Arthroplasty at Apollo Hospitals, Lucknow

Why Patients Choose Apollo Hospitals Lucknow for Arthroplasty

• A multi-specialty orthopaedic and joint replacement team covering hip, knee, shoulder and revision arthroplasty, supported by anaesthesia, critical care, cardiology, nephrology, endocrinology and infectious disease teams under one roof ? important because most joint replacement patients in India are over 60 and often have diabetes, hypertension or cardiac disease.
• The Apollo Hospitals group legacy since 1983, when India's first corporate hospital chain was founded in Chennai; the group now operates a large network of hospitals across India and has performed joint replacement surgery across its units for several decades.
• Apollo Hospitals Lucknow is a NABH-accredited tertiary care facility serving Uttar Pradesh, with dedicated modular operation theatres, laminar airflow, and post-operative critical care ? the infrastructure combination associated with lower periprosthetic joint infection risk.
• Technology and technique options discussed case by case, which may include computer-navigated or assisted alignment, patient-specific pre-operative planning from CT or long-leg radiographs, modern highly cross-linked polyethylene bearings, cemented and uncemented fixation, high-flexion and posterior-stabilised knee designs, and unicondylar (partial) knee replacement for suitable single-compartment disease. Availability of any specific platform should be confirmed with the orthopaedic OPD at the time of consultation.
• Structured, Indian-lifestyle-aware rehabilitation: physiotherapy protocols that account for floor sitting, squatting, Indian-style toilets, temple visits and joint-family home layouts, rather than a generic Western template.
• Separate care pathways for different patient groups ? sports and activity-related joint injuries in younger adults, degenerative arthritis in adults and elderly patients, inflammatory arthritis (rheumatoid, ankylosing spondylitis) in coordination with rheumatology, and paediatric and adolescent hip conditions in coordination with paediatric orthopaedics.
• Full continuum in one visit: on-site radiology (X-ray, CT, MRI), laboratory, pre-anaesthetic clinic, blood bank services, pharmacy, TPA and insurance desk, and physiotherapy ? reducing repeat trips for patients travelling from outside Lucknow.
• Enhanced recovery principles including multimodal pain control, early mobilisation, and mechanical plus pharmacological clot prophylaxis, in line with current national and international guidance.

We do not promise a specific outcome. Joint replacement is a well-established operation with generally good published results, but results vary with joint, diagnosis, age, weight, bone quality, other illnesses and how consistently rehabilitation is followed.

Overview

Arthroplasty, commonly known as joint replacement surgery, is a transformative procedure designed to alleviate pain and restore function in damaged joints. At Apollo Hospitals Lucknow, we aim to offer high-quality, evidence-based arthroplasty care with advanced technology and careful patient selection to support good outcomes. Our team of orthopaedic surgeons, working with modern implants and imaging, provides personalised care tailored to each patient's unique needs. With a focus on clinical governance and patient trust, Apollo Hospitals Lucknow is a considered choice for people in Uttar Pradesh seeking relief from long-standing joint pain.

Arthroplasty is not a single operation. It includes total knee replacement, partial (unicondylar) knee replacement, total hip replacement, hip resurfacing in selected cases, shoulder replacement (anatomic or reverse), elbow and ankle replacement in a small number of patients, and revision surgery when an earlier implant has loosened, worn out or become infected.

