Guide To Getting A Knee Replacement in Singapore (2020)

I have been an orthopaedic surgeon for a little over a decade. In these years, I have met a lot of Singaporeans who know little or next to nothing about the knee replacement process. Who would blame them after all, there is a barrage of conflicting information about knee replacement both online and offline. Hopefully, after reading this post, you will have all the information you need about the knee replacement process. You will be reading about everything there is to know about the knee replacement process in Singapore. But before we get into that, here are some of the questions that my patients ask about knee replacement in Singapore:

  • What is the cost of knee replacement in Singapore?
  • Can knee replacement surgery be avoided?
  • How to figure out the best knee replacement procedure?
  • How do you choose the best knee replacement surgeon?

Why people do knee replacement surgery  knee implants  

Replacing and smoothening impaired cartilage. In a way, it’s like getting a new set of tyres for your car. One other reason that people have a knee replacement is to correct severely deformed legs. This is important to guarantee a proper walking posture while easing the stress on your other joints.

Who gets the most from a knee replacement?

knee-pain-stages

Knee replacements will definitely make your life better if you are have been trying to manage knee pain. So it’s definitely going to be life-changing for people struggling with arthritis. In the course of my practice, I have come across patients whose quality of life has been negatively often affected by severe pain. When they attempt to combat this pain with pain killers, kidney damage and ulcers are often the side effects. In my opinion, you are better off replacing your knees than your kidney(s) or stomach for that matter.

What happens during a knee replacement?

Once upon a time, all orthopaedic surgeons used to judge the alignment of the knee replacement was a good look. Thankfully, robotic technology has made things much easier. These days’ surgeons can rely on accelerometers/gyroscopes/microcomputers. This has made the knee replacement process more accurate and precise. Let’s take a quick look at what happens during the process:

  1. The damaged cartilage is shaved off
  2. After that, smooth metal or ceramic cap is placed onto the shaved surface
  3. Implants are then fastened onto the thigh bone and leg bone using cement(not the regular kind)
  4. The cartilage is then replaced with by a different type of plastic component that allows pain-free movement of the knee joint
  5. Lastly, the tension in the ligament is altered to ensure that the knee replacement is functional and well suited to different angles.

 

What is the cost of knee replacement in Singapore?

cost-of-knee-replacement-singapore

In Singaporean government hospitals, knee replacements cost about $20,000 for the whole process. While that might seem a lot, $3000 paid as upfront fees are enough to get the replacement surgery. The Singaporean government offers subsidies of about $10,000 for eligible folks. You can also claim about $7000 from Medisave. It’s a different ball game in the private sector where knee replacements cost between $25,000 to $30,000 for the process. The reason knee replacements costs so much is because of the implants used. They are made from surgical-grade materials that are durable and corrosion-free. The fact that they are imported from the US make them more expensive. Patients with severe deformities require bigger, sturdier and definitely more expensive implants.

  Surgery Cost Government Subsidy Medisave Private Insurance
Public Hospital $20,000 About $10,000

 

Private Hospital $25,000 to $30,000 $25,000 to $35,000

 

Claimable – specifics depends on  your policy

 

Although getting knee surgery is more affordable at public hospitals, there are still many good reasons to take the private route. Some of these reasons are:

  • Usually takes a shorter time at getting appointments for the surgery and also for after care reviews.
  • Nicer environment, better service.
  • More choice of implants.
  • If you have private insurance that covers the surgery, then why not go for the best experience?

Knee replacement in Singapore: public or private sector?

singapore-public-hospital

The Singaporean public healthcare system is one of the most cost-effective systems in the world. However, it can hold a candle to private care in Singapore. Let’s look at the differences between both sectors.

  • Costs: It is cheaper to have your knee replacement surgery done in a Singaporean public hospital.
  • Time: It takes much less time to get the surgery done in a private hospital in Singapore (within a week).
  • Expertise: Private hospitals offer specialist care. With restructured hospitals, you get specialist care when you pay to be upgraded to the non-subsidized class of patients.
  • Environment: Patients who undergo specialized treatments do not get the best environments. Private hospitals offer high levels of comfort.
  • Quality of Implants: Public hospitals use reliable but basic implants. In private hospitals, patients can access implants that are suited to their peculiar needs.

Can You Avoid Having A Knee Replacement Surgery?

how-does-knee-replacement-work

Patients often want to know if knee replacement surgery can be avoided. The truth is, knee replacement surgery depends on the situation at hand. This is because there are instances when it is not absolutely necessary. There are other instances when it is absolutely necessary. Some of such instances are severe knee pain, malaligned limbs and the inadequacy of oral medication and physical therapy.

Why do some elderly people have walking challenges?

walking-difficulty

These folks did not choose to have walking challenges. They are simply victims of arthritis. The toll arthritis takes on the knee causes the bone to erode, causing malalignment. Once this occurs, only knee replacement surgery can correct the alignment of the knee.

 

What is the best knee replacement procedure in Singapore? 

partial-total-knee-replacement

That depends. In my experience, what counts as the best knee replacement procedure is that procedure that suits your individual needs.

