9552532038 / 9822020130    HELPLINE: 020 67286728      appointment@lokmanyahospitals.in

  9552532038 / 9822020130    HELPLINE: 020 67286728      appointment@lokmanyahospitals.in

  9552532038 / 9822020130

 HELPLINE: 020 67286728

Knee Treatment

KNEE ARTHROSCOPY

KNEE ARTHROSCOPY

Arthroscopy is a popularly used minimally invasive surgical technique to diagnose and treat a host of knee problems that can occur due to various reasons.  Knee arthroscopy is a surgical procedure that allows Orthopedic surgeon to view the concerned knee joint by making a very small incision and inserting a tiny fiber optic telescope called the arthroscope into your knee to view the inside of the joint on a screen. The surgeon can then investigate a problem with the knee and, if necessary, correct the issue using small instruments within the Arthroscope.

Knee Anatomy
Knee Arthroscopy

The procedure is more often used in patients where the issue does not require joint replacement surgery. Patients who have experienced sudden knee injuries or have twisted their knee perhaps while playing some sport that may have caused misalignment of the bones; the best treatment is generally arthroscopy.  There are limited risks to the procedure and the outlook is good for most patients. Your recovery time and prognosis will depend on the severity of the knee problem and the complexity of the required procedure.

Arthroscopic surgery can diagnose and treat knee injuries, including:

  • Torn Ligament reconstruction (ACL / PCL RECONSTRUCTION)
  • Pieces of torn cartilage that are loose in the joint
  • Swollen synovium (the lining in the joint) Patellar balancing (LATERAL RELEASE / MEDIAL PLICATION)
  • Reconstruction patella that’s out of position
  • Removal of a Baker’s cyst
  • Removal or repair of torn meniscus (the cartilage between the bones in the knee) MENISCAL BALANCING / EXCISION / REPAIR
  • Ligament avulsion fixation
  • Removal of loose debris, infected tissue (DEBRIDEMENT / LAVAGE)
  • Removal of infected or diseased or neoplastic synovium (SYNOVECTOMY)
  • Trimming damaged cartilage (ABRASIONPLASTY)
  • Release of stiff joints – which may happen after injury or after surgery (ARTHROLYSIS)
  • Recovering joint tissue for examination (BIOPSY)

Brief Idea about the procedure

After proper consultation with the doctor and on the basis of medical history, and investigations including MRI proper planning is done.

Anaesthesia is given which may be General, Spinal or Local depending upon the condition and requirement.

The surgeon will begin by making a few small incisions in your knee. Sterile salt water or saline, will then pump in to expand your knee. This makes it easier for the surgeon to see inside the joint. The arthroscope enters one of the cuts and the surgeon will look around in your joint using the attached camera. The surgeon can see the images produced by the camera on the monitor in the operating room.

When the surgeon locates the problem in your knee, they may then insert small tools into the incisions to correct the issue. After the surgery, the surgeon drains the saline from your joint and closes your cuts with stitches.

Outcomes are generally good if performed by an experienced orthopedic surgeon, with  very less probability of development of complications.

Benefits of Knee Arthroscopy Treatment

  • It’s minimally invasive so the number of incisions are less
  • Since the surgical instrument is very sleek, the cuts made are smaller compared to the larger incisions made in open surgeries.
  • There is less joint pain and stiffness post the surgery.
  • The recovery time is quicker and patient can without much gap return to their normal routines.

Depending on the diagnosis of the patient’s condition and subjective to his case, extent of damage, knee arthroplasty or an alternative suitable treatment will be advised by the surgeon.

