Total Hip Replacement Surgery Best Hospitals in India

Hip replacement, also called total hip arthroplasty, is a surgical procedure to replace a worn out or damaged hip123hip joint with a prosthesis (an artificial joint). This surgery may be an option after a hip fracture or for severe pain due to arthritis.

 

 

Various types of arthritis may affect the hip joint:

  • Osteoarthritis. This is a degenerative joint disease that affects mostly middle-aged and older adults. It may cause the breakdown of joint cartilage and adjacent bone in the hips.
  • Rheumatoid arthritis. This type of arthritis causes inflammation of the synovial lining of the joint and results in excessive synovial fluid. It may lead to severe pain and stiffness.
  • Traumatic arthritis. This is arthritis resulting from an injury. It may also cause damage to the hip cartilage.

Why might I need hip replacement surgery?

Hip replacement surgery is a treatment for pain and disability in the hip. The most common condition that results in the need for hip replacement surgery is osteoarthritis.

Osteoarthritis causes loss of joint cartilage in the hip. Damage to the cartilage and bones limits movement and may cause pain. People with severe pain due to degenerative joint disease may be unable to do normal activities that involve bending at the hip, such as walking or sitting, because they are painful.

Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a hip injury, can also lead to degeneration of the hip joint.

Hip replacement may also be used as a method of treating certain hip fractures. A fracture is an injury often from a fall. Pain from a fracture is severe and walking or even moving the leg is difficult.

If medical treatments are not effectively controlling arthritis pain, hip replacement may be an option. Some medical treatments for degenerative joint disease may include:

  • Anti-inflammatory medications
  • Glucosamine and chondroitin sulfate
  • Pain medications
  • Limiting painful activities
  • Assistive devices for walking (such as a cane)
  • Physical therapy

There may be other reasons for your healthcare provider to recommend a hip replacement surgery.

What are the risks of hip replacement surgery?

As with any surgical procedure, complications can occur. Some possible complications may include:

  • Bleeding
  • Infection
  • Blood clots in the legs or lungs
  • Dislocation
  • Need for revision or additional hip surgery
  • Nerve injury resulting in weakness or numbness

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider prior to the procedure.

How do I get ready for hip replacement surgery?

  • Your healthcare provider will explain the procedure to you and offer you the chance to ask any questions that you might have about the procedure.
  • You may be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
  • In addition to a complete medical history, your healthcare provider may perform a complete physical exam to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
  • Tell your healthcare provider if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
  • Tell your healthcare provider of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
  • Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
  • If you are pregnant or suspect that you are pregnant, you should notify your healthcare provider.
  • You will be asked to fast for 8 hours before the procedure, generally after midnight.
  • You may receive a sedative prior to the procedure to help you relax.
  • You may meet with a physical therapist prior to your surgery to discuss rehabilitation.
  • Stop smoking, as smoking can delay wound healing and slow down the recovery period.
  • Lose weight if needed.
  • Perform conditioning exercises as prescribed to strengthen muscles.
  • Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
  • Based on your medical condition, your healthcare provider may request other specific tests or exams.

What happens during hip replacement surgery?

Hip replacement requires a stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Hip replacement surgery is performed while you are asleep under general anesthesia or sedated under spinal anesthesia. Your anesthesiologist will discuss this with you in advance.

Generally, hip replacement surgery follows this process:

  • You will be asked to remove clothing and will be given a gown to wear.
  • An intravenous (IV) line may be started in your arm or hand.
  • You will be positioned on the operating table.
  • A urinary catheter may be inserted (after you are asleep).
  • The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  • The skin over the surgical site will be cleansed with an antiseptic solution.
  • The doctor will make an incision in the hip area.
  • The doctor will remove the damaged parts of the hip joint and replace them with the prosthesis. The hip prosthesis is made up of a stem that goes into the femur (thighbone), the ball (head joint) that fits into the stem, and a cup that is inserted into the socket of the hip joint. The stem and cup are made of metal. The ball may be made of metal or ceramic. The cup has a liner that may be made of plastic or ceramic. The two most common types of artificial hip prostheses used are cemented prostheses and uncemented prostheses. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis. Sometimes, a combination of the two types is used to replace a hip.
  • The incision will be closed with stitches or surgical staples.
  • A drain may be placed in the incision site to remove fluid.
  • A sterile bandage or dressing will be applied.