There are two main types of knee replacements to choose from:

  • Total knee replacement: This involves replacing the entire knee joint, ligaments and all. It is great for eradicating pain and is very effective in the long-term. The downsides are that it has a long recovery period, and the replaced knee may not feel “right” for some patients.
  • Partial knee replacement: Partial knee replacements are actually meant for patients that do not have severe knee damage. This is because it is focused on only the affected area, and less tissue and cartilage is removed. It is less painful with lower risks of complications, a faster recovery period, and the operated knee also feels more natural after the operation. However, it is not your best bet in the long term.

How long is the downtime after knee replacement surgery?

This is also a very important aspect of knowledge about the knee replacement process. For total knee replacement, patients are usually needed to stay for about five days in the hospital after the knee replacement operation. After they have been discharged, it will at least4 weeks before stability is gained and the pain is no longer present.

With partial replacement, most patients are discharged within 1 – 2 days post-surgery. The healing process is not complicated as patients mostly resume their daily activities after about 2weeks of physical therapy.

Who is suitable for a partial knee replacement?

Based on my experience, about 1 in every three patients will need at least partial knee replacement. Here are criteria that can help you decide if you are a candidate of partial knee replacement:

  • When the knee damage is localized, and the arthritis is limited to a certain area of the knee.
  • Leading a sedentary lifestyle (a lifestyle without exercise) makes you a prospective candidate for a partial replacement. The less wear and tear on your knee means that there is a higher probability that the other parts of your knee (partial cartilage, ligaments, tendons, etc.) will be healthier in the long run.
  • The success of a partial knee replacement depends on the structures around the new implant. So you will definitely need a fully intact anterior cruciate ligament to be eligible for a partial knee replacement.

The candidates who are best suited for partial knee replacement are those with arthritis in only one part of their knee. They also have an intact anterior and posterior cruciate ligament and a certain degree of flexibility.

What are the advantages of robotic surgery for knee replacements? 

robotic-surgery

Robotic surgery has taken surgery to new heights. It is the most recent state of the art technology to be applied in medicine. The major benefit it affords patients are levels of precision and reproducibility that are beyond humans.  Robotic surgery empowers surgeons by ensuring that they place the knee implants in the most appropriate positions all the time.  How? It also involves a pre-operative scan of the knee that allows the computer to get more information about your bone structures. Your surgeon is thus able to plan the surgery better as they can make micro-adjustment during the surgery when needed.  It even gets better with the in-built safety mechanism (“virtual boundaries set”)in the robot that prevents your blood vessels and the nerves at the back of the knee from accidentally being cut. In spite of the robot’s ability, the orthopaedic surgeon is still in full control of the procedure. The surgeon only activates the robot when there is a need to. Barringradical changes in artificial intelligence and the medical field, it is highly unlikely that robots will be in full control of the knee replacement surgery procedure.

Robotic surgery is the future of surgery in the future. At the moment, though, the high costs involved are the immediate concern for lots of potential patients. Hopefully, when the need and use of robotic surgery become proliferated in the future, these costs will reduce for good.

How much improvement can you expect after a knee replacement operation?   

knee-replacement-singapore

After a successful knee replacement surgery, patients find that they are able to do a lot of stuff like:

  • Bending their knees. It will interest you to know that some patients worry about their abilities to bend their knees after a knee replacement surgery.
  • Depending on how well they rehabilitate, a lot of post-surgery patients will be able to squat.
  • Walk up and down inclines(stairs and slopes)
  • Riding a bicycle
  • Dancing
  • Swimming

The more rugged patients are even able to participate in extreme sports snowboarding, water and triathlons (among others). It is important that you note that high impact activities like running, basketball and badminton (among others) may reduce the durability of implants.

How to get optimal results after your knee replacement

physiotherapy

The way you manage your rehabilitation is just as important as the surgery procedure. This is because rehabilitation serves to get your knee in good working condition after the surgery. While its okay to rest after undergoing a surgery procedure, lazing about all day and ignoring your post-surgery rehabilitation will cause more harm than good. You might find out that your knee might not function properly or might even be impaired in the process. One of the major concerns of patients is if they need to reduce their activities post-operation so as not to wear out their knee replacement. In my opinion, asking this question is akin to asking if driving a new car frequently will cause the tyres to wear out faster. Why buy a car if you are afraid of wearing the tyres out? Why try to improve your knee if you don’t intend to use it? The idea of knee replacement is for you to able to do more with it.

How do you choose a knee replacement surgeon and clinic in Singapore?

The truth is even in if all the surgeons in the world were specialists, some surgeons will. Be better at it than others. And since everyone wants a good deal, you will probably want to get the best knee replacement surgeons possible. The likelihood of an experienced orthopaedic surgeon, succeeding at a knee replacement procedure is much higher than an inexperienced one. This is because, with most things in life, perfection comes with practice. One way to choose a great knee replacement surgeon is by looking at the volume of operations executed. The minimum knee replacements done by a reputable surgeon should be in the range of 100-200 annually. Such a surgeon is also expected to have successfully completed at least 300 joints surgeries in a year.

Although its common practices for surgeons in some countries to post their stats, you won’t find such information about surgeons in Singapore. Since evaluating the success rate of surgeons is key to making the right choice, potential patients will have to carry out more research.

 

 

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