Knee Arthroscopy Treatment

KNEE REPLACEMENT SURGERY

Also Known as arthroplasty, is one of the most commonly performed surgeries with excellent outcomes and patient satisfaction if performed by a skilled and experienced Joint replacement surgeon

The objective of a Knee Replacement Surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments. There are several causes that can lead to issues in the knee joints. Arthritis is a degenerative joint disease that is one of the most common ailments that affect your knees. causes the breakdown of joint cartilage and adjacent bone in the knees causing pain and discomfort to the individual. Similarly, in Rheumatoid Arthritis, inflammation of the synovial membrane results in excessive synovial fluid which can lead to pain and stiffness.

Decision of surgery is most likely when

Knee Arthritis
  • Severe pain and stiffness makes it hard for you to walk, climb stairs, or get out of a chair.
  • Continuous knee pain bothers you while resting, possibly keeping you from sleeping well.
  • Your knee is often swollen.
  • There is a Crepitus and tenderness on examination and patient complains of crackling sound on bending or flexing the knee.
  • Waddling is present while walking
  • Your knee is bowed or has other defects.
  • Physical therapy and medication haven’t helped.
  • Walking is becoming difficult without support

Types of Knee Replacement Procedures

Knee joint replacement is a procedure that involves replacing an injured or affected knee with an artificial joint, or prosthesis that is mostly made of Inert Metal alloys, Ceramic, and polymers. During the surgery, the damaged cartilage and bone is removed from your joint and replaced with a prosthetic component that take over the shape and movement of a natural joint. The three core areas involved in the knee joint replacement are:

  • The lower portion of the thigh bone (femur),
  • upper end of the shinbone (tibia), and
  • behind the kneecap known as patella
Knee Joint Replacement

Partial or Unicompartmental Knee Arthroplasty (UKA) Surgery

Unicompartmental Knee Arthroplasty

Subject to the extent of damage in your knee joint, total knee replacement or Unicompartmental (partial) knee replacement surgery will be advised to you.

Because a partial knee replacement is done through a smaller incision, patients usually spend less time in the hospital and return to normal activities sooner than total knee replacement patients. Knee is divided into three major compartments:

  • Medial compartment (the inside part of the knee)
  • Lateral compartment (the outside part)
  • Patellofemoral compartment (the front of the knee between the kneecap and thighbone)

Advanced osteoarthritis that is limited to a single compartment may be treated with a unicompartmental knee replacement. Medial compartment of the knee joint degeneration is the most common deformity of arthritis. During this procedure, the damaged compartment is replaced with metal and plastic.

Advantages of Unicompartmental Knee Arthroplasty (UKA)

  • The healthy cartilage and bone, as well as all of the ligaments are preserved
  • Patients feel lighter and more natural than Total Knee replacement
  • Comes back to all his normal life quite earlier than Total Knee replacement.
  • Incision is smaller, blood loss is also less so shorter recovery period
  • Hospital length of stay is also lesser

Limitations

It is very important to do proper case analysis before advising the Partial or Unicompartmental Knee Replacement (UKA),

  • Extent of damage to the Knee joint /Stage of Arthritis
  • Weight of the patient
  • Ligament condition
  • Alignment of the knee

Any of the factors if not fitting then the case shouldn’t be considered for UKA

Knee Arthritis Cartilage Loss

Total Knee Replacement (TKR) Surgery

Total Knee Replacement (TKR) Surgery is one of the most commonly performed Surgical treatment around the World with very good outcomes if performed by a skilled and experienced orthopedic surgeon.

The purpose of the surgical procedure is to achieve pain free movement again, with full functionality of the joint, correct deformity and to recreate a stable joint with a full range of motion.

Total Knee replacement is most commonly done:

  • In case of advanced Osteoarthritis where bone is damaged and cartilage is worn off and due to no cartilage, there is friction between thigh bone (Femur) and shin bone(Tibia) patient is having severe pain and stiffness and his activities get hampered
Total Knee Replacement
  • In case of Rheumatoid Arthritis in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”
  • Post-traumatic arthritis. This can follow a serious knee injury. Fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.

Total knee arthroplasty is chosen when the patient has serious complaints and functional limitations. Surgery takes some 40-60 minutes and involves placement of three-part prosthesis.

