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

Hip Replacement Surgery in India

Total Hip Replacement Surgery (THR)

Hip replacement may be a surgical procedure within which the hip joint is replaced by a prosthetic implant. Hip pain is caused by osteoarthritis, fracture, rheumatoid arthritis, and aseptic bone necrosis. typically these conditions improve, however there’s no cure for joint pain and severe cases cannot invariably be controlled by medication and rehabilitation. once this happens, some patients have issue in walking and also the impaired movement hinders everyday activities.Hip-Replacement-Surgery-india These patients typically pick hip replacement surgery. This entails removal of the broken hip and replacement with prosthesis. The prosthetic hip is sometimes made from a combination of metal and plastic.

 

When is it recommended?

Total Hip Replacement is recommended when the patient is suffering from Rheumatoid Arthritis, Osteonecrosis, Injury of the hip joint, or some bone tumors have been diagnosed that are adversely affecting the hip joint. Additionally, if the patient has any of the following conditions then hip replacement is required:

  • Hip arthritis (Primary osteoarthritis)
  • Secondary osteoarthritis (more common in India)
  • Femoral neck fractures with preexisting osteoarthritis
  • Femoral neck fracture, Non unionship
  • Malunited hip socket and ball fractures
  • Avascular necrosis(AVN)
  • Protrusio acetabuli (deep socket)
  • Slipped upper femoral epiphysis
  • Perthes disease
  • Rheumatoid arthritis
  • Ankylosing spondylitis

What are the types of Hip Replacement Surgery?

Following are the various types of Hip Replacement Surgeries:

  • Total Hip Replacement
  • Partial Hip Replacement
  • Hip Resurfacing
  • Minimally Invasive Hip Replacement
  • Double Hip Replacement
  • Revision Hip Replacement

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Hip Replacement Surgery in India

Carpal Tunnel Release Surgery in India

What is the carpal tunnel?

The carpal tunnel could be a narrow canal within the wrist. very cheap and sides of the tunnel are shaped by a semi-circle of bones called carpal bones. a powerful tissue, called a ligament, forms the highest of the tunnel. The median nerve and tendons pass through this narrow area. carpel(The tendons are “rope-like” structures that connect muscles within the forearm to bones within the hand.) Tendons enable the fingers and thumb to bend and straighten. Conditions that further narrow the carpal tunnel or cause the tendons that meet up with this tunnel to swell cause carpal tunnel syndrome by compression the median nerve.

What is carpal tunnel syndrome?

The wrist comprises of several small bones collectively known as the carpal bones. The carpal bones are interconnected via strong ligaments and connective tissue known as the flexor retinaculum. Collectively, this arrangement forms a space known as the carpal tunnel .The carpal tunnel contains numerous flexor tendons from the muscles of the forearm allowing them to attach to the wrist and fingers via the carpal tunnel. In addition, a nerve known as the median nerve lies within the carpal tunnel . The median nerve is responsible for supplying some sensation and motor control to the hand.

Occasionally, the carpal tunnel may narrow resulting in compression of the median nerve. When this occurs, the condition is known as carpal tunnel syndrome. Carpal tunnel syndrome normally occurs following damage to the flexor tendons within the carpal tunnel. This results in swelling and inflammation of the tendons, thereby reducing the dimensions of the carpal tunnel, compressing the median nerve.

Damage to the flexor tendons usually occurs due to overuse of the forearm flexors. During contraction of the forearm flexors, tension is placed through the flexor tendons within the carpal tunnel. When this tension is excessive due to too much repetition or high force, damage to the tendons may occur. This is usually due to gradual wear and tear associated with overuse, however, it may also occur traumatically due to a specific incident. Although carpal tunnel syndrome can occur at any age, it is commonly seen in patients greater than 50. Carpal tunnel syndrome is also more common in women

Symptons :-

The Most Common Symptons of Carpal Tunnel Syndrome Include :-

  • Numbness, tingling, and pain in the handsigns-symptoms-img1
  • An electric shock-like feeling mostly in the thumb, index, and long fingers
  • Strange sensations and pain traveling up the arm toward the shoulder

Symptoms usually begin gradually, without a specific injury. In most people, symptoms are more severe on the thumb side of the hand.

