient's age and activity, and is decided after examination and X-rays.
Related pages: Partial knee replacement·Knee replacement
Who May Need a Total Knee Replacement?
- Severe knee pain from arthritis that limits walking, stairs or getting up from a chair
- Pain at rest or at night
- Stiffness or swelling that does not settle with medicines or physiotherapy
- A bow-leg or knock-knee deformity, or a knee that cannot straighten fully
- X-rays showing advanced arthritis in more than one compartment
A total knee replacement doctor in Ahmedabad - an orthopaedic surgeon - confirms with examination and standing X-rays whether a total replacement is needed.
Before surgery, treatments such as weight reduction, exercise, physiotherapy, pain-relief medicines, walking aids and, in selected patients, injections are usually tried. Surgery is advised when these no longer control pain or restore function. A total knee replacement treatment hospital should provide these non-surgical treatments as well as surgery.
When Surgery May Need to Be Delayed or Avoided
- An active infection anywhere in the body, until it has been treated
- Poorly controlled diabetes, blood pressure or other medical conditions, until they are better controlled
- Poor skin condition over the knee, or problems with blood supply to the leg, which need assessment
- Pain coming mainly from the hip or spine rather than the knee
Total Knee Replacement Surgery in Ahmedabad: Step by Step
The main steps are similar in any total knee replacement surgery hospital in Ahmedabad:
- 1Anaesthesia: usually spinal anaesthesia (numbing the lower body), often with a nerve block for pain relief after surgery; general anaesthesia is used in some patients
- 2Incision: a cut is made over the front of the knee to reach the joint
- 3Preparing the bone: the worn cartilage and a thin layer of bone are removed from the femur and tibia, and the bones are shaped to fit the implant
- 4Balancing: trial components are used to check size, alignment, ligament balance and movement
- 5Fixing the implant: the final components are fixed, usually with bone cement, and the plastic insert is placed; the kneecap is resurfaced if needed
- 6Closure: the wound is closed with stitches or staples and dressed
- 7After surgery: monitoring, pain relief, measures to prevent blood clots, and physiotherapy, often starting the same day or the next day
The operation usually takes about one to two hours for one knee, depending on the case.
Robotic Assistance and TriNova
In robotic-assisted total knee replacement, the surgeon uses a robotic system to measure the knee during the operation and to guide the size, position and alignment of the implant according to the surgical plan. Studies show that robotic assistance can improve the accuracy of implant positioning; whether this leads to better long-term results than conventional surgery is still being studied. At PMG Hospital, robotic-assisted knee replacement is performed using the ROSA Knee System (Zimmer Biomet).
"TriNova" is the name PMG Hospital uses when three choices are combined during surgery in suitable patients:
| Choice | What it means | Points to consider |
|---|---|---|
| Robotic assistance | Measurements during surgery guide implant size, position and alignment | Not every knee needs robotic assistance |
| Subvastus approach | The knee is opened from beneath the vastus medialis muscle instead of cutting into the quadriceps tendon | May help early muscle function; may not suit very stiff knees or some deformities |
| Surgery without a thigh tourniquet | The operation is done without a tight band on the thigh that stops blood flow | May reduce thigh discomfort; bleeding during surgery is controlled in other ways; decided case by case |
Related page: Robotic knee replacement
Implant Options
Knee implants differ in design, fixation and materials. The surgeon chooses the implant according to the knee's condition, ligament stability, bone quality, age, activity level and any metal allergy.
| Feature | Options | Notes |
|---|---|---|
| Ligament design | Cruciate-retaining (PCL kept) or posterior-stabilised (PCL function taken over by the implant) | Chosen according to the ligaments and deformity |
| Fixation | Cemented, uncemented or hybrid | Cemented fixation is the most widely used |
| Plastic insert | Fixed-bearing or mobile-bearing; standard or highly cross-linked polyethylene | Fixed- and mobile-bearing designs are both well established |
| Femoral component material | Cobalt-chromium alloy, or oxidised zirconium or coated components | Coated or oxidised zirconium components may be considered for patients with metal allergy |
| Kneecap | Resurfaced or not resurfaced | Decided according to the condition of the kneecap |
Can Both Knees Be Replaced at the Same Time?
| Feature | Both knees in one operation (simultaneous) | One knee at a time (staged) |
|---|---|---|
| How it works | Both knees are replaced under the same anaesthesia | Each knee is replaced in a separate operation, usually some weeks or months apart |
| Hospital stay and recovery | One stay and one rehabilitation period | Two stays and two rehabilitation periods |
| Risk | Higher risk of complications such as blood clots, heart and lung problems, the need for blood transfusion and, in some studies, a higher risk of death | Lower risk for each operation |
| Usually suitable for | Fit patients without significant heart, lung or other medical problems | Older patients or those with other medical conditions |
The decision is made after a fitness assessment by the surgeon and the anaesthetist.
