Five things you must consider before you opt for knee replacement

Persistent knee pain while walking, difficulty in climbing stairs, morning stiffness in joints, painkillers becoming part of daily routine… sounds relatable? If yes, then chances are that you or one of your loved one has reached chronic arthritis stage where the cartilage between joints wears out and bones rub against each other causing pain. Every year, osteoarthritis affects over 15 million Indians and approx. 1.5 lakh knee replacements are performed for pain relief and improving patient’s quality of life.

Factors that impact the outcome of knee replacement include the experience of the surgeon, hospital infrastructure and quality of implant being used. Government’s recent move to offers patients the choice of implants in major surgeries such as knee and hip replacement is a testimony that the government acknowledges that the quality of implant plays a critical role in success of the surgery. Since implant cost is no longer part of the surgery package, beneficiaries of Ayushman Bharat can now opt high-quality implants under the scheme that can help patient’s combat complications caused by a poor-quality implant.

A Chairman and Senior Consultant, Joint Replacement Surgery,  throws light on the things one must consider before undergoing knee replacement. Expert check – Knee replacement surgery is a complex procedure and requires specialised training and surgical skill-set. More the surgical experience of a surgeon, lesser are the chances of complications. Therefore, do enquire about your doctor’s experience and skill set.
Healthcare infrastructure – Post-op infection can cause complications. Hence it is important that the hospital has robust OT infrastructure and infection control system. Enquire about the infection rate at the hospital.
Know your new knee – A good quality implant can make a huge difference in helping you lead a pain-free, active life. With the advent of technology, innovations such as a single radius knee, navigation-based replacements, have revolutionized knee surgeries making way for efficient and effective solutions which may last up to 2 decades. While your surgeon can recommend what’s best for you, it is crucial to know what is getting placed in your body. Implant quality can be ensured by checking:

•  USFDA approval - confirms that the product is evaluated, approved as per most stringent guidelines and is high quality
•  Clinical legacy – assures that it is a proven high-quality product and is widely used globally due to its long-term success
• Survivorship – indicates that the product is durable and lasts longer thereby reducing chances of revision surgery

Recovery support – Advancements has enabled patients to walk just hours after the surgery using the walker. Our thigh muscles play a crucial role in recovery as they provide the knee with strength and mobility. Technologies like single radius knees which mimics the natural knee motion support these muscles aiding in quicker recovery and lesser physiotherapy sessions.
Rehabilitation – Post knee surgery, it is mandatory for patients to undergo at least 8 weeks of physiotherapy sessions. Highly advanced technologies today provide a wide range of motion as opposed to earlier times with fewer physical therapies. A single radius knee allows stable and efficient movement while climbing or descending stairs, squatting, playing badminton, among others.

this is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   
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Have your own Knee; a benchmark treatment for Knee Arthritis

The symptoms of arthritis, which has affected an estimated 180 million Indians, are stiffness or swelling of knees, knee lock or clicking, loss of gait in walking, buckling of knees in some cases, and pain in knees or even loss of mobility.

The key-hole procedure that the doctors are offering, aka stem cell alternative to knee replacement, is done by harvesting stem cells from the patient’s pelvis and injecting it into their knee joint.

"The worn-out cartilage in the knee which is the cause of all the discomfort and pain is first removed. Then the stem cells are mixed with clotting gel and injected into the knee joint. These stem cells help in the growth of new cartilage,” shares the Dr.

The surgery takes about an hour and a half and the patient remains in the hospital less than 48 hours totally. “We give spinal anesthesia to make both legs numb below the abdomen and the patient remains awake throughout the procedure,” says the Dr. adding that in rare cases general anesthesia is given.

The doctors had worked in the UK under  an Indian origin doctor - who along with a Prof. from South Korea pioneered the knee cartilage regeneration procedure - before returning to India and setting up the hospital in 2011 along with two other doctors.

This procedure received the prestigious Hunterian award for best surgical innovation in the UK in 2017. This is the first hospital to introduce this procedure in India and has performed around 350 such surgeries so far.

As awareness about the surgery is reaching the people, the number of patients undergoing the knee cartilage regeneration procedure at this hospital is increasing day by day.

The numbers speak for themselves. While between 2012 and 2016 the hospital performed 100 surgeries, there were 250 cases in the last two years.

“Happy patients are our referrals. We do not advertise much,” says the Dr., who feels in the next 10 years stem cell knee treatment will replace knee replacement by at least 50 per cent globally.
According to the doctors, the major advantage of stem cell knee treatment is that it is a natural way to preserve one’s knee and avoids any artificial implant in the body. But knee replacement surgeries require a revision surgery after 15-20 years and there is also high risk of infections attacking the region of the implant, since a foreign material is implanted into the body.

The stem cell knee cartilage regeneration treatment can be performed at any age. Around 60 per cent of patients who underwent the procedure at the hospital were above 60 years (40 patients were in the age group of 65-80), 30 per cent were in the age group of 50-60 and around 10 per cent were below 50 years.

