Breakthrough for SJMC with first total knee replacement surgery

Subang Jaya Medical Centre (SJMC) recently made a breakthrough when it performed the first Total Knee Replacement (TKR) surgery as a day care service in Malaysia, which enables patients to walk home on the day of their surgery.

A TKR surgery is performed to resurface the knee by replacing it with an artificial joint, commonly performed on patients with degenerated knees due to medical conditions such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis as a result of an injury.

The first case of day care TKR in Malaysia was performed on a 59-year-old patient in November 2021 by a team of experienced medical professionals from SJMC. The patient sought treatment from SJMC for her severe knee osteoarthritis. 

Conventional TKR surgery requires hospitalisation for three to five days but the revolutionary day care service allows for reduced recovery time in hospital and contributes to greater savings for patients who can be discharged on the day of surgery.

The team who made the TKR surgery a success consisted of consultant orthopaedic surgeon Dato’ Dr Siva Kumar Ariaretnam, consultant anaesthesiologist Dr Gunalan Palari, physiotherapist Milya Shazlin Mohd Ghazali, Home Connect Service head nurse Lee Sin Ying and staff nurse Wan Nur ’Atiqah Wan AB Razab.

Dato’ Dr Siva Kumar Ariaretnam said their success stemmed from two decades of careful technical improvements and adaptations to improve the overall patient experience while lowering complication rates and improving longevity of the implants.

“A great deal of care and technical expertise is employed to ensure that pain is reduced to allow rapid recovery and return to function after surgery. This is made possible by using a muscle-sparing approach into the knee and includes a superior wound-closure technique which I developed and am particularly passionate about,” Dr Siva said.

“It’s flexible enough to allow full knee flexion or bending immediately after surgery, and robust enough not to result in wound dehiscence or breakdown after surgery. This is then balanced with a novel intra-articular injection for effective pain management for the surgical procedure as well as post-surgery. Precise identification of the needed pain relief is critical in pain management.

“Another important factor is the management of bleeding and blood loss to ensure that patients may return home without further bleeding from the wound,” Dr Siva added. 

The procedure is followed by a complete rehabilitation programme alongside specialized physiotherapy sessions offered through SJMC’s in-house home-care nursing service, Home Connect Service, to ensure that patients receive the highest quality of care while recovering at home.