Recovery After Total Knee Replacement
| Time | What usually happens |
|---|---|
| Day of surgery or next day | Standing and first steps with a walker and the physiotherapist |
| First few days | Pain control, knee-bending exercises, stair practice, walking with support; discharge when safe |
| Weeks 1–2 | Walking with support, wound care, stitches or staples removed when the wound has healed |
| Weeks 3–6 | Less need for support, home exercises, light daily activities |
| Around 6 weeks | Driving, once the surgeon allows it |
| 3–6 months | Strength and stamina continue to improve |
This is a general guide; recovery differs from person to person and is slower when both knees are replaced. Some swelling and warmth around the knee can last for several months.
Physiotherapy and Pain Control
- Exercises to bend and straighten the knee start early and continue at home for several weeks
- Pain relief is given with a combination of medicines and, early on, nerve blocks; ice packs and elevation reduce swelling
- Blood-thinning medicines, leg exercises and early walking help to prevent blood clots
- Kneeling may feel uncomfortable for a long time after surgery
How Long Does a Total Knee Replacement Last?
Large joint registry studies show that most total knee replacements are still in place without needing further surgery 15 to 20 years or more after surgery. How long an implant lasts depends on age, weight, activity level, bone quality and accurate positioning of the implant. Over time, the plastic insert can wear or the implant can loosen, and revision surgery may then be needed. Regular follow-up visits help to detect problems early.
Related page: Revision knee replacement
Risks and Possible Complications
Total knee replacement is a common operation, but no surgery is without risk. The surgeon explains these risks before taking consent.
- Infection of the wound or around the implant, which may need further surgery
- Blood clots in the leg veins (deep vein thrombosis) or lungs (pulmonary embolism)
- Stiffness, sometimes needing manipulation under anaesthesia
- Continuing pain in some patients, even when the implant is well placed
- Wound problems, such as delayed healing or discharge
- Numbness of the skin on the outer side of the scar, which is common
- Injury to nerves or blood vessels, which is rare
- Fracture around the implant during or after surgery
- Instability, or loosening and wear of the implant over time, which may need revision surgery
- Anaesthesia-related and general medical risks, such as heart, lung or kidney problems, especially in older patients or those with other illnesses
Total Knee Replacement Surgery Hospital in Ahmedabad
Before choosing a total knee replacement hospital in Ahmedabad, check that the treating surgeon is a qualified orthopaedic surgeon with valid medical council registration, that the hospital regularly performs this operation, how infection is prevented, which implants and tests are available, what physiotherapy and follow-up are provided, and what the written estimate includes. You can also ask whether both knees can be replaced in one operation when it is suitable, and what fitness checks are done first.
Total Knee Replacement Surgery Cost in Ahmedabad
- One knee or both knees
- The implant chosen
- Robotic-assisted or conventional surgery
- Length of hospital stay and room category
- Other medical conditions and any extra care needed
- Physiotherapy and follow-up
A written, itemised estimate can be requested from the hospital after assessment.
Insurance
- Medically necessary knee replacement is generally covered under health insurance policies, subject to policy terms, waiting periods and insurer approval
- Some policies have limits on room rent or implant costs; check these with your insurer before surgery
- Ask the hospital whether cashless treatment is available with your insurer, and which documents are needed
Total Knee Replacement Doctor in Ahmedabad
Total knee replacement is planned and performed by an orthopaedic surgeon, usually one who works regularly in joint replacement (arthroplasty). A family doctor may treat the knee pain first, and other doctors and therapists help before and after the operation:
| Doctor or team member | Role in total knee replacement |
|---|---|
| Family physician | Treats early knee pain; refers to an orthopaedic surgeon when arthritis limits daily life despite treatment |
| Orthopaedic (joint replacement) surgeon | Confirms the diagnosis, advises non-surgical treatment, partial or total replacement, plans the implant and technique, performs the operation and leads follow-up |
| Radiologist | Reports the standing X-rays, and the MRI or CT scan when needed |
| Anaesthetist | Checks fitness for surgery and gives spinal or general anaesthesia, nerve blocks and pain relief |
| Physician or cardiologist | Assesses and helps control diabetes, blood pressure, heart or lung conditions before surgery |
| Physiotherapist | Guides walking and knee-bending exercises from the day of surgery or the next day, and through the weeks of rehabilitation |
Total Knee Replacement Surgery Doctor in Ahmedabad
Along with the questions in the FAQ below, it is reasonable to ask your total knee replacement surgery doctor in Ahmedabad a few questions about the details of the operation. The answers help you prepare and give informed consent.
- Will robotic assistance be used for my knee, and how does it change the plan?
- Will my bow-leg or knock-knee deformity be corrected during the operation, and how?
- Will the back of my kneecap be resurfaced?
- How will pain be controlled after surgery - will a nerve block be used?
- How much knee bending should I aim for in the first weeks, and which exercises will help?
- How will the risk of infection and blood clots be reduced before and after surgery?
- Which of my current medicines should I stop or continue before surgery?
- Whom should I contact after discharge if I have fever, wound discharge or calf swelling?
