Posts Tagged "India"

Knee replacement in India : overview

Knee replacement in India : overview

Knee replacement is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The surgery can be performed as a partial or a total knee replacement. And if you are looking for a cost saving surgery, India is your destination. Here not only you are getting best facilities provided by the hospitals compared to the Western and European hospitals, but also very low cost of surgery package. Knee replacement in India is more then half of price that Western or European hospitals quote.

Pre-operative preparation and Technique

Knee arthroplasty is major surgery. Before surgery is performed, pre-operative tests are done. They are complete blood count, electrolytes, APTT and PT to measure blood clotting, chest X-rays, and ECG for possible transfusion. Accurate X-rays of the affected knee are needed to measure the size of components which will be needed Medications such as warfarin and aspirin will be stopped some days before surgery to reduce the amount of bleeding.

The surgery involves exposure of the front of the knee, with detachment of part of the quadriceps muscle from the patella. The patella is displaced to one side of the joint allowing exposure of the distal end of the femur and the proximal end of the tibia. The ends of these bones are then accurately cut to shape using cutting guides oriented to the long axis of the bones. The lower part of the knee replacement joint is comprised of a flat metal plate and stem that your surgeon will implant in the tibial bone. A round ended implant is used for the femur, mimicking the natural shape of the bone. On the tibia the component is flat, although it often has a stem which goes down inside the bone for further stability. During the operation any deformities must be corrected, and the ligaments balanced so that the knee has a good range of movement and is stable.

Total Knee Replacement Implants A diagnosis of advanced osteoarthritis of the knee will indicate the need for total replacement of the knee joint. Based upon your age and lifestyle, some options are: 1.  Fixed bearing –  The polyethylene cushion may be part of the fixed platform, many people get fixed bearing that dramatically reduce there knee pain. And any last for many years. 2. Medial Pivot - The Medial-Pivot knee replicates the rotating, twisting, bending, flexion, and stability of your natural knee, so it feels more like your natural knee. 3. Rotating platform and mobile bearing – Knee implants imitate the motion of your natural knee. In the Rotating Mobile Knee prosthesis, the polyethylene insert can rotate slightly around a conical post.  It also slides back and forth on the tibial tray.  This allows the knee to twist and turn, as well as move back and forth, flexing and extending. Partial knee surfacing : Partial Knee Resurfacing is an innovative procedure designed to provide quicker recovery and improved surgical outcome for patients with osteoarthritis in only one part of the knee. By selectively targeting the portion of the knee that has become damaged by osteoarthritis, surgeons can isolate and resurface only the arthritic portion of the knee without compromising the healthy bone and tissue surrounding it.                                                                                          This procedure is made possible through a surgeon-interactive robotic arm system. This system allows the surgeon to pre-operatively determine the damaged area of the bone to be removed and to plan the precise alignment and placement of the resurfacing implant specific to the patient’s anatomy. This level of consistently reproducible precision enables surgeons to restore knee function by resurfacing the arthritic defects rather than replacing the entire knee. so it maybe the alternate solution for knee replacement in some cases. Partial knee replacement : Unicompartmental arthroplasty (UKA), also called partial knee replacement, is an option for some patients. The knee is generally divided into three “compartments”: medial (the inside part of the knee), lateral (the outside), and patellofemoral (the joint between the kneecap and the thighbone). Most patients with arthritis severe enough to consider replacement have significant wear in two or more of the above compartments and are best treated with total knee replacement. A minority of patients have wear confined primarily to one compartment, usually the medial, and maybe the candidates for unicompartmental knee replacement. Advantage of UKA compared to TKA include smaller incision, easier post-op rehabilition, shorter hospital stay, less blood loss, lower risk of infection, stiffness, and blood clots, and easier revision if necessary. Risks and complications : The most serious complication is infection of the joint, which occurs in <1% of patients. Deep vein thrombosis occurs in up to 15% of patients, and is symptomatic in 2-3%. Nerve injuries occur in 1-2% of patients. Persistent pain or stiffness occurs in 8-23% of patients. Prosthesis failure occurs in approximately 2% of patients at 5 years. Deep Vein thrombosis

According to the American Academy of Orthopedic Surgeons (AAOS), “blood clots in the leg veins are the most common complication of knee replacement surgery. Your orthopedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings and medication to thin your blood.”

Fractures

Periprosthetic fractures are becoming more frequent with the aging patient population and can occur intraoperatively or postoperatively.

Loss of Motion

The knee at times may not recover its normal range of motion (0 – 135 degrees usually) after total knee replacement. Much of this is dependent on pre-operative function. Most patients can achieve 0 – 110 degrees, but stiffness of the joint can occur. In some situations, manipulation of the knee under anesthetic is used to improve post operative stiffness. There are also many implants from manufacturers that are designed to be “high-flex” knees, offering a greater range of motion.

Instability

In some patients, the kneecap is unstable post-surgery and dislocates to the outer side of the knee. This is painful and usually needs to be treated by surgery to realign the kneecap. However this is quite rare.

Infection

The current classification of AAOS divides prosthetic infections into four types.

