Knee Replacement Surgery in Pokhara: Procedure, Recovery & Cost at A&B Hospital
Knee replacement surgery is one of the most performed orthopedic procedures globally — and for good reason. When the cartilage inside your knee joint has worn away, leaving bone grinding against bone, conservative treatments like physiotherapy and injections can no longer provide meaningful relief. Total knee replacement (TKR) replaces the damaged surfaces of the knee joint with precision-engineered implants, restoring pain-free movement and function.
Until recently, Nepali patients traveling from Pokhara often had to go to Kathmandu or India for knee replacement. A&B International Hospital now performs total knee replacement in Pokhara using American orthopedic technology, with ECHS cashless coverage available for eligible ex-servicemen and their dependents.
What Is Total Knee Replacement Surgery?
Total knee replacement is a surgical procedure in which the damaged cartilage and bone surfaces of the knee joint are removed and replaced with metal and plastic implant components. The goal is to eliminate pain, restore joint alignment, and return the patient to functional mobility.
The knee joint has three compartments: the medial (inner), lateral (outer), and patellofemoral (kneecap) compartments. In total knee replacement, all three are resurfaced. In partial (unicompartmental) knee replacement, only the most affected compartment is replaced — an option appropriate for select patients with localized disease.
The implant components typically consist of:
- A metal femoral component (caps the end of the thigh bone)
- A metal tibial base plate (anchors to the top of the shin bone)
- A polyethylene plastic spacer (sits between the two metal components)
- A plastic patellar button (optional, resurfaces the kneecap)
American-standard implants used at A&B are manufactured to tight engineering tolerances using cobalt-chromium alloys for the metal components and highly cross-linked polyethylene for the bearing surface — materials chosen for durability, wear resistance, and biocompatibility.
When Is Knee Replacement Surgery Necessary?
Knee replacement is necessary when severe joint damage causes constant pain, significant functional loss, and all non-surgical options have been fully tried without adequate relief over a period of at least three to six months.
Specific indications include:
- End-stage osteoarthritis — X-ray evidence of bone-on-bone contact with no cartilage space remaining
- Severe rheumatoid arthritis — joint destruction despite disease-modifying medications
- Post-traumatic arthritis — joint damage following old fractures or ligament injuries
- Avascular necrosis — death of bone tissue in the femoral condyle
- Failed conservative treatment — physiotherapy, weight loss, NSAIDs, and cortisone injections no longer controlling symptoms
Age and body weight alone are not disqualifying factors. The decision is based on symptom severity, functional limitation, X-ray findings, and overall health status. Many active patients in their 50s and 60s benefit enormously from timely knee replacement, while some 80-year-olds may not be appropriate surgical candidates due to comorbidities.
What Happens During the Knee Replacement Procedure?
The surgical procedure is performed under spinal or general anesthesia, typically takes 1.5 to 2.5 hours, and follows a precise sequence of steps to ensure correct implant positioning.
Step-by-step procedure:
- Anesthesia administration — usually spinal anesthesia, which numbs the lower body while keeping the patient awake or lightly sedated
- Surgical incision — a 15–20 cm incision over the front of the knee
- Bone preparation — damaged cartilage and bone surfaces are removed using precision cutting guides aligned to the patient’s anatomy
- Implant trialing — trial components are placed and the knee is tested for range of motion and stability
- Implant fixation — final components are cemented or press-fit into position
- Closure — layers of tissue are sutured and the knee is dressed; a drain may be placed
Surgical precision in cutting guide alignment directly determines long-term implant performance. Poorly aligned implants wear faster and cause pain. A&B’s use of American instrumentation systems is specifically designed to improve alignment accuracy.
What Does Recovery from Knee Replacement Look Like?
Recovery from knee replacement surgery follows a predictable timeline, but individual progress varies based on age, pre-surgical fitness, and adherence to physiotherapy.
