knee-replacement-surgery-peshawar

🦴Knee Arthroplasty Specialist — Peshawar

Knee Replacement Surgery in Peshawar

When knee pain stops you from climbing stairs, praying on the floor, or sleeping through the night — and every other treatment has stopped working — knee replacement surgery restores the joint that chronic arthritis has destroyed. At OAIC, Dr Muhammad Inam performs total and partial knee replacement with techniques refined through a dedicated Fellowship in Arthroplasty in Italy, delivering international-standard outcomes for patients across KPK.

⚠️ Symptoms that warrant assessment

Joint pain that worsens with activity and eases with rest
Morning stiffness lasting under 30 minutes
Clicking, grinding, or crepitus inside a joint
Swelling or warmth around the knee or hip
Difficulty squatting, climbing stairs, or rising from the floor

Knee replacement is the most transformative elective surgery in orthopedics — and one of the most delayed in KPK.

Patients in Peshawar typically live with severely limiting knee pain for 3–5 years beyond the point at which replacement would have been appropriate, because they are either not correctly staged, not offered surgery, or fear an operation they do not understand. At OAIC, Dr Muhammad Inam addresses this directly: patients receive an accurate assessment of where they are in the disease progression, a clear explanation of all options, and surgery recommended only when — and precisely when — it will genuinely restore what non-surgical care can no longer achieve.

The knee is the most load-bearing joint in the body. Every step transfers a force of three to four times body weight across the knee joint. When the cartilage that cushions this joint wears away — from osteoarthritis, rheumatoid arthritis, post-traumatic damage, or other joint disease — the underlying bones are exposed to each other. The result is progressive pain, deformity, and functional loss that eventually cannot be managed any other way.

Knee replacement surgery — medically called knee arthroplasty — resurfaces the damaged ends of the femur, tibia, and in most cases the patella with precision-engineered metal and polyethylene components, restoring a smooth, stable, pain-free joint. Dr Inam’s Fellowship in Arthroplasty in Italy provided dedicated training in the surgical techniques, implant selection, and complex case management that total and partial knee replacement demands. This is subspecialty arthroplasty training — not general orthopaedic surgery applied to joint replacement.

82%

Of total knee replacements still functioning at 25 years

90%+

Of patients report significant or complete pain relief post-surgery

25+

Years of orthopaedic experience in KPK

3–5

Average years KPK patients delay needed knee replacement

Types of Knee Replacement at OAIC Peshawar

The right type of knee replacement depends on which part of the joint is damaged, the patient’s age and activity demands, and the integrity of the remaining knee structures. Dr Inam assesses each case individually before recommending a procedure.

🦴Total Knee Replacement (TKR)

Most Common Procedure

All three compartments of the knee — medial (inner), lateral (outer), and patellofemoral (kneecap) — are resurfaced. The damaged ends of the femur and tibia are removed and replaced with metal components; a polyethylene spacer provides a smooth articulating surface between them.

TKR is appropriate when arthritis affects the entire joint surface, when significant deformity (Varus bow-leg or valgus knock-knee) is present, or when ligament integrity requires the stability of a total replacement.

Recovery: Walking with frame from day 1. Discharge at 3–5 days. Independent walking at 4–6 weeks.

🔲Partial (Unicompartmental) Knee Replacement

Suitable Patients Only

Only the single damaged compartment — most commonly the medial — is resurfaced. The healthy cartilage in the other compartments is preserved. The cruciate ligaments must be intact for this procedure to be appropriate.

Partial replacement produces a more natural-feeling knee, allows greater range of motion, involves a smaller incision, and has a faster recovery than total replacement. It is the better option when the criteria for it are met — but it is not suitable for all patients.

Recovery: Faster return to function than TKR. Suitable patients are typically walking unaided within 2–3 weeks.

🔧Revision Knee Replacement

Complex Surgery

Performed when a previous knee replacement has failed — due to implant loosening, wear, infection, instability, or component failure. Revision surgery is significantly more complex than primary replacement: it requires removal of the existing implant, bone loss management, and placement of a more constrained revision implant system.