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Total Hip Replacement Surgery Best Hospitals in India

Best Liver Cancer Treatment Hospitals in India

Overview

Liver cancer is cancer that begins within the cells of your liver. Your liver may be a football-sized organ that sits within the upper right portion of your abdomen, beneath your diaphragm and on top of your stomach.Liver Cancer Stages 1

Several forms of cancer can type within the liver. the most common variety of liver cancer is hepatocellular carcinoma, that begins within the main variety of liver cell (hepatocyte). different forms of liver cancer, like intrahepatic cholangiocarcinoma and hepatoblastoma, area unit much less common.
Not all cancers that have an effect on the liver area unit thought of liver cancer. Cancer that begins in another space of the body — like the colon, lung or breast — and so spreads to the liver is termed metastatic cancer rather than liver disease. And this sort of cancer is named when the organ during which it began — like metastatic colon cancer to describe cancer that begins within the colon and spreads to the liver. Cancer that spreads to the liver is additional common than cancer that begins within the liver cells.

Symptoms

Read about the possible symptoms of liver cancer and when it’s a good idea to get checked out by your doctor.

Weight loss

This is weight loss when you aren’t dieting. Doctors usually define significant weight loss as more than 10% of your body weight – a stone for every 10 stone you weigh.

See your doctor if there is no obvious explanation for your weight loss.

A swollen tummy (abdomen)

Swelling of the abdomen can happen in liver cancer for 2 reasons:

  • the liver itself can get bigger from the growing cancer. This can cause swelling over the right side of your abdomen.
  • generalized swelling of the abdomen caused by a build up of fluid. This is called ascites.
  • The fluid builds up because the liver is congested. This squeezes the blood vessels inside the liver and the blood that normally flows through it gets backed up in the veins. The pressure in these veins increases and forces fluid to leak from the veins into the abdomen.
  • The veins may grow in size so much that they can be seen underneath the surface of the skin. Fluid also tends to leak out of the veins and into the abdominal cavity if the liver is not able to make blood proteins as it should.

Other symptoms

You may have some discomfort or pain in the tummy (abdomen) caused by the liver getting larger. You may also have pain in the right shoulder. This is caused by the enlarged liver stimulating the nerves under the diaphragm, which are connected to nerves in the right shoulder (referred pain). Your diaphragm is a sheet of muscle just under your ribs.

Other possible symptoms include:

  • loss of appetite over a period of a few weeks
  • being sick
  • feeling full or bloated after eating, even after a small meal
  • itching
  • a sudden worsening of health in somebody with known chronic hepatitis or cirrhosis
  • a high temperature and sweating

Benign liver growths (non cancerous growths)

Most growths in the liver are benign. These are not cancer. Many benign growths can be treated without surgery, although some do need an operation. Benign growths of the liver do not go on to develop into cancer.

The most common types of benign growths of the liver are:

  • haemangioma
  • hepatic adenoma
  • focal nodular hyperplasia

Risks and causes

Liver cancer is quite rare but is increasing. We don’t know what causes most liver cancers. But there are some factors that might increase your risk of developing it.

Having any of these risk factors doesn’t mean that you will definitely develop cancer.

  • Cirrhosis
  •  Alcohol
  •  Non alcoholic fatty liver disease
  •  Infection with hepatitis viruses
  •  Smoking
  •  Low immunity
  •  Lupus
  •  Family history
  •  Diabetes
  •  Gallbladder removal
  •  Radiation from X-rays or CT scans
  •  Body weight
  •  Betel quid
  •  Aflatoxin
  •  Chemicals

Treatment Overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Treatment options and recommendations depend on several factors:

  • How much of the liver is affected by the cancer
  • Whether the cancer has spread
  • The patient’s preferences and overall health
  • The damage to the remaining cancer-free area of the liver

When a tumor is found at an early stage and the patient’s liver is working well, treatment is aimed at trying to eliminate the cancer. The care plan may also include treatment for symptoms and side effects, an important part of cancer care. When liver cancer is found at a later stage, or the patient’s liver is not working well, the patient and doctor should talk about the goals of each treatment recommendation. At this point, the goals of treatment may focus on slowing growth of the cancer and relieving symptoms to improve quality of life.

The various disease-directed treatment options can be grouped according to whether they may cure the cancer or will improve survival but will most likely not eliminate the cancer. Descriptions of the most common treatment options, both disease-directed and those aimed at managing side effects and symptoms, are listed below. Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. It is likely to be the most successful disease-directed treatment, particularly for patients with a tumor smaller than 5 cm. If the tumor has spread outside the liver, or if the patient has other serious illnesses, surgery may not be an option. A surgical oncologist is a doctor who specializes in treating cancer using surgery. Learn more about the basics of cancer surgery.

Two types of surgery are used to treat HCC:

  • When a portion of the liver is removed, the surgery is called a hepatectomy. A hepatectomy can be done only if the cancer is in one part of the liver and the liver is working well. The remaining section of liver takes over the functions of the entire liver. The liver may grow back to its normal size within a few weeks. A hepatectomy may not be possible if the patient has advanced cirrhosis, even if the tumor is small.