Type 1 (Positive intraoperative culture): 2 positive intraoperative cultures Type 2 (early postoperative infection): Infection occurring within first month after surgery Type 3 (acute hematogenous infection): Hematogenous seeding of site of previously well-functioning prosthesis According to a recent review the following tests can be used in the diagnosis of a periprosthetic infection. Conventional radiograph: Rule out other conditions such as loosening and/or osteolysis. Radionucleotide Imaging: Technetium-99m Sulfur imaging combined with indium-111-labeled leukocytes probably offers improved specificity than either test alone. Gallium 67 scans alone have low sensitivity for infection. FDG-PET imaging has been shown to have variable specificity and sensitivity. Serology: Elevated serum C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR) more than three months following arthroplasty are good screening tests. Joint fluid leukocyte counts: A joint fluid white blood cell count of more than 500/?l is suggestive of an infection. Frozen sections of implant membranes: More than five white blood cells/High power field is indicative of infection. Newer tests: Polymerase chain reactions involving the bacterial 16S rRNA have high rates of false positives because they can detect necrotic bacterial debris even in the absence of active infection

Why India:

Indian medical tourism offers you a complete package of surgical treatment in India for specialized healthcare sectors. There are ample of knee repalcement surgery hospitals in India. which provide international medical healthcare facilities to abroad patients. The package shall include: Pre-Operative stay in Specialized Guest Houses, surgical package, which includes domiciliary hospitalization and stay in India, in patient care, post operative medical consultancy with complete healthcare advice. In cases of emergencies / critically ill patients we have state of the art Ambulances well equipped with life saving equipments and paramedical forces. In order to facilitate you Indian medical tourism helps in visa processing, Airport pick and drop and your local travel, they will guide you as per your treatment plan.

Robotic CABG Treatment In India At Affordable Low Cost

Robotic CABG

Robotically-assisted heart surgery is the latest advance in trying to move open heart surgical procedures to the category of minimally invasive surgery – that is, to minimize the extent and the trauma of cardiac surgery as much as possible.

Such endoscopic surgery works well for several types of operations (such as gallbladder removal and knee repairs,) where the part of the body to be operated upon is motionless, and the surgical maneuvers that need to be performed are relatively simple. But moving the surgical instruments manually during endoscopic surgery can be difficult – the length of the instruments is far longer than normal, and the “feel” of these long instruments is non-intuitive to the surgeon. Long instruments also exaggerate normal hand tremors. Thus, endoscopic surgery has achieved only limited success in more complicated operations such as heart surgery, where the heart is beating and the necessary surgical maneuvers tend to be complex.

Robotically-assisted endoscopic heart surgery is aimed at making endoscopic heart operations feasible. With this technology, the surgeon manipulates the surgical instruments with the help of a computer. An endoscope is passed through a tiny incision in the chest wall, and two surgical instruments are passed through additional tiny incisions. The surgeon views the image provided by the endoscope on a computer screen…

How is robotic heart surgery being used ?

Much of the early work with robotically-assisted heart surgery has been with bypass surgery. So far, this technique has been limited to single bypass grafts in the left anterior descending coronary artery (the LAD). The LAD is located on the front of the heart, and therefore is relatively accessible. It is predicted that with advances in technology, multiple grafts with robotic assistance will be possible, at virtually any location on the heart…

What are the advantages of robotic heart surgery ?

The chief advantage of such surgery is that the incisions that are made are tiny, and therefore recovery from surgery is extremely quick. Rapid recovery from cardiac surgery is not only better for the patient, but it is less expensive for society.

What surgeries can be performed using the robotically assisted heart surgery technique ?

At We Care India partner hospitals, the robotically assisted surgical technique can be used in select patients during these heart operations : -

Mitral valve repair and replacement surgery and reoperations Tricuspid valve repair and replacement surgery and reoperations Combined mitral and tricuspid valve surgery Coronary artery bypass surgery Catheter ablation for the treatment of paroxysmal atrial fibrillation Atrial septal defect (ASD) repair Patent foramen ovale (PFO) repair Removal of cardiac tumors Lead placement

Robotic surgery is used to assist the surgeon during coronary artery bypass surgery.

Traditionally, bypass surgery involves placing the patient on the heart-lung bypass machine (to circulate oxygenated blood during surgery); creating a 6 to 8 inch incision to visualize the heart; stopping the heart in order to stabilize the blood vessels; and performing the bypass procedure.

Minimally invasive bypass surgery decreases the size of the incision to about 3-4 inches. Depending on the technique, the surgeon may choose to perform surgery on a “beating heart” or off the heart-lung bypass machine (“off-pump”).

Robot-assisted surgery is used in combination with traditional minimally invasive surgery to perform the bypass surgery through a much smaller incision. The robotic arms are used to open the pericardium (sac that surrounds the heart) and to harvest the mammary artery (in the chest wall) through a very small incision. Then, the surgeon uses the mammary artery to bypass a blocked heart artery through a minimally invasive incision. In most cases, the sternum or breastbone does not need to be opened.

Recovery

Following surgery, all patients are closely monitored in the intensive care unit. Generally you will be awake shortly after surgery and can expect to sit up in bed the night of surgery, sipping fluids. Like most patients, you can move out of bed to a chair or take short walks the next day. Medication will be prescribed, adjusted or discontinued depending on your condition. Patients receive physical rehabilitation while in the hospital and are usually ready to go home a few days after surgery. Although the speed of recovery varies, patients can expect to resume their lifestyle within weeks of their operation.

Please log on to : www.indiahospitaltour.com

Send your query : Get a Quote

We Care Core Values

We have a very simple business model that keeps you as the centre.

Having the industry’s most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at each partner hospital, we provide you the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to five patients our patient care standards are unmatched across the sub continent.

Will Roomba cleaning system work in India. Is there somebody who is using Roomba?