Patients who had knee replacement surgery elsewhere in Pakistan and are experiencing pain, swelling, or instability should seek specialist review at OAIC. Early identification of implant problems improves revision outcomes.

Note: Revision surgery requires detailed pre-operative planning including CT scanning and implant identification.

Types of Hip Replacement Performed at OAIC

The procedure is matched to the pattern and extent of joint damage.

Knee Osteoarthritis

The most common cause. Cartilage breakdown accelerated by habitual squatting, floor sitting, and weight-bearing in the KPK population. Many patients present with severe varus (bow-leg) deformity from medial compartment collapse after years of untreated disease.

Avascular Necrosis of the Knee

Blood supply disruption to the femoral condyle — caused by prolonged steroid use, alcohol, or spontaneous occurrence — leads to bone death and collapse. Steroid-induced AVN is disproportionately common in KPK due to unmonitored corticosteroid prescribing, and frequently presents at an advanced, replacement-requiring stage.

Rheumatoid Arthritis

Inflammatory destruction of the knee joint synovium causes rapid joint space loss and deformity. Knee replacement in rheumatoid arthritis requires careful peri-operative management of DMARDs and biologics — an area where Dr Inam’s rheumatology training is directly relevant.

Psoriatic and Reactive Arthritis

Less common but significant — inflammatory arthritides other than rheumatoid can cause severe knee joint destruction requiring replacement. Accurate diagnosis before surgery ensures the systemic disease is controlled peri-operatively to protect the new implant.

Post-Traumatic Knee Arthritis

Old tibial plateau fractures, untreated ACL tears, and meniscal injuries that were never managed correctly cause accelerated cartilage loss over 10–15 years. Many patients in Peshawar have this history — a road accident or sports injury in their 30s that has led to a knee requiring replacement in their 50s.

Severe Knee Deformity

Fixed varus (bow-leg) or valgus (knock-knee) deformity from long-standing untreated arthritis — common in elderly patients presenting late in Peshawar — requires correction at the time of knee replacement. Dr Inam’s arthroplasty fellowship training specifically included deformity correction techniques.

Are You Ready for Knee Replacement?

Good surgical candidacy requires more than severe pain. Dr Inam assesses the complete clinical, imaging, and patient-specific picture before recommending knee replacement — and will tell you honestly if the time is not yet right.

✅ Factors that support knee replacement

Severe knee osteoarthritis confirmed on weight-bearing X-ray
Persistent pain significantly limiting walking, stairs, and daily function
Pain present at rest or at night — not only with activity
Physiotherapy, weight management, and joint injections have been tried and failed
Patient is medically fit for anaesthesia and committed to rehabilitation
Quality of life is severely affected and the patient accepts realistic outcome expectations

⚠️ Situations requiring careful individual assessment

Age under 60 — higher lifetime revision risk; delay strategies explored thoroughly
Severe obesity — increases surgical risk and implant wear; weight management first
Poorly controlled diabetes — must be optimised pre-operatively to reduce infection risk
Active knee infection — must be fully resolved; staged procedure required
Significant muscle weakness — physiotherapy pre-habilitation recommended first
Pain without clear structural X-ray correlation — source of pain requires reassessment

Treatment Pathway at OAIC Peshawar

Treatment follows a logical escalation — starting with the least invasive, most reversible options and moving upward only when required. The majority of patients never need to reach the final step.

1

Pre-operative planning & templating

Weight-bearing X-rays of the full leg are used to measure the degree of deformity, select the correct implant size, and plan the bone cuts required to restore normal limb alignment. Blood tests, ECG, and anaesthetic assessment address any correctable risk factors — anaemia, uncontrolled blood glucose, anticoagulant medications — in the weeks before surgery.

2

Anaesthesia at Lady Reading Hospital MTI

Most knee replacements at OAIC are performed under spinal anaesthesia — preferred over general anaesthesia because it significantly reduces intraoperative blood loss, lowers DVT risk, and provides excellent post-operative pain control in the immediate recovery period. A nerve block (adductor canal block) is added to further reduce post-operative pain and minimise opioid requirements.