The side effects of a hepatectomy may include pain, weakness, fatigue, and temporary liver failure. The health care team will watch for signs of bleeding, infection, liver failure, or other problems that need immediate treatment.

  • Liver transplantation.Sometimes, a liver transplantation can be done. This procedure is possible only when the cancer has not spread outside the liver, a suitable donor is found, and very specific criteria are met in terms of tumor size and number. These criteria usually are a single tumor 5 cm or smaller or 3 or fewer tumors, all of which are smaller than 3 cm. It is important to understand that the number of donor livers available is very limited, so transplantation is not always an option.

After a transplant, the patient will be watched closely for signs that the body might be rejecting the new liver or that the tumor has come back. The patient must take medication to prevent rejection. These drugs can cause side effects, such as puffiness in the face, high blood pressure, or increased body hair.

Liver transplantation is a particularly effective treatment for people with a small tumor because transplantation removes the tumor and the damaged liver. However, there are few donors, and people waiting for a liver transplant may have to wait for a long time before a liver becomes available. During this time, the disease may get worse. The transplant center will advise you on how long the wait is likely to be and what rules are used to prioritize people on the waiting list.

Thermal ablation

Radio frequency ablation (RFA) and microwave therapy both use heat to destroy cancer cells. They may be given through the skin, through laparoscopy, or during a surgical operation while a patient is sedated. Sedation is giving medication to become more relaxed, calm, or sleepy.

Percutaneous ethanol injection

Percutaneous ethanol injection is when alcohol is injected directly into the liver tumor to destroy it. Side effects include fever and pain after the procedure. In general, the procedure is simple, safe, and particularly effective for a tumor smaller than 3 cm. However, if the alcohol escapes from the liver, a person may have brief but severe pain. This option is currently being used less often and has been largely replaced by RFA (see above).

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist.

  • Stereo-tactic body radiation therapy (SBRT).SBRT is a term that describes several methods of delivering high doses of radiation to a tumor while limiting the amount of radiation to which healthy tissues are exposed. This is important because healthy liver tissue can be damaged by radiation. SBRT effectively treats tumors that are approximately 5 cm or smaller. However, it is still considered investigational compared to thermal ablation (see above) because little long-term information about its effectiveness exists.
  • Radioembolizationis similar to chemoembolization (see below), except that during radioembolization, a doctor places radioactive beads into the artery that supplies the tumor with blood. The beads deliver radiation directly into the tumor when they become trapped in the small blood vessels of the tumor.

Side effects may include damage to the stomach and lungs. However, these side effects can often be prevented. Learn more about the basics of radiation therapy.

Chemoembolization

This is a type of chemotherapy treatment that is similar to hepatic arterial infusion (see below). Chemotherapy is the use of drugs to destroy cancer cells. During this procedure, drugs are injected into the hepatic artery, and the flow of blood through the artery is blocked for a short time so the chemotherapy stays in the tumor longer. Blocking the blood supply to the tumor also destroys cancer cells.

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Best Liver Cancer Treatment Hospitals in India

Best Robotic Prostate Surgery Hospitals in India

Robotic Prostate Surgery

Robotic prostate cancer surgery using the da Vinci system offers several advantages over the traditional laparoscopic surgical method of treating prostate cancer when objectively compared in the following areas:

  • Clinically Superior Results
  • Reduced Risk of Complications
  • Quicker Recovery Period
  • Minimize Scarring

Clinically Superior Results With Robotic Prostate Cancer Surgery    

The da vinci robotic prostate cancer surgery system is ready to produce superior clinical prostate cancer treatment results compared to non-robotic traditional and scope-assisted procedures.robotic-prostate-cancer-surgery 1.jpg this is often as a result of the da vinci system’s surgeon Console is provided to produce the surgeon with a revolutionary, three-dimensional, multi-level magnification spectrum. additional ancient scope-assisted surgery generally provides a way lower resolution image, and a way more restricted field of vision. moreover, the da vinci system’s sensitive physical science and one metric linear unit diameter surgical arms enable the surgeon to form extremely precise movements within the incision throughout robotic prostate cancer surgery. this suggests that the malignant tissue is removed with Associate in Nursing efficiency and ease unparalleled before the era of robotic surgery. This bigger precision reduces the likelihood of relapse because of missed cancerous tissue. The exactness of the da vinci system also permits the surgeon to avoid damaging healthy prostate tissue, that improves clinical results, reduces scar tissue build up, and contributes to an overall shorter recovery amount when robotic prostate surgery.

