Knee Replacement

Apollo Hospitals, India, offers advanced treatment for conditions of the knee joint such as arthritis that can severely affect the knee and hamper routine activities.

What is Arthritis?

Arthritis is inflammation of the joints. A gradual wearing away of the tissue on the ends of bones results in reduction of joint space and friction at the exposed bone surfaces, changing regular bone movement and causing severe pain. Knee Replacement Surgery is the best solution to treat the condition and allow resumption of normal activities in the knee.
The types of arthritis are:

Osteoarthritis

This occurs after the age of 50 in individuals with a family history of arthritis. The tissue that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.

Rheumatoid Arthritis

This is a disease in which the inner membrane of joints is thickened and inflamed. This results in excessive production of the fluid that lubricates these joints. This chronic inflammation can damage the tissue covering the ends of the bones and eventually result in loss of the tissue, pain and stiffness.

Traumatic Arthritis

It can result from a serious knee injury. A knee fracture or severe tears of the knee's connective tissue may damage the tissue covering the ends of the bones over time, causing knee pain and limiting knee function.
Symptoms

  • Severe pain in the joint that restricts everyday activities such as walking, climbing stairs and getting up from chairs.
  • Severe pain while resting.
  • Inflammation and swelling of the joint that does not improve with medication and rest.
  • Deformity in the joint.
  • Joint stiffness or inability to move the joint in a normal manner.

Treatments
Some of the knee surgeries and treatments performed at Apollo Hospitals, India are:

Total Knee Replacement

For patients suffering from severe arthritis that can cause acute pain and make even routine activities difficult, Total Knee Replacement is the best solution. The procedure involves removing all diseased portions of bone and tissue on their ends, and replacing them with metal and high density plastic components shaped to create a structure that allows normal movement of the joint. Other knee deformities will also be corrected during the Surgery.

Partial Knee Replacement

This minimally invasive procedure is an option for arthritis patients in whom only one part of the knee has been affected. In a Partial Knee Replacement the diseased portion is removed and replaced with a metal implant.

High Tibial Osteotomy

An osteotomy is Surgery that involves shaping and realigning of bones at a joint. It is usually used to treat arthritis in young patients, and is particularly recommended for those with very shallow joint sockets.In High Tibial Osteotomy the upper part of the tibia - one of the limbs forming the lower leg - is resurrected, mostly by removing a small part of bone in the area.

Minimally Invasive Knee Replacement (Resurface) Surgery (MIKRS) using OrthoGlide Medial Knee system.

OrthoGlide, a metallic, wedge-shaped device is a novel implant that replaces worn cartilage inside the knee. It offers patients a less invasive alternative to total knee replacement. This device is inserted into the knee through a 5 to 7 cm incision, which relieves pressure, restores proper joint alignment, redistributes the load more evenly and increases stability.This surgery promises a less expensive and easy path of regaining normal lifestyle functions, and it definitely offers a new ray of hope to active and young patients who are worried about major surgery and prolonged post op rehabilitation to deal with Knee Arthritis.

The Major advantages of this surgery over standard Total Knee Replacement includes its affordable cost and early rehabilitation which helps patients to return to their normal routine and life style expeditiously. It allows the patient to squat and seat cross legged, an important part of our daily lives in India and which is not possible with the conventional knee replacement surgery. Above all OrthoGlide allows delay of total knee replacement until patients are older and less likely to require a second knee replacement.

As against a Total Knee Replacement, Minimally Invasive Knee Replacement (Resurface) Surgery involves a 2 inches incision, no cutting of the natural bone, the joint is left intact, no cutting of the muscle therefore no bleeding, less painful, low infection, less complications, fast recovery, can walk the same day, the surgery can be performed as a day care surgery and therefore doesn't require hospitalization.

Minimally Invasive Subvastus Total Knee Replacement
Minimally Invasive Subvastus Total Knee Replacement is a revolutionary procedure performed at Apollo Hospitals with great success.

This procedure promises lesser pain along with quick recovery and is performed by pushing the muscles to the side-following the Sub Vastus approach instead of cutting the muscles. This treatment is cosmetically appealing because the skin is cut only upto 8-10 cms. Also, the kneecap is not flipped as in the conventional method but it is only pushed to the side to expose the joint. Due to this, the strength of the muscles in front of the thigh extensors is preserved. The bones are not separated from each other but they are cut in place, which minimizes the stretch injury to the structures surrounding the joints. This approach can result in significantly less trauma to the leg, faster healing and more strength and mobility in the new knee.

Along with good pain control measures, minimal pain after the surgery is ensured. The patient will be able to lift the leg immediately after the surgery and can stand and walk with support the same day. The knee can be bent upto 90 degrees and the patient will be able to walk atleast 100 steps by the 3rd day-at the time of discharge. After 2 weeks time, they will be able to walk independently without any support and getting up from the sitting position becomes easy in 1 to 2 months time. Within 2 to 3 months, they will be able to stand for a long time and walk any distance without suffering from any heaviness in the thigh muscles. In other words, the patient tends to forget the knee surgery in 2-3 months and will be able to resume their day to day activities comfortably.

Total knee replacement using Patient specific zigs

Total knee replacement using patient specific zigs is a new cutting edge technology in this field. The customized cutting blocks are made preoperatively using CT scan images of the patient's knee and leg and then the surgery is done with the help of these blocks. This technology not only improves the accuracy of the knee prosthesis placement but also helps in less operative time, reduced blood loss, improved accuracy, enhanced surgical outcome and faster recovery with shorter hospital stay.

This first ever "Made in India-Made for India" technology has been indigenously designed and developed by a leading US based company that has its RND centre in India. This customized zig that meets quality standards will take Knee Replacements to a new level.

Correct alignment of the artificial knee replant is the key to a successful surgery. Closer the implant alignment , the better will be the surgical outcome. Traditionally achieving this alignment was based on the experience, skill and judgment of the surgeon. With the advent of the customized zig technology, the accurate alignment for the individual patient can be the calculated much more before the surgery, based on a CT Scan. The CT Scan and computer analysis help arrive at the most accurate alignment for the particular patient, based on which a specific zig is manufactured.

The zig which is customized for each patient is used to give the most appropriate bone cuts and positioning of the implant during the surgery. Apart from the official surgery, customized zigs also improve knee functions post surgery and the costs are one third too.

This technology not only improves the accuracy of the knee prosthesis placement but also helps in less operative time, reduced blood loss, improved accuracy, enhanced surgical outcome and faster recovery with shorter hospital stay.