In simple terms, arthritis or'osteoarthritis is a disease condition where in the normal smooth bearing surface of the knee-joint is damaged or lost This condition produces pain and sometimes deformity, which in tum lead to loss of function and finally disability and dependence. The various common causes of kner arthritis include age related wear & tear (osteo-arthritis), wear & tear due to extra demand (eg obesity), injury to the knee (contact sports, accidents), inflammation (rheumatoid arthritis) and others.

Fain is the most important symptom. Pain may be accompanied by swelling. Because of pain, there is loss of motion (stiffness) and restriction of activity. As the patient experiences pain, gradually there is restriction of outdoor activities first, and eventually patient becomes house-bound. There is pai on simple activities like walking and climbi becomes extremely difficult to sit on the ground or get up from a chair. In the later stages even house hold activities like bathing, cleaning and toilet become painful. In some patients there is also bone damage, leading to bow-knees or knock-knees. There is a feeling of Enderg stairs. It Advanced arthritis loss of balance and loss of confidence. These patients become dependent on spouse, children, relatives or neighbours. Thus there is dependence on others and independence is lost. Dependence is associated with disability and finally the patient becomes handicap even though he or she may be otherwise mentally and physically healthy.

Rheumatoid arthritis is a chronic inflammatory disorder that damages various joints including small joints of hands, feet and knees. An autoimmune disorder rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis damages cartilage by causing a painful swelling that can eventually result in joint damage and deformity. While new types of medications have improved treatment options dramatically, rheumatoid arthritis can still cause physical disabilities. Among women, the incidence increases in 25 to 55 years age group. RA is rare in men under 45 years of age. Rheumatoid arthritis patients are often younger (by approximately 10 or more years) than osteoarthritis patients at the time of permanent knee damage.

When arthritis has progressed to advanced stage, cartilage is worn off and pain is not relieved by medicines, a knee replacement surgery can offer long term pain relief When in addition to pain, there is stiffness, instability, loss of confidence, restriction of day to day activity, dependence and disability, the best treatment alternative available to the patient is a joint replacement surgery In a joint replacement surgery the damaged surfaces of the knee joint are replaced by metal prosthesis (artificial joints) generally made of cobalt-chromium alloy or titanium Metallic prosthesis glides over a polyethylene bearing, thus providing pain free range of movement and ambulation. The prosthetic components are fixed to the bone using bone-cement or rarely using cementless technique where in the bone grows onto and into a porous coated component The right decision about choice of an appropriate prosthesis for a particular patient is made by the treating surgeon in consultation.

Patient is hospitalised for less than 1 week after surgery. The patient usually starts walking on the next day of surgery. This is a major operation and may take a couple of month in some patients. In others, the recovery is much faster especially in thinner patients and those who participate enthusiastically in rehabilitation. After a knee replacement patient can comfortably participate in activities like long distance walking, light jogging cycling and swimming Some patients also go back to sports like tennis and badminton without extra risk of damaging the new knee. Knee replacement is highly successful operation in patients disabled by pain, and helps them recover fully from disability and gain their independence All the patients disabled by knee arthritis are enabled by a knee replacement, so that they can perform all usual activities of daily living.