Current Clinical Guidance Behind Our Practice

Our approach reflects the direction of current orthopaedic guidance rather than any single fixed rule:

• Indian Orthopaedic Association (IOA) and the Indian Society of Hip and Knee Surgeons (ISHKS) maintain the ISHKS Joint Registry, India's national arthroplasty registry launched in 2006 and progressively expanded. Indian registry data have repeatedly shown that Indian arthroplasty patients are, on average, younger and more often female than Western cohorts, with a high proportion of bilateral knee replacement and advanced deformity at presentation ? which supports earlier discussion of surgery rather than waiting until the joint is severely deformed.
• Osteoarthritis Research Society International (OARSI) 2019 guidelines and the American College of Rheumatology / Arthritis Foundation 2019 guideline for hand, hip and knee osteoarthritis both place weight loss, structured exercise and physiotherapy as core first-line care, with strong recommendations against routine use of intra-articular hyaluronic acid injection for knee osteoarthritis and against long-term opioids. Surgery is reserved for people with persistent pain and functional loss despite adequate non-surgical treatment.
• AAOS clinical practice guideline on the management of osteoarthritis of the knee, third edition (2021), and the AAOS guideline on Management of Osteoarthritis of the Hip (2023) support total joint arthroplasty for end-stage disease, and note strong evidence for tranexamic acid to reduce blood loss and for perioperative antibiotic prophylaxis.
• Venous thromboembolism prophylaxis: AAOS/ACCP-informed practice has shifted toward risk-stratified prophylaxis, with aspirin now accepted as a reasonable agent in many standard-risk hip and knee replacement patients rather than low-molecular-weight heparin for all. Your surgeon and physician decide the agent for you individually.
• Infection prevention: current guidance (including WHO 2018 global guidelines on surgical site infection prevention and 2018 International Consensus Meeting on Musculoskeletal Infection recommendations) supports dental and skin sepsis clearance, screening and optimising blood sugar, stopping smoking before surgery, and a single properly timed pre-incision antibiotic dose rather than prolonged post-operative antibiotics.
• Anaemia and nutrition optimisation before elective arthroplasty is now a recognised part of pre-operative pathways ? relevant in India, where iron-deficiency anaemia and low vitamin D are common and correctable before surgery.

Guidelines change. Where evidence is uncertain ? for example the long-term functional benefit of robotic-assisted over conventional knee replacement ? we say so, and we do not present unproven advantages as fact.

Why Arthroplasty is Necessary

Arthroplasty is often necessary for individuals suffering from severe joint pain due to conditions such as osteoarthritis, rheumatoid arthritis, or traumatic injuries. These conditions can lead to significant deterioration of the joint, resulting in chronic pain, reduced mobility, and a diminished quality of life. The primary goal of arthroplasty is to replace the damaged joint surfaces with artificial components, thereby alleviating pain and restoring function.

The benefits of arthroplasty extend beyond pain relief. Patients often experience improved mobility, enhanced physical activity, and a return to daily activities that were previously hindered by joint pain. At Apollo Hospitals Lucknow, we understand the importance of these outcomes, and our team supports you through every step of the process.

Other common indications seen in our practice include avascular necrosis of the femoral head (frequently linked to steroid use, alcohol, sickle cell disease or previous trauma), post-traumatic arthritis after a neglected or malunited fracture, hip and knee damage from ankylosing spondylitis, tubercular arthritis with a burnt-out healed joint, and fractures of the neck of femur in older adults where replacement is often preferred to fixation.

Risks of Delay

Delaying arthroplasty can lead to complications that may worsen your condition. As joint damage progresses, patients may experience increased pain, stiffness, and greater loss of mobility. This can result in a sedentary lifestyle, contributing to additional health issues such as weight gain, cardiovascular deconditioning, and muscle wasting.

Postponing the procedure can also complicate the surgery itself. Advanced joint degeneration, severe varus or valgus deformity, fixed flexion contracture, bone loss and shortening may require more extensive surgical intervention, bone grafting or constrained implants, with a longer operation and a higher chance of complications. Long-standing disuse also weakens the quadriceps and hip abductors, which slows rehabilitation even after a technically perfect operation. At Apollo Hospitals Lucknow, we emphasise timely, well-timed treatment ? not rushed treatment ? to reduce these risks.

