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Precision in Joint Replacement Surgery through Computer Navigation System
Dr Thomas A Chandy
HOSMAT HOSPITAL is the first and only hospital in India to have comprehensive
computer navigation system - Brain Lab Germany for Joint Replacement Hip, knee,
neuro surgery, spinal surgery, surface replacement hip, unicondylar knee replacement
(partial surface replacement of the knee), arthroscopic ligament reconstruction
( ACL & PCL) and accident trauma.
Here we describe Joint Replacement Surgery
- Joint replacement is an operation to replace the
rough surface of an arthritis or damaged joint with a new surface, to enable
the person to return to a painless active life style.
- A joint replacement is needed in individuals who
suffer from painful.
- Arthritic joints with or without deformity, secondary
to rheumatoid arthritis, osteoarthritis, traumatic arthritis and certain other
forms of nonseptic arthritis. The procedure is done for hip, knee, elbow,
shoulder and finger.
A knee replacement is not a transplant, and is not a major surgery. Here, a
new surface is put in the knee. In hip and shoulder replacement, a new ball
and socket joint is used. In osteoarthritis, it is done after 50 or 55 years
of age and in rheumatoid arthritis after 35 to 40 years of age if there is a
persisting pain. Age can be less for severe pain.
Hip replacement is done commonly for AVN (A vascular Necrosis) or loss of circulation
to the back, from various causes and for arthritis and old fractures.
Knee replacement means a new surface lining for the bones of the knee joint.
The new joint has a smooth weight bearing surface - the one component covers
the thigh bone like a cap - made up of Titanium, the tibial component covers
the upper end of the shin bone (tibia) and patellar (knee cap) component. These
2 surfaces are of special plastic called ultra high-density polyethylene.
Hosmat Hospital is one of few hospital in India having special operation theaters
devoted exclusively for joint replacement with exponential laminar air flow
system to make the infection rate less than many of the major medical centres
in the US.
Stiffness is prevented by early physiotherapy. The deformities (knock knee and
bow legs) are also straightened out during the surgery for arthritis.
The patient undergoes routine blood tests, including blood sugar, ECG a physician
or a cardiologist's opinion is also seeked to prevent any complications. The
patient is admitted one or two days before the operation.
The anesthesiologist will evaluate the patient, discuss the type of anesthesia,
which is usually an epidural anesthesia or light general. For the hip, a side
incision is placed, the diseased ball is removed, the socket is made smooth,
with the plastic socket and a new ball is placed.
The patient is discharged 8 to 12 days after the operation. By this time, the
patient is able to bear 75 per cent of weight on the operated leg and regular
physiotherapy either in the hospital or at home is given. Most of the time home
care physiotherapy is given.
The implant used are normally imported from the US. The total cost for a top
quality imported knee or hip replacement is about Rs 99,000 for economy, 116,000
for semi private and Rs 1,25,000 for private room. Besides the cost of drugs,
consumables and disposables which cost about Rs 15,000 to Rs 18,000.
The patient normally uses a stick for two or three weeks and can be completely
independent after that.
Revision of the hip and knee replacement
Revision surgery of the hip and knee is when the surgery has to be done again
due to several reasons. The commonest reason is loosening of the implant in
the bone. It is caused or aggravated by the wear and tear process.
Other causes are breakage, joint instability, breakage, joint Instability fracture,
gradual bone loss and dislocation of the kneecap. However, persisting pain in
the hip and knee is the most common reason for a revision, Hosmat does the largest
number of replacement and revision surgeries in Karnataka.
The Laser camera captures the patient's anatomy & joint bio-mechanics
via infra-red data transfer - It tracks patient, instrument position, implant
alignment and fine tuning at all stages during the surgery
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Display presents truly interactive 3D image to the surgeon both pre
and intra operatively - Its is a simple, user-friendly and precise
interface
- Presents precise real-time information
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- Pointer defines accurate limb extremity and
joint space
- Landmarks for the computer and laser to recognize
and register the data
- Data acquired helps surface map the individual
patient anatomy
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For further information, write to Dinesh Madhavan - Public
Relation Dept Hosmat Hospital, No. 45, Magrath Road, Bangalore - 560 025 or
contact on Hospital number 25543796 or 25593796 at Ext. 252 or 253 or Fax: 51124695
or website www.hosmatnet.com. Or email - hosmatpr@yahoo.com
The author is chairman and chief of orthopaedics, Hosmat Hospital, Bangalore.
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