Reduced Risk of Complications With Robotic Prostate Surgery

Surgery is an inherently risky medical procedure. However, for prostate cancer treatment, surgery can be the most effective choice for eradicating malignant tumors without the painful side effects of chemotherapy and radiation therapy. Among the more serious risks associated with surgical treatment is the possibility of infection at the incision site. ro 2Such infections are often the primary cause of serious complications which may hamper a quick and uneventful recovery. The da Vinci system greatly mitigates the risk of infection during robotic prostate surgery. First, the size of the incision(s) is significantly smaller with robotic prostate surgery than with the traditional procedure. A standard, non-robotic prostate surgery requires a six- to eight-inch vertical incision to the abdomen. A large, open incision increases the patient’s susceptibility to bacterial infection during and after the surgery. Post-operative infections are more common than intra-operative infections, as hospital rooms are not maintained at the same level of sterility which operating rooms are. The da Vinci robotic prostate surgery system utilizes a much less invasive technique  requiring four to five small incisions, each less than two inches. These smaller incisions will heal significantly faster than the large incision needed in traditional surgery.

Quicker Recovery Period After Robotic Prostate Surgery

When a physician determines robotic prostate surgery is the best prostate cancer treatment option, da Vinci’s robotic technology optimizes the chances of  a quicker recovery time as opposed to traditional surgical prostatectomy. The smaller incisions required to maneuver the operating arms heal much faster, require fewer sutures and, therefore, are less vulnerable to tearing or infection. The precise movements of the robotic arms  allow a more targeted approach for cleaner removal of malignant tissue and reduces damage to healthy tissue during robotic prostate surgery. The operating arms of the da Vinci Surgical System are designed to avoid contact between the operating instruments and the walls of the incision. All of these advantages translate to a speedier and less worrisome recovery period.

Minimal Scarring After Robotic Prostate Cancer Surgery

The sheer size of the incision needed for a traditional prostatectomy produces significant scarring in the patient’s lower abdomen. The robotic prostate surgery procedure leaves incisions which heal with little or no visible scarring. In addition to the obvious aesthetic value, minimizing scar tissue on the interior walls of the incision promotes better healing. Excess scar tissue build-up can sometimes interfere with the proper function of the prostate. Although such a complication is rare, it’s worth considering when exploring prostate cancer treatment options. The precision of robotic prostate surgery offers an inherent solution to this potential difficulty. By minimizing the size of the incision needed to remove cancerous tissue, the risk of scar tissue-related complications is greatly mitigated.

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Best Robotic Prostate Surgery Hospitals in India

Best Spinal Fusion Surgery Hospitals in India

What Is Spinal Fusion?

Spinal fusion is a surgical treatment during which two or additional vertebrae are for good joined into one solid bone with no area between them. Vertebrae are the tiny, interlocking bones of the spine.spinal 1
In spinal fusion, extra bone is used to fill the area that sometimes exists between the two separate vertebrae. once the bone heals, there’s no longer area between them.

Spinal fusion is also known as:

  • arthrodesis
  • anterior spinal fusion
  • posterior spinal fusion
  • vertebral interbody fusion

Uses of Spinal Fusion

Spinal fusion is performed to treat or relieve symptoms of many spinal problems. The procedure removes mobility between the two treated vertebrae. This may decrease flexibility, but it’s useful for treating spinal disorders that make movement painful. These disorders include:

  • tumors
  • spinal stenosis
  • herniated “bulging” disks
  • degenerative disk disease
  • fractured vertebrae that may be making your spinal column unstable
  • scoliosis (curvature of the spine)
  • kyphosis (abnormal rounding of the upper spine)
  • spinal weakness or instability due to severe arthritis, tumors, or infections
  • spondylolisthesis (a condition in which one vertebra slips onto the vertebra below it, causing severe pain)

A spinal fusion procedure may also include a diskectomy. When performed alone, a diskectomy involves removing a disk due to damage or disease. When the disk is removed, bone grafts are placed into the empty disk space to maintain the right height between bones. Your doctor uses the two vertebrae on either side of the removed disk to form a bridge (or fusion) across the bone grafts to promote long-term stability.

When spinal fusion is performed in the cervical spine along with a diskectomy, it’s called cervical fusion. Instead of removing a vertebra, the surgeon removes disks or bone spurs from the cervical spine, which is in the neck. There are seven vertebrae separated by intervertebral disks in the cervical spine.

Preparing for Spinal Fusion

Typically, the preparation for spinal fusion is like other surgical procedures. It requires preoperative laboratory testing.