Benefits of Arthroplasty

• Pain Relief: The primary benefit is substantial reduction, and in many patients near-complete relief, of joint pain, allowing a return to activities they enjoy.
• Improved Mobility: Most patients experience meaningful improvement in range of motion and can perform daily tasks with greater ease.
• Enhanced Quality of Life: With less pain and better movement, patients can return to normal routines, social and religious activities, and a more active lifestyle.
• Long-lasting Results: Modern techniques and bearing materials are designed to be durable. Large registry data suggest a high proportion of hip and knee replacements are still functioning well at 15 to 20 years, though individual longevity varies with age, weight and activity.
• Personalised Care: Treatment plans at Apollo Hospitals Lucknow are matched to your joint, your diagnosis, your other illnesses and your functional goals.

Honest counterpoint: a small minority of patients remain dissatisfied even after a technically successful knee replacement, most often because of unrealistic expectations, pre-existing back or nerve pain, or widespread pain conditions. We discuss this openly before you consent.

Preparation and Recovery

Preparation Tips

• Consultation: Book a detailed consultation with our orthopaedic specialists to discuss your condition, treatment options and concerns.
• Preoperative Assessment: Complete the required tests, including blood investigations and imaging, to assess overall health and joint condition.
• Medications: Review all current medicines with your doctor. Some ? blood thinners, certain diabetes drugs, biologics and disease-modifying anti-rheumatic drugs ? may need adjustment or temporary withholding.
• Lifestyle Modifications: Begin the prescribed pre-habilitation exercises to strengthen the muscles around the joint and improve general fitness before surgery.

Recovery Tips

• Follow Postoperative Instructions: Stick to the care plan, including medication schedules, wound care and activity limits.
• Physical Therapy: Attend physiotherapy as advised to regain strength and movement ? this is the single biggest factor you personally control.
• Pain Management: Use the prescribed multimodal pain relief so that you can move comfortably and early.
• Gradual Return to Activities: Resume daily activities in stages, as advised, allowing tissues to heal.

Our team supports you throughout recovery with clear milestones and access to guidance between visits.

Timing of Surgery and the Pre-Procedure Phase

Elective arthroplasty is rarely an emergency. The usual sequence is:

1. Weeks minus 6 to minus 4 ? decision and workup. Clinical examination, weight-bearing X-rays (long-leg alignment films for knees), and sometimes CT or MRI. Blood tests including haemoglobin, HbA1c, kidney and liver function, vitamin D, and infection markers.
2. Weeks minus 4 to minus 2 ? optimisation. Correct anaemia and vitamin D deficiency, bring HbA1c toward target where possible, treat urinary or skin infection, obtain dental clearance and treat any dental sepsis, stop smoking and reduce alcohol, and start pre-habilitation exercises.
3. Week minus 2 to minus 1 ? pre-anaesthetic clinic. Cardiac and respiratory review as needed, medication plan, and anaesthesia discussion (spinal, regional block, general, or a combination).
4. Home preparation. Arrange a Western-style commode or a commode chair over the Indian toilet, a firm bed at knee height rather than a floor mattress, a raised chair with armrests, an anti-skid bathroom mat, adequate lighting, and clear walking paths. Remove loose rugs and door thresholds where possible.
5. Admission day. Fasting as instructed, skin preparation, marking of the limb, antibiotic and tranexamic acid administration in theatre.

If both knees or both hips are badly affected, your surgeon will discuss whether to operate on both in one sitting (simultaneous bilateral), both during the same admission a few days apart (staged same-admission), or separately after full recovery. Simultaneous bilateral knee replacement is common in India and can suit a fit patient with symmetrical disease, but it carries a higher transfusion and cardiopulmonary demand, so it is not offered to everyone.