What are the Aims and Benefits of Carpal Tunnel Release Surgery?

  • Relief from Neural Compression
  • Pain Reduction
  • Prevention of Further Deterioration

The chance of obtaining a significant benefit from surgery depends upon a wide variety of factors. Your neurosurgeon will give you an indication of the likelihood of success in your specific case.

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Carpal Tunnel Release Surgery in India

Benefits of Ankle Replacement Surgery in India

What is Ankle Replacement Surgery?

Ankle replacement surgery is used to treat the pain and immobility of severe finish stage arthritis that has not knowledgeable non-surgical treatments. The goal of ankle joint replacement surgery is to eliminate your pain and increase the quality of your ankle joint. arthritis may be a general term covering various conditions wherever the joint surfaces wear out. The joint surface is roofed by a swish articular surface made of animal tissue that enables pain free movement within the joint.ankle-replacement-surgery-3d-printing-3-png This surface will wear out for variety of reasons. typically the definite cause is unknown. once the articular cartilage wears out, the bone ends rub on each other inflicting pain. There square measure various conditions which will cause arthritis and often the precise cause isn’t known.

Types of Ankle Replacement Surgery

Total ankle replacement surgery, conjointly called Total ankle surgery or Endoprosthetic ankle replacement may be a procedure performed for patients with advanced ankle osteoarthritis. The aim of associate ankle replacement is to eradicate persistent pain and preserve ankle quality

Ankle replacement replaces the broken components of the three bones that form up the ankle joint. artificial joint components (prosthetics) area unit wont to replace your own bones. they come in several sizes to suit different-size individuals.

Other indications for ankle joint replacement surgery include:

  • Severe ankle fracture in older patients with osteoporosis, a disease that causes bone loss raises the risk of increased fractures.
  • Tumour or growth in the ankle joint
  • History of previous ankle surgery

Benefits of Ankle Replacement Surgery

  • Relieve pain and restore joint function in patients with end-stage degenerative joint disease resulting from osteoarthritis, traumatic arthritis or rheumatoid arthritis.
  • It helps protect the surrounding joints (eg. subtalar joint) compared to an ankle fusion
  • Gives a good useable range of movement of ankle
  • Ability to maintain movement in the joint
  • Encourages a more normal walking gait pattern

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Benefits of Ankle Replacement Surgery in India

KNEE REPLACEMENT SURGERY IN INDIA

What is Knee Surgery?

The knee has the responsibility of supporting the entire weight of the body which makes it particularly prone to stress and strain. The main aim of Knee Surgery is to increase the mobility and to reduce the pain associated with knee injuries and diseases.

revision-knee-replacement People world – wide are affected by knee problems. This problem is commonly found among people over 50 years of age and those who are overweight. Other reasons of knee pain can be health issues such as bursitis, arthritis, tears in the ligaments, osteoarthritis of the joints, or infections. Each year, millions of people undergo knee surgery and how quickly they recover depends on many factors such as their age, the severity, location of the injury and pre-existing conditions, such as arthritis.

Knee surgery typically refers to total knee replacement, or knee arthroplasty. Knee surgery can be performed arthroscopically or in an open fashion. Special techniques and latest implants ensure return of natural movements. It covers major surgeries like total and partial knee replacement surgery and less invasive procedures like knee arthrothscopy.

What is the cause of knee joint disintegration?

Osteoarthritis

Osteoarthritis occurs from ‘wear and tear’ and is the most common reason for the total knee replacement. It usually occurs after the age of 50 and is a genetic problem. When the tissue covering the bones softens and wears away, the bone began to rub against each other and leads to severe pain.

Rheumatoid Arthritis

When the tissues surrounding the bone releases excessive fluid due to inflammation, it causes damage to cartilage and other parts of the joint and causes pain and stiffness.

Traumatic Arthritis

This type of arthritis usually occurs after a serious knee injury. Due to the knee fracture, the connective tissue and the tissue covering the ends of the bone wears away, resulting in pain and stiffness.