Before spinal fusion, you should tell your physician about any of the following:

  • cigarette smoking, which may reduce your ability to heal from spinal fusion
  • alcohol use
  • any illnesses you have, including colds, the flu, or herpes
  • any prescription or over-the-counter medications you’re taking, including herbs and supplements

You’ll want to discuss how the medications you’re taking should be used before and after the procedure. Your doctor may provide special instructions if you’re taking medications that could affect blood clotting. These include anticoagulants (blood thinners), such as warfarin, and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen.

You’ll be given general anesthesia, so you’ll need to fast for at least eight hours before your procedure. On the day of surgery, use only a sip of water to take any medications your physician has recommended.

How Is Spinal Fusion Performed?

Spinal fusion is performed in the surgical department of a hospital. It’s done using general anesthesia, so you won’t be conscious or feel any pain during the procedure.

During the procedure, you’ll be lying down and have a blood pressure cuff on your arm and heart monitor leads on your chest. This allows your surgeon and anesthesia provider to monitor your heartbeat and blood pressure during surgery. The whole procedure may take several hours.spinal 2.jpg

Your surgeon will prepare the bone graft that will be used to fuse the two vertebrae. If your own bone is being used, your surgeon will make a cut above the pelvic bone and remove a small section of it. The bone graft may also be a synthetic bone or an allograft, which is a bone from a bone bank.

Depending on where the bone will be fused, your surgeon will make an incision for placement of the bone.

If you’re having a cervical fusion, your surgeon will often make a small incision in the horizontal fold of the front of your neck to expose the cervical spine. The bone graft will be placed between the affected vertebrae to join them. Sometimes, the graft material is inserted between the vertebrae in special cages. Some techniques place the graft over the back part of the spine.

Once the bone graft is in place, your surgeon will may use plates, screws, and rods so that the spine won’t move. This is called internal fixation. The added stability provided by the plates, screws, and rods helps the spine to heal faster and with a higher rate of success.

Complications of Spinal Fusion

Spinal fusion, like any surgery, carries the risk of certain complications, such as:

  • infection
  • blood clots
  • bleeding and blood loss
  • respiratory problems
  • heart attack or stroke during surgery
  • inadequate wound healing
  • reactions to medications or anesthesia

Spinal fusion also carries the risk of the following rare complications:

  • infection in the treated vertebrae or wound
  • damage to a spinal nerve, which can cause weakness, pain, and bowel or bladder problems
  • additional stress on the bones adjacent to the fused vertebrae
  • persistent pain at the bone graft site
  • blood clots in the legs that can be life-threatening if they travel to the lungs

The most serious complications are blood clots and infection, which are most likely to occur during the first weeks following surgery.

Contact your doctor or seek emergency help if you experience any of theses symptoms of a blood clot:

  • a calf, ankle, or foot that suddenly swells
  • redness or tenderness above or below the knee
  • calf pain
  • groin pain
  • shortness of breath

Contact your physician or seek emergency help if you experience any of the following symptoms of infection:

  • swelling or redness at the edges of the wound
  • drainage of blood, pus, or other liquid from the wound
  • fever or chills or elevated temperature over 100 degrees
  • shaking

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Best Spinal Fusion Surgery Hospitals in India

Advanced Treatment of Knee Replacement Surgery in India

Overview

Total knee replacement surgery (which is typically known as total knee arthroplasty).
Knee replacement may be a surgical procedure that decreases pain and improves the standard of life in several patients with severe arthritis of the knees. usually patients undergo this surgery once non-operative treatments have did not offer relief of arthritic symptoms.knee 27 Non-operative treatments will include activity modification, anti-inflammatory medications, and knee joint injections.
Surgeons have performed knee replacements for over three decades usually with excellent results; most reports have ten-year success rates in more than 90 percent.

 

Total Knee Replacement

Traditional total knee replacement involves a 7-8” incision over the knee, a hospital stay of 3-5 days, and a recovery period (during which the patient walks with a walker or cane) typically lasting from one to three months. The large majority of patients report substantial or complete relief of their arthritic symptoms once they have recovered from a total knee replacement.

Symptoms

Pain

Pain is the most noticeable symptom of knee arthritis. In most patients the knee pain gradually gets worse over time but sometimes has more sudden “flares” where the symptoms get acutely severe. The pain is almost always worsened by weight-bearing and activity. In some patients the knee pain becomes severe enough to limit even routine daily activities.

Stiffness

Morning stiffness is present in certain types of arthritis. Patients with morning stiffness of the knee may notice some improvement in knee flexibility over the course of the day. Rheumatoid arthritis patients may experience more frequent morning stiffness than patients with osteoarthritis.

Swelling and warmth

Patients with arthritis sometimes will notice swelling and warmth of the knee. If the swelling and warmth are excessive and are associated with severe pain, inability to bend the knee, and difficulty with weight-bearing, those signs might represent an infection. Such severe symptoms require immediate medical attention. Joint infection of the knee is discussed below.