3

Bone resection & preparation

A midline incision over the knee exposes the joint. Using precision cutting guides aligned to the patient’s individual anatomy, the damaged surfaces of the distal femur and proximal tibia are resected at the exact angles required to restore correct limb alignment. The patella is assessed and resurfaced if appropriate. All cartilage and bone osteophytes are removed.

4

Trial components & alignment verification

Trial implant components are placed on the prepared bone surfaces and the knee is put through its full range of motion. Ligament balance — ensuring the knee is stable in both flexion and extension — is assessed and adjusted before any permanent components are fixed. This step is where surgical experience matters most: a well-balanced knee replacement feels natural; a poorly balanced one does not, regardless of component quality.

5

Final implant fixation

The definitive femoral component, tibial tray, and polyethylene insert are fixed in place — using cement (cemented fixation) or press-fit cementless fixation depending on the patient’s bone quality and age. The knee is tested once more through full range of motion before the wound is closed. Surgery takes approximately 60–90 minutes.

6

Wound closure & immediate recovery

The wound is closed in layers. A dressing and compression bandage are applied. The patient is transferred to recovery and then to the ward. DVT prophylaxis (blood-thinning medication) is started within hours of surgery and continued for 4–6 weeks. A physiotherapist begins the patient standing and walking with a frame on the same afternoon or the following morning.

Knee Implant Options — What Patients Should Know

Implant selection is a clinical decision based on the patient’s age, bone quality, activity level, and deformity pattern — not a consumer choice. This table explains the options discussed at OAIC.

Implant Type

Construction

Best For

Longevity

At OAIC

Cemented Total Knee Metal + polyethylene, bone cement fixation

Metal femoral component, polyethylene insert, metal tibial tray fixed with acrylic cement

Most patients; especially over 65 or with osteoporotic bone

15–25 years

Standard choice

Cementless Total Knee Porous ingrowth surface

Porous-coated components allow direct bone ingrowth without cement

Younger patients (<65) with good bone stock and active lifestyle

20–25+ years

Selected cases

Unicompartmental (Partial) Single compartment resurfacing

Smaller implant resurfaces medial or lateral compartment only; cruciate ligaments preserved

Single-compartment OA, intact ligaments, limited deformity

10–20 years

Suitable patients

Posterior-Stabilised (PS) PCL-sacrificing design

Femoral cam-post mechanism replaces posterior cruciate ligament function

Patients with PCL deficiency, prior PCL injury, or severe deformity requiring correction

15–25 years

When indicated

Revision / Constrained High-constraint system

Stems extending into femoral and tibial canals; greater mechanical constraint for ligament-deficient knees

Revision surgery, severe bone loss, significant ligament insufficiency

10–20 years

Revision cases

Dr Inam discusses implant selection with each patient before surgery. The best implant is the one correctly matched to the patient’s anatomy, bone quality, and lifestyle — not the most expensive or most marketed option.

Knee Replacement Recovery — What to Expect

Recovery from knee replacement follows a predictable sequence, but its pace is individual. What matters most is understanding what is normal at each stage — and what requires urgent review.

Day 1–3 — Hospital

Standing, walking & swelling management

Physiotherapy begins on the first day. The goal is to stand, transfer safely, and begin walking with a frame. Pain is well-controlled with regular analgesia and nerve block. The knee will be warm and swollen — this is normal and expected. DVT prophylaxis medication is started immediately.

Week 1–2 — Home recovery

Wound care & early exercises

Discharge at 3–5 days with crutches or a frame and a structured home exercise programme. Wound inspection at 10–14 days. Priority exercises: knee straightening (extension) and gentle bending (flexion) — achieving full extension is the most important early milestone.

Week 2–6 — Progressive independence

Building range of motion & strength

Transitioning from a frame to a single crutch, then walking unaided. Stair climbing is relearned — good leg up, operated leg down. Driving resumes at 6–8 weeks once quad strength and reaction time allow safe braking. Swelling reduces but may persist for 3–6 months — this is normal.