Types of Knee Replacement Surgery

There are two main types of surgery, depending on the condition of the knee:

•Total Knee Replacement (TKR) – both sides of your knee joint are replaced

• Partial (half) Knee Replacement (PKR) – only one side of your joint is replaced in a smaller operation with a shorter hospital stay and recovery period

Knee surgery is recommended for older people, although adults or teenagers of any age can be candidates for the procedure, since they are physically active and will more rapidly wear the joint out. The weight, gender, or age of the person is never a factor when considering knee replacement surgery. When considering the option of knee replacement surgery, doctors take into account a number of symptoms:

• Severe knee pain or stiffness: Do symptoms seriously undermine the patient’s ability to carry out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair, etc?

• Moderate but continuous knee pain: Is pain present while sleeping or resting?

• Chronic knee inflammation and swelling: Does the swelling not improve after taking medications or resting? Do drugs cause unpleasant side effects?

• Knee deformity: Is there is a noticeable arch in the inside or outside of the knee?

• Nothing else worked: The doctor has prescribed medications and physical therapy without any substantial improvement.

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KNEE REPLACEMENT SURGERY IN INDIA

Total Hip Joint Replacement and Hip Resurfacing Surgery at World Best Hospitals in Indi

Total hip replacement (THR) is a treatment option for late-stage degenerative hip disease, also known as osteoarthritis or degenerative arthritis. THR is one of the most successful and common surgical procedures in orthopedic surgery. In addition to marked reduction in pain and improvement in sleep, most people regain range of motion, physical ability, and quality of life.

• The hip joint is composed of a ball and socket, with the surface of each covered by cartilage.

• A number of conditions and diseases can cause the cartilage surfaces to degenerate, which in turn leads to pain, stiffness, loss of hip joint range of motion, and disability.

• Surgeons replace both the ball (femoral head) and socket (acetabulum) during total hip replacement surgery

When is it recommended?
Total Hip Replacement is recommended when the patient is suffering from Rheumatoid Arthritis, Osteonecrosis, Injury of the hip joint, or some bone tumors have been diagnosed that are adversely affecting the hip joint. Additionally, if the patient has any of the following conditions then hip replacement is required:

• Hip arthritis (Primary osteoarthritis)

• Secondary osteoarthritis (more common in India)

• Femoral neck fractures with preexisting osteoarthritis

• Femoral neck fracture, Non unions

• Malunited hip socket and ball fractures

• Avascular necrosis(AVN)

• Protrusio acetabuli (deep socket)

• Slipped upper femoral epiphysis

• Perthes disease

• Rheumatoid arthritis

• Ankylosing spondylitis

Types and techniques of Hip Joint Replacement Surgery

There are specifically two types of Hip replacement surgeries, one that is most commonly used is the Total hip replacement surgery and the other one is the semi (half) hip replacement surgery. The surgeons adopt various techniques to do these surgeries.

 

Anterior Hip Replacement Surgery/Operation:
Anterior hip replacement technique is also known as mini anterior approach towards hip replacement. It provides similar results as the traditional hip replacement procedure of replacing worn out bones of the hip joints with prosthetic implants. The only difference in anterior technique is that the method of opening the body to reach for hip joint. It has emerged as a feasible substitute of posterior or traditional approach.

While undergoing the anterior hip replacement operation the orthopedic surgeon uses a small incision that’s approximately 4 inches long; which is located in front of the leg or hip portion, through this approach the surgeon can easily push the muscle aside instead of cutting and making passage through them to reach the hip joint and again reattaching the muscle. This method is considered best because it causes less trauma and damage to the soft tissue, risk of dislocation of new prosthetic implant is lesser and it also allows quick recovery.

Partial Hip replacement surgery
This surgery is also known as semi Arthroplasty. In this procedure the ball that is scientifically called ‘femoral head’ of the worn out or damaged joint is replaced with the prosthetic implant. During this procedure, the socket i.e. the acetabulum is not replaced. Partial hip replacement operations are usually conducted when the patient has fractured or broken his hips or had a traumatic hip injury. This type of hip replacement surgery is not recommended for degenerative arthritis in hip joint. It is also a good technique of semi hip replacement surgery.