Diagnosis

An orthopedic surgeon will begin the evaluation with a thorough history and physical exam. Based on the results of these steps your doctor may order plain X-rays.

X-rays

If a patient has arthritis of the knee it will be evident on routine X-rays of the joint. X-rays taken with the patient standing up are more helpful than those taken lying down. X-rays with the patient standing allow your physician to view the way the knee joint functions under load (i.e. standing) which provides important treatment clues.

Also, plain X-rays will allow an orthopedic surgeon to determine whether the arthritis pattern would be suitable for total knee replacement or for a different operation such as minimally-invasive partial knee replacement (mini knee).

Treatment

Medications

It is important to distinguish broadly between two types of arthritis: inflammatory arthritis (including rheumatoid arthritis, lupus and others) and non-inflammatory arthritis (such as osteoarthritis).

There is some level of inflammation present in all types of arthritis. Conditions that fall into the category of true inflammatory arthritis are often very well managed with a variety of medications and more treatments are coming out all the time. Individuals with rheumatoid arthritis and related conditions need to be evaluated and followed by a physician who specializes in those kinds of treatments called a rheumatologist. Excellent non-surgical treatments (including many new and effective drugs) are available for these patients; those treatments can delay (or avoid) the need for surgery and also help prevent the disease from affecting other joints.

So-called non-inflammatory conditions including osteoarthritis (sometimes called degenerative joint disease) also sometimes respond to oral medications (either painkillers like Tylenol or non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, celebrex, or vioxx) but in many cases symptoms persist despite the use of these medications.

It is important to avoid using narcotics (such as Tylenol #3, vicoden, percocet, or oxycodone) to treat knee arthritis. Narcotics have many side effects, are habit-forming, and make it harder to achieve pain-control safely and effectively after surgery ,should that become necessary. Narcotics are designed for people with short-term pain (like after a car accident or surgery) or for people with chronic pain who are not surgical candidates. People who feel they need narcotics to achieve pain control should consider seeing a joint replacement surgeon (an orthopedic surgeon with experience in knee replacements) to see whether surgery is a better option.

Surgery

Possible benefits of total knee replacement surgery

Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement (mini knee) is performed the goals and possible benefits are the same: relief of pain and restoration of function.

The large majority (more than 90 percent) of total knee replacement patients experience substantialknee 28.jpg or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most don’t require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you don’t know (s)he even had surgery!

Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.

Surgical options

If a knee surgeon and a patient decide that non-operative treatments have failed to provide significant or lasting relief there are sometimes different operations to choose from.

Knee arthroscopy

If X-rays don’t show very much arthritis and the surgeon suspects (or has identified by MRI) a torn meniscus, knee arthroscopy may be a good choice. This is a relatively minor procedure that is usually done as an outpatient and the recovery is fairly quick in most patients.

However, if X-rays demonstrate a significant amount of arthritis, knee arthroscopy may not be a good choice. Knee arthroscopy for arthritis fails to relieve pain in about half of the patients who try it.

Osteotomy

For younger patients (typically under age 40 but this age cutoff is flexible) who desire to return to a high level of athletic activity or physical work a procedure called osteotomy (which means “cutting the bone”) might be worth considering. This option is suitable only if the arthritis is limited to one compartment of the knee.

Osteotomy involves cutting and repositioning one of the bones around the knee joint. This is done to re-orient the loads that occur with normal walking and running so that these loads pass through a non-arthritic portion of the knee. That’s why it doesn’t work well if more than one compartment of the knee is involved–in those patients there is no “good” place through which the load can be redistributed.

Knee fusion

Knee fusion also called “arthrodesis ” permanently links the femur (thigh bone) with the tibia (shin bone) creating one long bone from the hip to the ankle. It removes all motion from the knee resulting in a stiff-legged gait.

Because there are so many operations that preserve motion this older procedure is seldom performed as a first-line option for patients with knee arthritis. It is sometimes used for severe infections of the knee certain tumors and patients who are too young for joint replacement but are otherwise poor candidates for osteotomy.

Minimally-invasive partial knee replacement (mini knee)

Patients who are of appropriate age–certainly older than age 40 and older is better–and who have osteoarthritis limited to one compartment of the knee may be candidates for an exciting new surgical technique minimally-invasive partial knee replacement (mini knee). Partial knee replacements have been done for over 20 years and the “track record” on the devices used for this operation is excellent. The new surgical approach which uses a much smaller incision than traditional total knee replacement significantly decreases the amount of post-operative pain and shortens the rehabilitation period. The decision of whether this procedure is appropriate for a specific patient can only be made in consultation with a skillful orthopedic surgeon who is experienced in all techniques of knee replacement.