Month 2–3 — Functional restoration

Return to daily activities

Most daily activities — cooking, light household tasks, short walks — are possible by 6–8 weeks. Physiotherapy focuses on quadriceps strengthening, balance, and normalising gait. A limp that was present for years before surgery takes several months to fully correct as muscle memory and strength recover.

Month 3–6 — Full independence

Walking distances & light activity

Walking distances increase progressively. Cycling (stationary or road) and swimming are the best low-impact exercises for maintaining knee function long-term. Most patients achieve their best pain relief and functional level by 6 months. Some continue improving for up to 12 months.

Long term — Implant care

Annual reviews & lifestyle adaptation

Modern implants last 15–25 years with appropriate activity. High-impact sport and running are avoided permanently. Periodic X-ray reviews at OAIC monitor implant position and detect early loosening. Any new pain, swelling, or instability in a replaced knee should be assessed promptly — never assumed to be normal.

A Note on Prayer, Floor-Level Activities & Daily Life in KPK

Deep knee flexion — fully squatting, kneeling, and sitting cross-legged — is restricted after total knee replacement to protect the implant from dislocation and excessive wear. This has real implications for daily life in Peshawar and KPK, where floor-level prayer, floor sitting, and squatting are habitual. Dr Inam addresses this directly at the pre-operative consultation. Most patients can perform namaz on a chair without difficulty. Many Islamic scholars confirm the permissibility of seated prayer following surgery when kneeling causes genuine harm. Practical adaptations — raised toilet seats, chair seating arrangements, modified squatting postures — are discussed as part of the discharge plan, because restoring quality of life in the context patients actually live in is the point of the surgery.

Why Patients Across KPK Choose OAIC for Knee Replacement

🏅 Arthroplasty Fellowship — Italy

Dr Inam completed a dedicated Fellowship in Arthroplasty in Italy — subspecialty training specifically covering total and partial knee replacement, deformity correction, and complex revision surgery. The techniques and implant selection approach used at OAIC reflect this international training standard.

🎓 FCPS · FRCS UK · FACS

Three of the most rigorous surgical qualifications in the world, held simultaneously. The surgical standard at OAIC reflects training across Pakistan, the UK, and the United States — uncommon among orthopaedic surgeons practising in Peshawar.

🏥 Full Hospital Infrastructure

Knee replacement is performed at Lady Reading Hospital MTI Peshawar — a major tertiary centre with full anaesthetic, ITU, blood bank, and post-operative nursing capability. Patients receive the perioperative safety infrastructure that major elective joint surgery requires.

🩺 Rheumatology Expertise Built In

Patients with rheumatoid arthritis or other inflammatory joint disease requiring knee replacement need their systemic medications managed correctly around surgery. Dr Inam’s Certificate in Rheumatology (AACME USA) ensures this is handled without a separate referral chain.

📋 No Premature Surgery

Many patients attending OAIC have been told elsewhere they need immediate knee replacement. A significant proportion are found to have options that have not been adequately tried. Surgery is recommended at OAIC only when the clinical evidence clearly shows it is the right next step — not before.

📍 Serving All of KPK

Patients from Peshawar, Charsadda, Mardan, Nowshera, Swabi, Dir, Swat, and across Khyber Pakhtunkhwa attend OAIC for knee replacement surgery — receiving the same standard of arthroplasty care without the expense and disruption of travelling to Lahore or Islamabad.

Clinic Locations & Booking

Main Clinic — Peshawar

Akbar Medical Centre

Address:Clinic 311A, Third Floor, Akbar Medical Centre, Peshawar

Days:Monday – Friday

Hours:4:00 PM – 7:30 PM

Sunday:12:00 PM – 4:00 PM

Charsadda

Haleem Medical Centre

Address:Peshawar Road, Charsadda

Days:Saturday

Hours:9:00 AM – 7:00 PM

Hospital OPD

Lady Reading Hospital MTI

Address:Department of Orthopaedics, LRH MTI, Peshawar

Phone:091-9211430

For complex fractures and surgical procedures requiring hospital facilities.