Technique and Alternative Options Compared

Procedures Sometimes Done at the Same Time

• Soft-tissue balancing releases for severe varus, valgus or fixed flexion deformity of the knee.
• Bone grafting or metal augments where there is bone loss, common in neglected arthritis and revisions.
• Removal of previously implanted plates, screws or nails in the same bone before the joint replacement.
• Patellar resurfacing or patellar denervation and osteophyte trimming during knee replacement.
• Second-side replacement in a simultaneous bilateral procedure, when the patient is assessed as fit.
• Biopsy and tissue culture when infection or tuberculosis is suspected in the joint.
• Correction of leg-length discrepancy during hip replacement, planned pre-operatively on templated radiographs.

Phase-by-Phase Recovery Timeline

This is a general guide for hip and knee replacement. Shoulder and revision surgery follow slower schedules, and your surgeon's advice overrides any table.

Return to Activity, Work and Sport

Decisions are based on healing, muscle control and confidence, not the calendar alone. General criteria:

• Walking without aid: when you can bear full weight without limp or pain and have good quadriceps or abductor control.
• Driving: when you are off strong painkillers, can perform an emergency stop, and can sit in and out of the car unaided ? usually four to six weeks for a right knee or hip, sometimes earlier for a left-side operation in an automatic car. Confirm with your surgeon and your motor insurer.
• Desk or supervisory work: commonly four to six weeks.
• Manual or field work, long commutes on two-wheelers or by bus: usually three months or more, and two-wheeler riding needs individual clearance.
• Low-impact sport encouraged long term: walking, swimming, stationary or road cycling, gentle yoga with modified postures, doubles badminton at recreational pace, golf.
• Generally discouraged after replacement: running as regular exercise, jumping, contact sport, kabaddi, competitive singles racquet sport, heavy squatting under load, and repeated deep kneeling.

Squatting, cross-legged sitting, floor sleeping and Indian toilets

This matters more in India than most global material acknowledges. Realistically:

• Indian-style toilets: avoid indefinitely after hip replacement and generally after knee replacement. A Western commode or a commode chair placed over the squat pan is the practical solution.
• Cross-legged sitting: many knee replacement patients regain it partially after three to six months with good flexion; after hip replacement it is often possible later but must be cleared by your surgeon because of dislocation risk in the first three months.
• Full deep squatting: not advised after total knee replacement as a routine activity, even if the implant is described as high-flexion.
• Floor sleeping: avoid for at least the first three months. If floor sleeping is unavoidable in your household, discuss it before surgery so that physiotherapy can train safe floor transfers, and consider a firm mattress on a low cot instead.
• Religious and social settings: ask for a chair at temple, gurudwara, mosque or wedding functions rather than sitting on the floor. Prayer stools and low chairs are widely available.

Protecting the Implant and Preventing Problems

• Keep body weight in a healthy range ? every extra kilogram multiplies load across the knee and hip.
• Continue lifelong strengthening of thigh, hip and core muscles, two to three sessions weekly.
• Treat dental, urinary, skin and chest infections promptly; bacteria in the bloodstream can seed a prosthesis years later. Tell your dentist that you have a joint implant.
• Control diabetes, and treat osteoporosis if diagnosed ? bone quality affects implant fixation and periprosthetic fracture risk.
• Prevent falls: adequate lighting, grab bars in the bathroom, sensible footwear with grip, cataract and vision checks, review of sedating medicines.
• Attend follow-up as scheduled, including periodic X-rays, so that wear or loosening is detected before it becomes symptomatic.
• Carry your implant card and operative details when travelling, and inform airport security if asked.

Considerations for Younger, Older and Paediatric Patients

Younger adults (under 55)

Common reasons are avascular necrosis, ankylosing spondylitis, rheumatoid arthritis, post-traumatic arthritis and sports-related joint damage. The key issue is implant survival over a long remaining lifespan and the probability of one or more revisions later. Joint-preserving options ? osteotomy, core decompression, partial replacement ? are considered first where feasible. Uncemented fixation and hard-wearing bearing surfaces are often preferred.

