A team of orthopaedic surgeons providing outpatient consultations is available on weekdays. Orthopaedic surgeries and fracture cases are operated in the state-of-the-art Operation Theatre equipped with C-arm. There is X-ray equipment available for early diagnosis of fractures.
The following services are available:
Arthritic or damaged bones surfaces are removed and resurfaced with an artificial joint know as prosthesis. Knee and hip replacements are most common, but joint replacement can be performed on other joint such as the shoulder, elbow, etc.
When complete joint is damaged with degenerated cartilage all over then it becomes difficult for the patient to continue day to day activities of life. So total joint replacement to be considered if other options like medication, physiotherapy etc will not relieve pain and disability in such condition. The goal is to relieve the pain in the joint caused by the damage done to the cartilage. Total joint replacement which is also called as Arthroplasty is one of the most successful and innovative surgery of 19th Century.
Under the effect of spinal or epidural or general anesthesia the damaged ends of the bones and cartilage are replaced with an artificial joint made of metal and plastic surfaces. They are shaped to restore joint movements and function.
The materials used in a total joint replacement are designed to enable the joint to move just like your normal joint and hence resemble the normal joint closely. The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Alloys of cobalt, chrome and titanium are main metal used. The plastic used is ultra-high-molecular-weight-polyethylene. Using these advanced bio-materials and well executed surgical technique one can expect excellent results of long term durability.
Total Hip Replacement Surgery This surgery is the most successful innovation of 19th Century. This remains gold standard procedure. In this operation socket and ball (head) of the femur bone is removed. Depending up on the bone quality new socket and stem-head made of different materials is used in. This articular surface material could be combination of plastic (ultra high molecular weight polyethylene) on Metal (cobalt chrome molibdinum), plastic on ceramic ball and ceramic on ceramic ball. Again depending up on the age and quality of bone these joints have been put in with bone cement or without bone cement. Results of this conventional hip replacement surgery are excellent only difference from hip resurfacing is that original ball is not conserved and patients are not allowed to squat.
Total Knee Replacement When whole knee joint (all compartments) is affected then only solution to relieve pain and get back to normal routine activities is total knee replacement surgery. In this procedure thigh bone side of joint (femur) is replaced with metal prosthesis, leg side (tibia) is replaced with metal and plastic and knee cap (patella) is replaced with plastic prosthesis. Results and durability of this surgery is excellent. There is a breakthrough technology with high flexion –Knee designs where patient can get complete knee bending and can sit cross legged after surgery. This has been done regularly in Dr L H Hiranandani hospital. Knee replacement surgery in our hospital regularly done using computer navigation system.
Unicondylar Knee Replacement When one compartment of knee joint is arthritic then replacing this part with metal and plastic joint through a small incision (skin cut) provides excellent quick recovery. Benefit of this operation is that patient can bend the knee fully and can perform most of the activities. Hospitalization for this surgery is just two days.
A very special technique patient control analgesia (PCA) is used where a catheter is kept in epidural space and through PCA pump pain relieving medicines are delivered in controlled fashion to relieve pain. If patient need more dose of medication as per pain, (extra medicine) a bolus can be adjusted by patient himself/herself through hand press button given to them in post-operative period for 2 to 3 days. There is no post-operative pain; hence this is painless joint replacement surgery. .
In case of knee, hip, shoulder and elbow replacements patients have to be in the hospital for about 3 to 5 days. After unicompartmental knee replacement patient goes back home in 2 days time. .
In general physiotherapy program is neither strenuous nor painful. Few simple actions of exercises are taught to the patients by physiotherapist. They have been also taught proper gait training with the use of walker and crutches or canes.
Yes. Both knee/bilateral knee replacement can be done same day & same time. Safety of the patient is the most important criteria for this surgery. Medically fit patient having pain in both knees and willing to undergo surgery on both sides is the indication for bilateral total knee replacement. Advantages of joint replacement surgery
Advantages of joint replacement surgery
Computer-assisted joint replacement surgery is one of the most advanced treatment approaches utilized within orthopedic medicine. In the course of preparing for a knee operation, this technology allows your surgeon to complete a comprehensive assessment of the joint, including the potential creation of a 3-dimensional anatomical model. During the actual surgical procedure, these pre-op insights will be used to ensure proper joint alignment (often within fractions of a millimeter) and prosthetic placement. This means surgery could be performed with high accuracy and precision.
Computer-assisted surgery, abbreviated CAS, uses special probes attached to the body to help your surgeon ensure proper positioning of the joint replacement implants. The probes are detected by an infrared camera that is connected to a computer terminal. The computer terminal constructs an electronic model of the knee or hip based on the information gathered by sensing the position of these probes. The computer can then help guide your surgeon's placement of the knee or hip replacement implants to ensure proper positioning of the joint replacement. This also helps in proper alignment of implant, lower limb axis and ligament balancing.
The Advantages of Computer Guided Joint Replacement Surgery are :
Arthroscopy is a technical term for keyhole surgery of any joint. Keyhole surgeries in joints such as knee, shoulder are well established. There are very few centers in India where Hip and small joint arthroscopy is performed. Dr L H Hiranandani Hospital is one of those distinguished few.
Until recently any approach to the joint pathologies by surgeons, involved open surgery. Open surgery means a large incision and a hospital stay of 7 days or longer, exposing the patient to potential risks such as infection, deep vein thrombosis (clots in deep veins), major nerve or vessel injury and muscle weakness. Open surgery of the joint in young adults, therefore, may expose the joint to the ravages of arthritis in later years. Arthroscopic surgery of the joints therefore, appears to be an attractive option has proved to be very successful in multiple clinical studies.
Arthroscopy is usually a day case, or overnight stay. There are multiple procedures that can be now performed with keyhole approach and use of camera and telescope, right from cleaning of arthritic debris to ligament and tendon repair and reconstructions, instability surgery and also intra-articular fracture fixation.
Almost everyone with joint problem can be treated with arthroscopic surgery when indicated. The indications are increasingly becoming vast. Historically, athletes and active young individuals were the only targeted population but arthroscopic surgery has led to a better understanding of the mechanisms and injury patterns not known before. Hence even the elderly with knee, shoulder and other joint problems benefit significantly from arthroscopic procedures.
Hip and small joint arthroscopy although a fairly new concept in India, globally has taken arthroscopic surgery by storm. Arthroscopy of the hip joint has led to a greater understanding of the nature of adolescent and adult hip pathologies, and, offers comprehensive access to an evolving series of conditions that affect the hip joint, many of which were previously unrecognized and, thus, left untreated.
A number of orthopaedic & sports conditions remain a major therapeutic challenge even this day and age; for example: Achilles tendon and tennis elbow. Two treatment methods that hold promise for the future of tendon disease management are injection of autologous platelet rich plasma (PRP) / Autologous Platelet concentrate (APC) and a tissue engineering approach to regenerate healthy tendon tissue.
Platelets are small disk or plate like structures formed in blood, that are partially responsible for blood clotting (stops bleeding), and are critical in healing process. They promote more rapid healing by secreting various growth factors, which enhance recovery.
It is safe because it is the patient’s own blood that is processed and used in the therapy. Thus there is NO RISK of transmission of infectious disease.