Frequently Asked Questions

Q 1 Who is the best knee replacement surgeon in Peshawar?

Dr Muhammad Inam Khan at OAIC is among the most experienced knee replacement surgeons in Peshawar and KPK. He holds FCPS, FRCS (UK), and FACS, and completed a dedicated Fellowship in Arthroplasty in Italy covering total and partial knee replacement, deformity correction, and revision surgery. He performs knee replacement at Lady Reading Hospital MTI and consults at Akbar Medical Centre, Monday to Friday from 4:00 PM.

Q 2 How long does a knee replacement last?

Around 82% of total knee replacements remain functional at 25 years. Implant longevity depends on the patient’s age, body weight, activity level, bone quality, and implant type. Younger and heavier patients experience more wear over time. Regular follow-up X-rays at OAIC allow early detection of any loosening or component issue before it becomes significant.

Q 3 What is the recovery time for knee replacement surgery in Peshawar?

Most patients are walking with a frame on the day of or morning after surgery. Discharge occurs at 3–5 days. Walking without a stick is typically achieved by 4–6 weeks. Driving resumes at 6–8 weeks. Full functional recovery — walking distances, climbing stairs, and managing daily activities comfortably — takes 3–6 months. Optimal strength and gait can continue improving for up to 12 months.

Q 4 What is the difference between total and partial knee replacement?

Total knee replacement resurfaces all three compartments of the knee. Partial (unicompartmental) replacement resurfaces only the single damaged compartment, preserving the healthy cartilage and both cruciate ligaments. Partial replacement produces a more natural-feeling knee and faster recovery, but is only appropriate when arthritis is confined to one compartment and the ligaments remain intact. Dr Inam assesses suitability for each approach individually.

Q 5 Can I pray on the floor or squat after knee replacement?

Deep knee flexion — squatting fully, kneeling, and sitting cross-legged — is restricted after total knee replacement to protect the implant. Most patients can perform namaz seated on a chair. Dr Inam discusses practical adaptations for floor-level prayer and daily activities specific to life in KPK at the pre-operative consultation. Many Islamic scholars confirm the validity of seated prayer when kneeling causes documented medical harm — and Dr Inam is familiar with supporting patients through this conversation.

Q 6 Is knee replacement surgery available in Peshawar without going to Lahore?

Yes. Total and partial knee replacement is performed at OAIC by Dr Muhammad Inam Khan at Lady Reading Hospital MTI, Peshawar. Patients from across KPK — Charsadda, Mardan, Nowshera, Swabi, Dir, Swat — attend OAIC for knee arthroplasty with full pre-operative assessment, surgery, and post-operative follow-up in Peshawar.

Q 7 My knee replacement done elsewhere is painful — what should I do?

Pain, swelling, stiffness, or instability in a previously replaced knee should never be assumed to be normal ageing or expected discomfort. It requires assessment. Possible causes include implant loosening, polyethylene wear, infection, instability, or malalignment — each requiring a different management approach. Bring your previous surgical records and implant details to the consultation at OAIC. Dr Inam performs revision knee replacement and will advise on the appropriate next step after imaging review.

Q 8 I am overweight — can I still have knee replacement?

Obesity significantly increases the risk of wound complications, infection, and implant wear after knee replacement. At OAIC, patients who are significantly overweight are counselled on the benefits of pre-operative weight loss — even a modest reduction of 5–10 kg improves surgical outcomes and implant longevity meaningfully. In some cases, weight management is pursued first and surgery planned once a safer BMI is achieved. Dr Inam advises honestly on the balance between the risk of delay and the risk of surgery at the current weight, without refusing care to patients who genuinely need it.

Knee Pain in Peshawar? Find Out If You Need Replacement.

Most patients with knee pain can be managed without surgery for years — but when replacement is needed, the earlier it is correctly planned, the better the outcome.

Peshawar Clinic: Mon–Fri 4:00 PM – 7:30 PM · Sunday 12:00 PM – 4:00 PM | Charsadda: Saturday 9:00 AM – 7:00 PM

Start typing to see products you are looking for.