“We are getting patients from all over India, from as far as Punjab and Assam, and from foreign countries such as Kenya and Zimbabwe,” says the Dr. Outstation patients need not worry about frequent trips to the hospital for post-operative care. “They can just send x-ray through email or WhatsApp and follow up with phone consultation.”

Though the knee cartilage regeneration treatment is available in UK, it is far expensive there compared to the rates offered by this hospital. “We charge Rs 1.6 lakh, but whereas in the UK it would cost around 18 lakh in Indian rupees. We expect more patients from abroad,” says the Dr.

The cost of stem cell knee treatment or knee cartilage regeneration surgery is much lower than knee replacement surgery in India. Patients vouch for it.

A 62-year-old housewife came to the hospital last year from Bengaluru, with her feet swollen from arthritis. The swelling used to get worse in the morning and she would find it hard to get up on her feet after being in a sitting position or after lying down.

The swelling has now gone and she has got much relief from the pain. “We are here to do the surgery on her other knee. We are happy with her progress,” says her son, who chose this hospital after consulting other major hospitals for a knee replacement surgery. “Their rate came to around Rs 3.5 lakh for knee replacement surgery, but we decided to do the stem cell surgery .”

Eight months later they have come back for the surgery on the second knee. The total cost for the two surgeries would still be less than the amount they would have spent on a single joint replacement surgery in the other hospitals that they had checked with earlier.

"We performed this keyhole cartilage regeneration surgery on an 87-year-old from Bengaluru, the oldest patient we have treated, someone who would be considered too old for knee replacement treatment elsewhere. At 87 he is active and has become our brand ambassador now," says the Dr. laughing.

For a 68 year old resident of Kovilpatti in South Tamil Nadu, the stem cell knee surgery was performed by a team guided by Prof., who was on a visit to Chennai, along with this Dr.  in 2017. "I am feeling completely normal today. I am back doing my regular activities," she says.

When a 52-year-old housewife, was diagnosed with arthritis and recommended knee replacement, she was apprehensive about going for surgery but had to take a decision as the pain in her knees was persistent, also affecting her mobility severely.

She had reached stage four arthritis and her legs had also begun to buckle. A radiologist then suggested that she check on the keyhole procedure for cartilage regrowth that was showing promise as an alternative to knee replacement.

After doing their research on the internet, including watching surgery videos,the lady visited this hospital, which is close to her residence. The doctors encouraged her to speak to others who had undergone the keyhole surgery and their testimonials boosted her confidence.

She underwent the surgery in September 2017 and the results delighted her. In July 2018 she got a surgery done on her other knee as well. "The pain was down by 90 percent in the first knee. I am now looking forward to drive the car," says the lady, who has since been promoting the surgery among her friends as well as those who call and ask.
"It is cost effective but the relief from pain is the biggest gainer. It is also natural which is why I went in for this surgery," she says.

For the doctor entrepreneurs,  the last financial year turned out good when they achieved a turnover of Rs 6 crore. But for them the real reward is in seeing more and more people benefitting from their technique and relieved of their pain.

Sharing their future plans, the Dr . says, “We are operating on a light asset model and working out of a leased building. We are currently having a 30-bed facility, and we are doing an average of two to three surgeries per day, which includes all types of orthopaedic surgeries. Our vision is to develop a world class orthopaedic chain.”

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                             PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/   

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Bone TB or Osteoarthritis

Remember that when doctor says you've osteoarthritis and your one knee needs replacement, it can be wrong diagnosis, as osteoarthritis affects both the knees and can be easily identified in a simple X-ray itself. Also, when you've osteoarthritis, you'll find relief while resting, which you'll not find when you've bone TB, as bacteria increases at that time.

There was a case where a lady was told to undergo knee replacement surgery and suffered more with constant pus formation, had 3 surgeries still no relief, couldn't bend her leg, pus had to be constantly drained out. Then luckily another orthopedic surgeon, diagnosed her problem, and said,, what should have been done before the surgery was treat the TB with medication, then make bone graft or reconstruction of the joint and not replacement surgery. So, this surgeon treated her for TB for 4 months, to curtail it, then operated doing the reconstruction, after which, she is relieved of the pain that she suffered for 8 years. Now, she is able to walk, bend her knee, which she'ld not do after the knee replacement surgery earlier.

Bone TB is very difficult to diagnose, unlike chest TB, one doesn't get fever or has weight loss. Normally if only joint is affected, then one should distinguish it from arthritic pain and after proper diagnosis, have the proper treatment to be well on your feet. So, what we all would need is a good doctor, as when I had prolapsed disc of L4-L5, 2 doctors didn't diagnose, as I didn't get relief from physiotherapy or acupuncture, they termed as a psychiatric case ! luckily, another doctor, by seeing walk a few steps, asked me since how long I was walking like that. I told him, sorry, I don't understand, then he told me that people with L4-L5 prolapsed disc have peculiar walk, with one shoulder lower than another one, which none can mimic ! after the surgery my pain and burning sensations had all gone. So, always search for a good surgeon for any surgery.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.






PS- THOSE INTERESTED IN RECIPES ARE FREE TO VIEW MY BLOG-
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FOR INFO ABOUT KNEE REPLACEMENT, YOU CAN VIEW MY BLOG-

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