Minimally-invasive partial knee replacement (mini knee) is not for everyone. Only certain patterns of knee arthritis are appropriately treated with this device through the smaller approach.

Generally speaking patients with inflammatory arthritis (like rheumatoid arthritis or lupus) and patients with diffuse arthritis all throughout the knee should not receive partial knee replacements.

Patients who are considering knee replacements should ask their surgeon whether minimally-invasive partial knee replacement (mini knee) is right for them.

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Advanced Treatment of Knee Replacement Surgery in India

Best Pediatric Heart Surgery Hospitals in India

Pediatric Heart Surgery

The news that your kid needs heart surgery isn’t easy to listen to. we tend to understand that you simply can have several queries and concerns about the surgical process and what you’ll expect.pediatric-heart-surgery-1 The expert cardiac surgeons and specially-trained staff at Sacred Heart Children’s Hospital can support your family through every turn.
Our pediatric cardiac surgeons are highly regarded for his or her experience in a very broad vary of congenital repairs.
Your child’s viscus surgery are going to be performed by pediatric cardiac surgeons in one in all the nation’s most advanced surgery centers. Providence Sacred Heart could be a leader within the treatment of heart disease and our extremely trained team offers a wealth of experience in traditional procedures, still as innovative techniques.
As a partner in your child’s cardiac care, we are going to work closely together with your referring physician to help ensure coordinated care throughout your lodge in the hospital and once you come back home.

Pediatric Cardiac Procedures

Once your child’s condition is diagnosed by the pediatric cardiologist, there may be several options to correct the problem.  Some children may not require any intervention, but will simply be checked at intervals by the congenital heart team.  Others may be treated with medication, a catheterization procedure or surgery.

Sacred Heart has long been a leader in the treatment of heart disease and has pioneered a variety of procedures, including minimally-invasive and robotic surgeries that result in less pain, tiny incisions and faster recovery. The medical staff of the Children’s Hospital includes board certified pediatric cardiologists and cardiac surgeons.

Cardiac Catheterization

The cardiac catheterization laboratory is a state-of-the-art facility used for diagnosis and interventional procedures. Cardiac catheterization uses small tubes, called catheters, which are passed through the chambers of the heart and vessels, to measure pressures. This process provides important information on the heart condition, and helps determine if a surgical procedure may be necessary to repair an abnormality.

Interventional catheterizations treat some heart conditions without surgery.  Procedures offered include: valvuloplasty, angioplasty, PDA Closure, coil embolization of vessels, stenting of coarctation of the aorta/vessels, atrial septal defect (ASD) closure, patent foramen ovale (PFO) closure, mitral valvuloplasty, catheter ablation.

Preparing for Pediatric Heart Surgery

Pre-Surgery Preparation

The Pediatric Surgery Center is staffed by pediatric surgeons, child life specialists and specially trained pediatric nurses and anesthesiologists. All possess skills in responding to the special needs of their young patients and families. The Center has a pre-surgery preparation room designed to take the fear and uncertainty out of surgery. A child life specialist familiarizes the child (and parents) with a surgical hat and mask, and provides appropriate, pre-operative teaching so the child knows what to expect. The anesthesiologist and pediatric cardiac surgeon talk with the parents and answer any questions they may have. Parents may stay with their child right up until time for surgery.

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Best Pediatric Heart Surgery Hospitals in India

Best Breast Cancer Surgery Hospitals in India

What Is Breast Cancer?

Breast cancer starts once cells within the breast begin to grow out of control. These
cells typically kind a tumor which will usually be seen on an x-ray or felt as a
lump.breast-surgery The neoplasm is malignant (cancer) if the cells will grow into (invade)
surrounding tissues or unfold (metastasize) to distant areas of the body. Breast
cancer happens nearly entirely in ladies, however men will get breast cancer, too.
Cells in nearly any a part of the body will become cancer and may spread to alternative areas of the body. to be told a lot of concerning what’s cancer and the way all cancers begin and spread, see our section on Cancer Basics.

Breast Cancer Signs and Symptoms:-

Knowing how your breasts normally look and feel is an important part of breast health. Finding breast cancer as early as possible gives you a better chance of successful treatment. But knowing what to look for does not take the place of having regular mammograms and other screening tests. Screening tests can help find breast cancer in its early stages, even before any symptoms appear.

The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancer, but breast cancers can be tender, soft, or rounded. They can even be painful. For this reason, it is important to have any new breast mass or lump or breast change checked by a health care provider experienced in diagnosing breast diseases.