Orthopedic Hospital for Total Knee Replacement in Ahmedabad
The hospital where a total knee replacement is done should be able to operate under strict infection control, monitor the patient closely after surgery and start physiotherapy early. These are the facilities that matter most:
| Facility | Why it matters |
|---|---|
| Operation theatre suitable for joint replacement, with strict infection-control practices | Infection around an implant is a serious complication |
| Anaesthesia services | Needed for spinal or general anaesthesia and nerve blocks for pain relief |
| X-ray and laboratory services | Needed for planning, pre-operative tests and checking the implant position |
| Blood transfusion support | Knee replacement, especially of both knees, can involve blood loss |
| Access to intensive care for high-risk patients | Older patients and those with heart or lung disease may need closer monitoring |
| Physiotherapy | Knee bending and walking need regular, supervised exercise in the early weeks |
| Follow-up arrangements | Regular checks help to detect stiffness, wear or loosening early |
The facilities available at PMG Hospital are listed further below on this page.
Treating Surgeon
At PMG Hospital, total knee replacement is performed by:
| Detail | Information |
|---|---|
| Name | Dr. Hiren Patel |
| Qualification | MS (Ortho), B.J. Medical College, Ahmedabad |
| Specialty | Orthopaedics |
| Designation | Director & Head Joint Replacement Surgeon, PMG Hospital |
| Registration status | Registered Medical Practitioner |
| Registration number | Gujarat Medical Council Reg. No. G-20583 |
| OPD availability | Monday to Saturday, 10:00 AM - 8:00 PM |
Facilities at PMG Hospital
- Orthopaedic OPD, Monday to Saturday
- Emergency and trauma care, 24×7
- Orthopaedic physiotherapy centre
- Robotic-assisted knee replacement system (ROSA Knee System)
Frequently Asked Questions
When should I see a doctor about total knee replacement?
See an orthopaedic surgeon if knee arthritis causes pain that limits walking, stairs or sleep, if the knee is stiff or bending out of shape, or if medicines, exercises and physiotherapy no longer help. The surgeon then decides whether a total replacement, a partial replacement or continued non-surgical treatment is suitable.
What should I ask the surgeon before total knee replacement?
Ask why a total rather than a partial replacement is advised, which implant design and fixation will be used, whether one or both knees should be operated on, what the risks are for you, how long the hospital stay and physiotherapy will be, and what the written estimate includes. The surgeon should explain these clearly before you decide.
What is total knee replacement?
Total knee replacement resurfaces all three compartments of the knee. The worn cartilage and a thin layer of bone are removed and replaced with metal parts on the thigh and shin bones and a plastic insert between them. The back of the kneecap may also be resurfaced.
Do I need a total or a partial knee replacement?
It depends on how much of the knee is worn and on the condition of the ligaments. Arthritis affecting more than one compartment, significant deformity or a damaged anterior cruciate ligament usually needs a total replacement. Arthritis limited to one compartment with healthy ligaments may be treated with a partial replacement.
Can both knees be replaced at the same time?
Yes, in selected patients who are fit for a longer operation. Replacing both knees together means one hospital stay and one recovery period, but carries a higher risk of complications such as blood clots, heart and lung problems and the need for blood transfusion. Replacing them a few months apart may be safer for patients with other medical conditions. The choice is made after a fitness assessment.
Which knee implant is suitable for me?
There is no single implant that suits everyone. The surgeon chooses the design, fixation and materials according to the knee's condition, ligament stability, bone quality, age, activity level and any metal allergy. Most total knee replacements use a metal-and-plastic design that has been in use for many years.
How long does a total knee replacement last?
Large joint registry studies show that most total knee replacements are still in place without needing further surgery 15 to 20 years or more after surgery. How long an implant lasts depends on age, weight, activity level, bone quality and follow-up. Regular check-ups help detect wear or loosening early.
How long does recovery take?
Many patients walk with support on the day of surgery or the next day and go home after a few days. Light daily activities usually return over the first few weeks, driving after about six weeks once the surgeon allows it, and fuller strength over three to six months with regular physiotherapy. Recovery differs from person to person.
What facilities should a hospital have for total knee replacement?
It should have an operation theatre suitable for joint replacement with strict infection-control practices, anaesthesia services, X-ray, laboratory tests, physiotherapy, blood transfusion support, access to intensive care for high-risk patients, and arrangements for follow-up. You can ask which facilities are available on site and which are arranged elsewhere.
What decides the cost of total knee replacement?
The cost depends on whether one or both knees are replaced, the implant, the use of robotic assistance, the length of hospital stay, room category, other medical conditions and physiotherapy. A written, itemised estimate can be requested from the hospital after assessment.
Contact and Location
PMG Hospital
3rd Floor, Athena Avenue, B/H Jaguar Showroom, Nr. Eulogia Inn Hotel, Gota, Ahmedabad, India
- Phone / WhatsApp:
- +91 96627 70141
- OPD:
- Mon – Sat · 10:00 AM – 8:00 PM
- Emergency and trauma care:
- 24×7