Older adults (over 70)

Focus shifts to medical optimisation, anaemia correction, cardiac and renal assessment, delirium prevention, early mobilisation and fall prevention. For a displaced femoral neck fracture, arthroplasty rather than fixation is usually preferred. Frailty screening, nutrition support and family caregiver planning influence outcome as much as implant choice.

Children and adolescents

True joint replacement is uncommon in this age group. Most paediatric hip and knee problems ? Perthes disease, slipped capital femoral epiphysis, developmental dysplasia, juvenile idiopathic arthritis, bone tumours ? are managed with joint-preserving surgery, guided growth or reconstruction. Replacement is reserved for severely destroyed joints, usually after skeletal maturity, and is planned jointly with paediatric orthopaedics and rheumatology.

If You Choose Not to Have Surgery

Declining arthroplasty is a legitimate choice, and many people live with arthritis for years using non-surgical care. What you can expect:

• Symptoms typically progress slowly and unevenly, with flares and quieter periods.
• Walking distance usually shortens, and deformity, stiffness and shortening may increase over years.
• Reduced activity commonly leads to weight gain, muscle loss, poorer blood sugar and blood pressure control, low mood and social withdrawal.
• Long-term reliance on painkillers carries its own risks ? NSAIDs affect the stomach, kidneys and blood pressure, and opioids are not recommended for long-term arthritis pain.
• Surgery performed much later, at an older age with more deformity and more medical problems, is generally technically harder and carries more risk.

If you decline surgery now, we will still offer a structured programme: physiotherapy, weight management, gait aid, footwear advice, vitamin D and calcium correction, injections where appropriate, and periodic review so the decision can be revisited.

Factors That Influence the Cost of Arthroplasty

We do not publish figures here, and we do not quote prices from third-party aggregator websites. For a written estimate specific to your case, contact the Apollo Hospitals Lucknow reception, billing desk or insurance and TPA desk. The following factors change the estimate:

Insurance, Cashless Treatment and TPA Process in India

Planned joint replacement is covered by most Indian health insurance and government schemes when medically indicated, but coverage rules matter. Points to check with your insurer and with our insurance desk:

• Waiting periods. Joint replacement for degenerative arthritis is frequently treated as a specified or pre-existing condition with a waiting period, often two to four years depending on the policy wording. Read your policy schedule, not just the brochure.
• Planned versus accident cover. Arthroplasty after a documented accident ? for example a femoral neck fracture ? is usually payable much earlier than elective arthritis surgery, since accidental injury is generally not subject to the same waiting period. Keep the FIR or accident record, casualty notes and imaging.
• Sub-limits and capping. Some policies cap joint replacement, implant cost, or room rent. Room-rent-linked proportionate deduction can reduce the payable amount across the whole bill.
• Cashless pre-authorisation. For planned surgery, submit documents through the hospital insurance desk ideally seven to ten working days before admission: policy copy, photo ID, Aadhaar, doctor's advice note, diagnosis, X-ray and MRI reports, and past treatment records showing failed conservative management. Approval timelines depend on the insurer or TPA, not the hospital.
• National Health Claims Exchange and faster processing. Many insurers now route pre-authorisation and claims digitally, which has shortened turnaround times, but approval still depends on policy terms.
• Reimbursement route. If your insurer is not empanelled or approval is delayed, you may pay and claim later. Retain the discharge summary, itemised final bill, implant invoice with sticker or batch number, investigation reports and payment receipts.
• Government and corporate schemes. Ayushman Bharat PM-JAY, CGHS, ECHS, state schemes, railway and PSU panels have their own eligibility, referral and package rules. Empanelment status can change, so confirm your specific scheme with the hospital front office before admission.
• Non-payable items. Consumables, some registration and administrative charges, walker and commode, attendant food and certain items are usually excluded.
• Second joint later. If you plan a staged bilateral replacement, check your remaining sum insured and whether the second surgery falls in the same policy year.

Never rely on a verbal assurance about coverage. Ask for the pre-authorisation approval letter