Recovery milestones:
| Timeframe | Expected Progress |
|---|---|
| Day 1 | Sitting up, beginning ankle pumps, physiotherapy assessment |
| Day 2–3 | Standing with support, first steps with walker |
| Day 3–5 | Discharge from hospital (in most uncomplicated cases) |
| Week 2–3 | Walking with a cane, wound check, suture removal |
| Week 6 | Driving (for left knee in automatics), light daily activities |
| Month 3 | Most patients walking without aids on flat ground |
| Month 6 | Return to low-impact activities: swimming, cycling, light hiking |
| Year 1 | Full functional recovery; long-term implant performance established |
Physiotherapy begins on the day after surgery. Range of motion exercises, quadriceps activation, and gradual weight-bearing are critical in the first two weeks. A&B’s physiotherapy team coordinates directly with the orthopedic team so rehabilitation is integrated, not incidental.
What Is the Post-Surgery Physiotherapy Plan at A&B?
Physiotherapy after knee replacement at A&B follows a structured, phased protocol beginning the day after surgery and continuing for three to six months, with the goal of restoring full functional range of motion and independent walking.
Phase 1 (Days 1–14): Passive and active-assisted range of motion exercises, quadriceps sets, straight leg raises, walking with a walker, swelling management (ice, elevation)
Phase 2 (Weeks 2–6): Progressing to a cane, stair training, stationary cycling, increasing knee flexion to 90+ degrees
Phase 3 (Weeks 6–12): Strengthening exercises, balance training, transition to unsupported walking, activity-specific conditioning
Phase 4 (Months 3–6): Return to daily activities including light trekking, temple climbing, and community mobility
What Does Knee Replacement Cost in Pokhara Compared to India or Kathmandu?
Knee replacement surgery in Pokhara at A&B International Hospital is substantially less expensive than in India or Kathmandu private hospitals, with comparable or superior implant quality thanks to American-standard components.
Approximate cost comparison (total package including implant, surgery, anesthesia, hospital stay):
- India (Delhi/Mumbai private hospital): INR 2,50,000–4,50,000 (approx. NPR 4,00,000–7,20,000)
- Kathmandu private hospital: NPR 3,50,000–5,50,000
- A&B International Hospital, Pokhara: Competitive pricing with American-standard implants — contact the hospital directly for current package rates
For ECHS-eligible patients, the cost burden is eliminated under cashless coverage guidelines. ECHS empanelment at A&B means ex-servicemen do not need to travel to Kathmandu or cross the border for covered knee replacement surgery.
What Are the Risks and Complications of Knee Replacement?
Knee replacement is a safe procedure with well-established outcomes, but like all major surgeries it carries defined risks that patients must understand before consenting to the procedure.
Reported risks include:
- Deep vein thrombosis (DVT) — blood clots in leg veins, prevented with blood thinners and early mobilization
- Infection — superficial wound infection (managed with antibiotics) or deep periprosthetic infection (rare, serious, may require revision surgery)
- Implant loosening — usually occurs years after surgery if alignment was poor or infection occurred
- Nerve or blood vessel injury — rare, usually transient numbness
- Persistent pain — a minority of patients (5–8%) report ongoing pain despite technically successful surgery
- Stiffness — inadequate physiotherapy compliance is the most common cause
- Implant wear — modern implants last 15–25 years; revision surgery becomes necessary in some patients over time
The overall success rate for total knee replacement exceeds 90% at 10-year follow-up in well-selected patients with appropriate implants.
Book Your Knee Replacement Consultation in Pokhara
If knee pain is limiting your ability to walk, climb stairs, pray, or work — and conservative treatments have not helped — it is time to discuss surgical options with an orthopedic specialist.
A&B International Hospital
Pokhara-02, Bindhyaabasini
Phone: +977 061-412512
Website: abinthospital.com
ECHS-eligible patients receive cashless coverage for knee replacement surgery at A&B. Walk in or call to schedule a consultation with our orthopedic team. Emergency orthopedic care is available 24/7.
