CLINICAL CASE STUDY
Total Knee Replacement in a Patient with Rheumatoid Arthritis
PATIENT PROFILE
Age
47 years
Gender
Female
Occupation
Homemaker
City
Karimnagar
Presenting Complaint
Long-standing, worsening knee joint pain limiting daily activity
Diagnosis
Rheumatoid arthritis of the knee, with co-existing diabetes mellitus
Duration of Issue
Approximately 5 years
Previous Treatments
Conservative management (medication and supportive care) before surgery was advised
Outcome
Good- 70-80% improvement reported
THE PROBLEM
CONDITION
The patient, a 47-year-old woman from Karimnagar, had been living with rheumatoid arthritis affecting one knee joint for around five years. Rheumatoid arthritis is an autoimmune condition in which the body’s immune system attacks the lining of the joints, causing persistent inflammation, pain and progressive loss of movement. Over time this leads to cartilage damage and stiffness that conservative measures can no longer control. By the time she was advised to undergo total knee replacement, the joint damage in the affected knee had progressed to the point where medication and supportive care were no longer enough to manage her pain or preserve normal movement.
EMOTIONAL & PSYCHOLOGICAL IMPACT
Facing surgery on both hands after a sudden accident is naturally frightening, and uncertainty about what the operation involves can add to that anxiety. The patient noted that not knowing what would be done or how the surgery would proceed was a source of worry. What made the difference for her was that Dr. Venkat Swamy explained her condition and the plan clearly, which helped her feel reassured and comfortable going into the procedure.
CONSULTATION & TREATMENT PLAN
WHAT WAS ASSESSED DURING THE CONSULTATION?
Severity of rheumatoid joint damage in the knee and suitability for total knee replacement
Co-existing diabetes and the need to optimise blood sugar control before surgery
Overall medical fitness for the procedure and anaesthesia
Range of motion and degree of joint deformity, and confirmation that conservative management had been exhausted
Because the patient had diabetes, she was referred for diabetic management. Blood sugar was brought under control first, and only after that was the knee replacement planned – a sequencing decision that reduces surgical and healing risk.
WHY THIS APPROACH WAS CHOSEN
Diabetes was treated and stabilised to lower infection and healing risks before any surgery
Total knee replacement was recommended after the surgeon judged conservative management was no longer sufficient for the arthritic joint
An imported implant from Johnson & Johnson was used, provided to the patient free of cost
A durable, well-established imported implant was selected to give a reliable long-term result appropriate for an active homemaker
PROCEDURE DETAILS
STEP-BY-STEP OVERVIEW
Pre-operative markings finalised and surgical site confirmed
Anaesthesia administered
Incision made over the knee and the joint exposed
Damaged cartilage and bone surfaces removed and prepared
Imported Johnson & Johnson implant components positioned and fixed
Alignment, stability and range of movement checked intra-operatively
Layered wound closure
PROCEDURE FACTS
Duration
Approximately 1.5-2 hours (typical for the procedure)
Anaesthesia
Implant / Device Used
Imported Johnson & Johnson knee implant (provided free of cost)
Approach / Incision
Standard anterior (midline) approach to the affected knee
Intraoperative Complications
None reported
Hospital Stay
Short inpatient stay, in line with routine knee replacement
POST-OPERATIVE RESULTS
Following surgery, the patient reported no problems and was able to return to regular routine work at home. The family described an expected improvement of around 70–80%, which is consistent with a good functional outcome after total knee replacement. The recovery was helped by the diabetes being well controlled before the procedure, lowering the risk of infection and supporting steady healing.
OUTCOMES AT A GLANCE
Outcome Metric | Result |
Pain Relief | ✔ Significant – longstanding joint pain relieved |
Functional Improvement | ✔ 70-80% improvement reported; able to do routine work at home |
Diabetes Management | ✔ Controlled pre-operatively by Dr. Anusha Rao |
Complications | ✔ None reported |
Patient Satisfaction | ✔ High -family expressed satisfaction with care and result |
PATIENT FEEDBACK
The following reflects the testimonial given by the patient’s family member during the recovery period.
“We came to the hospital because she had been suffering from rheumatoid joint pain for the last five years. She also had a diabetic problem, so she was first given diabetic treatment, and then the knee replacement was planned. After the surgery we did not have any problem. A good, imported implant from Johnson & Johnson was used, free of cost. She can now do regular routine work at home, and there is about 70 to 80% improvement.”
Profile: Female · 47 years · Homemaker · Karimnagar
Procedure: Total Knee Replacement · Roma Hospital, Hyderabad · December 2024
Surgeon: Dr. Venkateshwaran · Roma Hospital, Hyderabad
POST-PROCEDURE CARE & RECOVERY
INSTRUCTIONS GIVEN TO PATIENT
Prescribed pain relief and antibiotics as directed by the surgical team
Early, guided physiotherapy and knee mobilisation to restore movement
Use of a walking aid initially, with weight-bearing as advised
Continued diabetes monitoring and blood-sugar control throughout recovery
Wound care, keeping the incision clean and dry until reviewed
Attend scheduled follow-up appointments for suture check and progress review
RECOVERY TIMELINE
Day 1–3
Early mobilisation begins with physiotherapy support; pain managed with medication; rest encouraged.
Week 1–2
Week 4–6
Gradual return to normal daily activities around the home.
Month 3
Most functional milestones reached; light activity reintroduced as advised.
Month 6
Final outcome confirmed at follow-up; full benefit of the surgery realised.
FAQ's
Can knee replacement be done if the patient has rheumatoid arthritis?
Yes. Rheumatoid arthritis is one of the common reasons a knee joint becomes too damaged for conservative treatment, and total knee replacement can relieve the pain and restore function. As in this case, the surgical team assesses joint damage and overall fitness before recommending surgery.
Is knee replacement safe for a patient who also has diabetes?
It can be, provided blood sugar is well controlled before surgery. In this case the patient’s diabetes was treated and stabilised before the knee replacement was scheduled at Roma Hospital, Hyderabad, which helps reduce the risk of infection and supports better healing.
What kind of implant is used in knee replacement?
Modern total knee replacements use prosthetic implants designed for durability and natural movement. This patient received an imported Johnson & Johnson knee implant, which was provided free of cost.
How much improvement can be expected after knee replacement?
Most patients experience a major reduction in pain and a return to everyday activities. The family in this case reported around 70-80% improvement, with the patient able to resume regular routine work at home after surgery.
Why choose Roma Hospital, Hyderabad for knee replacement?
Patients choose Roma Hospital, Hyderabad for its experienced orthopaedic team, use of quality imported implants, and a coordinated approach that manages related conditions such as diabetes before surgery. Care is led by experienced surgeons including Dr. Venkateshwaran, with the aim of safe, comfortable recovery and a good long-term result.