Other possible symptoms of breast cancer include:

  • Swelling of all or part of a breast (even if no distinct lump is felt)
  • Skin irritation or dimpling
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scaliness, or thickening of the nipple or breast skin
  • Nipple discharge (other than breast milk)

Sometimes a breast cancer can spread to lymph nodes under the arm or around the collar bone and cause a lump or swelling there, even before the original tumor in the breast tissue is large enough to be felt. Swollen lymph nodes should also be checked by a health care provider.

Although any of these symptoms can be caused by things other than breast cancer, if you have them, they should be reported to a health care provider so that he or she can find the cause.

Because mammograms do not find every breast cancer, it is important for you to be aware of changes in your breasts and to know the signs and symptoms of breast cancer.

What tests do physicians use to diagnose breast cancer?

Although breast cancer can be diagnosed by the above signs and symptoms, the use of screening mammography has made it possible to detect many of the cancers early before they cause any symptoms.breast-cancer-treatment

Women should have the opportunity to begin annual screening between 40-44 years of age. Women age 45 and older should have a screening mammogram every year until age 54. Women 55 years of age and older should have biennial screening or have the opportunity to continue screening annually. Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer.

Mammograms are a very good screening tool for breast cancer. As in any test, mammograms have limitations and will miss some cancers. An individual’s family history and mammogram and breast exam results should be discussed with a health-care provider.

Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderate risk (15%-20%) should talk to their doctor about the benefits and limitations of adding MRI screening to their yearly mammogram

How are breast cancer stages determined?

Staging is the process of determining the extent of the cancer and its spread in the body. Together with the type of cancer, staging is used to determine the appropriate therapy and to predict chances for survival.

To determine if the cancer has spread, several different imaging techniques can be used.

  • Chest X-ray: It looks for spread of the cancer to the lung.
  • Mammograms: More detailed and additional mammograms provide more images of the breast and may locate other abnormalities.

Computerized tomography (CT scan): These

  • specialized X-rays are used to look at different parts of your body to determine if the breast cancer has spread. It could include a CT of the brain, lungs, or any other area of concern.
  • Bone scan: A bone scan determines if the cancer has spread (metastasized) to the bones. Low level radioactive material is injected into the bloodstream, and over a few hours, images are taken to determine if there is uptake in certain bone areas, indicating metastasis.
  • Positron emission tomography (PET scan): A radioactive material is injected that is absorbed preferentially by rapidly growing cells (such as cancer cells). The PET scanner then locates these areas in your body.

What are breast cancer treatments?

Radiation therapy

Radiation therapy destroys cancer cells with high energy rays. There are two ways to administer radiation therapy.

External beam radiation

This is the usual way radiation therapy is given for breast cancer. A beam of radiation is focused onto the affected area by an external machine. The extent of the treatment is determined by a health-care team and is based on the surgical procedure performed and whether lymph nodes were affected or not.

The local area will usually be marked after the radiation team has determined the exact location for the treatments. Usually, the treatment is given five days a week for five to six weeks.

Chemotherapy

Chemotherapy is treatment of cancers with medications that travel through the bloodstream to the cancer cells. These medications are given either by intravenous injection or by mouth.

Chemotherapy can have different indications and may be performed in different settings as follows:

  • Adjuvant chemotherapy: If surgery has removed all the visible cancer, there is still the possibility that cancer cells have broken off or are left behind. If chemotherapy is given to assure that these small amounts of cells are killed as well, it is called adjunct chemotherapy. Chemotherapy is not given in all cases, since some women have a very low risk of recurrence even without chemotherapy, depending upon the tumor type and characteristics.
  • Neoadjuvant chemotherapy: If chemotherapy is given before surgery, it is referred to as neoadjuvant chemotherapy. Although there seems to be no advantage to long-term survival whether the therapy is given before or after surgery, there are advantages to see if the cancer responds to the therapy and by shrinking the cancer before surgical removal.
  • Chemotherapy for advanced cancer: If the cancer has metastasized to distant sites in the body, chemotherapy can be used for treatment. In this case, the health-care team will need to determine the most appropriate length of treatment.

There are many different chemotherapeutic agents that are either given alone or in combination. Usually, these drugs are given in cycles with certain treatment intervals followed by a rest period. The cycle length and rest intervals differ from drug to drug.

Alternative treatments

Whenever a disease has the potential for much harm and death, physicians search for alternative treatments. As a patient or the loved one of a patient, there may be an inclination to try everything and leave no option unexplored. The danger in this approach is usually found in the fact that the patient might not avail themselves of existing, proven therapies. One should discuss any interest in alternative treatments with a health-care team and together explore the different options.

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Best Breast Cancer Surgery Hospitals in India