The three-part prosthesis:

  • A part for the femur,
  • A part for the tibia,
  • A polyethylene shock absorbing disc as substitute of Meniscus and
  • Sometimes a replacement patella.
  • A high comfort insert design is chosen to achieve this.
Total Knee Arthroplasty

The perfect prosthesis doesn’t exist every prosthesis must be different and the most appropriate size and shape is chosen on a patient by patient basis and therefore it is always good to use technological aids like Robotic Assisted Knee replacement to avoid any human error in measurement and make the procedure more precise and controlled with maximum success.

There are three basic steps to a knee replacement procedure.

  • Prepare the bone: The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone to remove the diseased part and create a room for implant/ prosthesis but the implant thickness is always minimal and replicates the natural bone structure and shape
  • Position the metal/ creamic implants: The removed cartilage and bone is replaced with metal/ ceramic components that recreate the surface of the joint. These parts may be cemented or “press-fit” into the bone as per the specifications
Total Knee Arthroplasty
  • Insert a spacer: A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
  • Resurface the patella: The undersurface of the patella (kneecap) is resurfaced and replaced with a plastic button if required depending upon the case.

Once the procedure is completed, your progress will be monitored and post-surgery care will be administered. With advanced medical procedures today, recovery is quicker and in many cases hospital stay is minimized.

ROBOTIC ARM ASSISTED KNEE REPLACEMENT

An Introduction to Robotic Knee Replacement Surgery

Robotic Knee Replacement Surgery is the highly advanced and sophisticated surgical procedure for knee joint replacement. India’s first ever Robotic assisted unicondylar knee replacement surgery was successfully pioneered by Dr. Narendra Vaidya at Lokmanya Hospitals, Pune, in India.

The highly advanced Robotic arm assisted Surgical System is a technologically advanced knee surgery platform which adds an extra layer of pre-surgical planning and improved accuracy for partial and total knee replacement procedures.

Robotic Knee Replacement Surgery
Robotic Knee Replacement Surgery

This surgery employs robotic-arm assisted technology that provides the orthopedic and joint replacement surgeon with a personalized surgical plan based on the patient’s unique anatomy. A 3D model of the knee joint will be used to pre-plan and assist the surgeon in performing a partial knee replacement. Using all of this vital information the surgeon can then determine the correct size and position of the implant, which is critical to knee alignment and stability. This is a state of art technology which enables the surgeon to replace only the damaged part of the knee to absolute perfection.

Benefits of Robotic Knee Replacement Surgery

Robotic Knee Replacement Surgery
Robotic Knee Replacement Surgery

This highly advanced joint replacement surgery has is a revolution in the field of Orthopedics. In earlier conventional knee replacement procedures, the surgeon had to open up a large area of the knee joint. Moreover, there is no technical assistance and the best surgical approach is developed on approximate measurements of similarly shaped knees that operated before so chances of Human error in measurements always exist. There is also higher probability of blood loss and excess bone cutting in these procedures surrounding soft tissues are more likely to be damaged resulting in prolonged healing period, pain and discomfort to the patient.

In Robotic Arm-Assisted Knee Surgery there is a combination of surgeon’s skills and technology, exact measurements and mapping bring in almost 100% precision in prosthesis placement, which is of paramount importance in longevity (life) of the prosthesis. This minimally invasive surgery involves smaller incision, less blood loss and bone damage as well as faster recovery. It is always said that less is the damage to surrounding damage, better is the surgery and its outcomes. Here in Robotic Arm Assisted Knee surgery, Patients treated can experience full movement and have a very natural feel of the knee joint, as all the ligaments are preserved. Bone is just resurfaced to remove the damaged part only and placement of implant, patellar bone is preserved, surrounding muscles and soft tissues are very well respected. This high level of precision brings more perfection and helps the surgeon to achieve desired outcomes in a better way.