Minimally Invasive Hip Replacement surgery
Minimally invasive hip replacement technique is a process through which the orthopedic surgeon can implant the prosthetic components through one or two smaller incisions. Operation using such technique means that there will be a very small scar, less post-operative pain,less loss of blood during surgery and shorter recovery time. Tough the time taken for the surgery may be more. For operation the surgeon may also require some special equipment that may not be available everywhere

Bilateral Hip Replacement Surgery
Bilateral hip joint replacement surgery is a surgery where the surgeons replace and resurfaces both the hips at the same time because of excessive stiffness and arthritic pain. This type of surgery is not common, because arthritis in hips do not usually advances at a same rate. But occasionally, such situations may appear. If there is any major damage along with severe pain because of arthritis in both the hips, then the candidate may be advised to undergo bilateral hip replacement operation

• The best of hip replacement surgeons in India have acquired super specialisation and training in the UK, USA, etc

• The low cost of Total or Partial Hip Replacement surgery in India is offered without any compromise on quality or

• The success rate in India for Total & Partial Hip Joint Replacement surgery at India’s best hospitals is a phenomenal 99%

• Success rate, which is as high as 99% at the best orthopaedic hospitals in India

• The cost of Hip Replacement surgery in India is amongst the lowest anywhere in the world

If your hip has been damaged by arthritis, a fracture, or other conditions, common activities such as walking or getting in and out of a chair may be painful and difficult. Your hip may be stiff, and it may be hard to put on your shoes and socks. You may even feel uncomfortable while resting. If medications, changes in your everyday activities, and the use of walking supports do not adequately help your symptoms, you may consider hip replacement surgery. Hip replacement surgery is a safe and effective procedure that can relieve your pain, increase motion, and help you get back to enjoying normal, everyday activities.

The most common forms of arthritis which affect the hip joint are the following:

Osteoarthritis : This condition is primarily age-related and generally occurs in individuals over the age of 50, who have a family history of this condition. Osteoarthritis causes the cartilage cushion in the hip to wear away, leading to bone friction and hip pain

Rheumatoid arthritis : This condition causes inflammation of the synovial membrane, which produces the lubricating fluid for the hip joint.

Hip disease during childhood : Some hip diseases suffered during infancy or childhood can result in arthritis in adult life even if the diseases were treated and cured during childhood

Arthritis caused by hip fracture/trauma : Fracture of the hip or severe damage to the ligaments in the hip joint can cause degeneration of the cartilage, resulting in hip pain.

There are two major types of artificial hip replacements – Cemented Prosthesis and the Uncemented Prosthesis. Both types of prosthesis are widely used.

Computer assisted surgery (CAS) / Computer aided surgery/Image guided intervention and Surgical Navigation

Orthopedic surgeons may use computer assisted surgery (CAS) technology, also known as surgical navigation, during total hip replacement procedures to help ensure that the implants are properly aligned to the patient’s unique anatomy. Accurate alignment of the hip components is crucial to the overall function of the new hip joint. Proper alignment may also help the new joint feel more natural, and enable it to potentially last longer. Hip replacement surgery involves replacing the femur (head of the thighbone) and the acetabulum (hip socket) with an artificial prosthesis consisting of three parts: a cup (replacing the hip socket), a metal stem (replacing the neck of the thighbone) and a metal or ceramic ball (replacing the damaged head of the thigh bone and linking the cup and stem together).

CAS technology offers a hip replacement patient several benefits including: –

• With CAS technology, surgeons are able to make precise adjustments to ensure the optimal implant fit, range of motion and joint stability. This may help to reduce joint wear and extend the life of the implant.

• CAS may allow for less invasive techniques which have other potential advantages including: smaller incisions with reduced muscle disruption and decreased rehabilitation time.

• Provides your surgeon with comprehensive data about your anatomy which may help determine proper placement of your joint replacement

• Ability to plan for surgery with a computer generated model of your hip .

• Provides the surgeon with feedback and the ability to correct potential misalignment during the surgery

• Allows for better visualization of anatomy, which is particularly important when minimally-invasive techniques are used.

Total Hip Joint Replacement and Hip Resurfacing Surgery at World Best Hospitals in Indi