latestadvancesinjointreplacementkneeimplant-091129010716-phpapp02

7/28/2019 latestadvancesinjointreplacementkneeimplant-091129010716-phpapp02

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Dr.A.K.VenkatachalamMS Orth, DNB Orth, FRCS, M.Ch Orth,Consultant Orthopedic surgeon

www.kneeindia.comwww.hipsurgery.in

www.shoulderindia.com

Latest advances in Joint replacement& Knee Implant surgery
http://www.kneeindia.com/http://www.hipsurgery.in/http://www.shoulderindia.com/http://www.shoulderindia.com/http://www.hipsurgery.in/http://www.kneeindia.com/


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Madras Joint Replacement Center



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MJRC on the Web

akvenkat


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MJRC on the web

Second live Oxinium knee replacement onTwitter

First Live knee replacement Tweetcastfrom India.

First result for Knee replacement India in


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Exclusive center for Joint replacements andarthroscopyZero wait time for Joint replacementORs have Laminar air flow/ guided air flow toeliminate infection

Choice of rooms catering to all budgets

Performing Joint Replacements for more than15 years in UK & India.

Western trained team of Orthopedic Surgeons& Anesthetists

Pioneered several Joint replacements in India.Short stem hip replacements, Shoulder

resurfacing, Knee replacements for youngpatients.



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Total Knee replacements Partial knee replacements Hip resurfacing Total hip replacements. Short stem hip replacement Shoulder resurfacing & replacement

Elbow replacement Biological Joint replacement with cartilage

Latest advances in Joint Replacements


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Cartilage & bone regenerative procedures

Cartilage regeneration Bone regeneration for non unions, AVN

Cartilage repair


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Pioneered flexibleknee replacements inSouth India.

Flexible kneereplacements allowknee bending

Full bending requiredfor activities likekneeling, gardeningrecreation.

Knee Replacements


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All patients had High flex knee replacements

Patients with High flexion Knees


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Minimally invasive Hip & Knee surgery - What is it?

Skin incisions are smaller thanconventional surgery

It is not Key hole or arthroscopicsurgery

Inside soft tissue dissection is less.

More Bone, tendons, soft tissues arepreserved


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Small incisions thatmeasure 4- 5 inches

Cause less pain Less blood loss Less requirement for

analgesics

Faster recovery

Minimally invasive knee replacements

C


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Standard TKR

incision

Minimally invasive TKR

incision


M d J i t R l t C t


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Incision forMIS knee 4 inch incision for TKR

M d J i t R l t C t


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Advanced Regional & Local anesthesia allows painless kneereplacements

Short Video

Painless knee replacements

M d J i t R l t C t
http://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/Dr.%20venket%201.mpeg4http://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/Dr.%20venket%201.mpeg4


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Increasing number ofpatients < 50 years seekingknee replacements.

Youngest patient so far is 34

years. Patient of 24 years is on

waiting list for kneereplacement.

Special considerations of

material, technique needed.Oxinium knee is an exampleof a TKR for young patients.

Knee replacements for young patients

M d J i t R l t C t


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Journey knee replacement

High flex knee prosthesis Only implant in market to reproduce

normal knee movements Provides excellent stability Oxinium confers longevity of implant

Can be used with patient matchedinstrumentation ( PMI) allowing accurateimplantation


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Patient matched

instrumentation( PMI) Alternative to Computer assisted knee replacement-

Customized cutting blocks.

Used for Journey knee

Reduces operating steps and time In the long run will reduce the cost of the implant Requires a standing x ray and MRI scan of the knee. Data sent to Lab in US where cutting blocks are made.

Cutting blocks delivered to patient in 3 weeks. Patients travel to India from the US/Canada carrying

their own customized cutting blocks.



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Hip Resurfacing



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Hip resurfacing- Initial considerations

Longevity of any primary THA cannot bepredictedRevision remains an issue

Young/active patient may outlive primary THA. Hip resurfacing extends continuum of care in

young patients with hip disease as a hipreplacement is still possible in future.



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Young and middle aged patientswith hip arthritis

Pain is severe to need a Hipreplacement

X-rays show evidence of hiparthritis

Bone density is normal Anatomy of hip is normal Limb lengths are equal

Who is a candidate for hip resurfacing?



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Metal on metal bearingshave longevity

More bone preservation incomparison to a total hipreplacement

Full range of movement &less chance of dislocation.

Revision to a total hipreplacement is possiblelater on.

Advantages of Hip resurfacing



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Surgical technique

Femoral reaming



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Technique- Femoral head cemented



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Acetabular reaming & component insertion

Uncemented cup Fixationby

circumferential fins(Durom)

Hydoxy apatitecoating

Cobalt chromemolybdenum

High carbon content



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www.hipsurgery.in



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ad as Jo t ep ace e t Ce te

www.hipsurgery.in



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www.hipsurgery.in



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Birmingham Hip ResurfacingAmerican patient story

Short Video

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Indications for Proxima or short stemHip replacement

Any patient with Hip arthritis for whom a totalhip replacement is the permanent solution butProxima will preserve more bone than a total hipreplacement. Bone stock should be intact.

Those patients with disease in the head which ismore extensive making Resurfacing

unsuitable. For eg- Avascular necrosis



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Short Stem Hip replacement



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Proxima is a bone preservinghip replacement

Neck portion offemur is

preserved Only head isremoved.

The shaft of thefemur is notentered orreamed, onceagain preservingbone.



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Alternative to hip resurfacing &total hip replacement.

Head portion of the femur is notanatomical

Short stem is impacted into theupper portion of the femur.

No thigh pain vs THR Versatility- Can assemble

variety of head size andmaterial

Less incidence of dislocation Minimally invasive procedure

Mini or short stem hip replacement



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Comparison of total hip & Proxima

Total hip removes theneck portion

In short stemreplacement neckportion is preserved

Reaming of the upperfemur.



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Advantages of Proxima

Less soft tissue dissection Less bony resection

Large diameter Head- less chance ofdislocation Fluid film lubrication leads to less wear

of the implant

Metal on metal bearings- less wear Hence less is More



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Short stem or mini hip replacement-American patient story

Short Video

http://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/Short%20stem%20hip%20replacement_0001.wmvhttp://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/Short%20stem%20hip%20replacement_0001.wmv


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Shoulder resurfacing is aneffective alternative toreplacement

Most patients with shoulderarthritis can have a resurfacingrather than a replacement

Resurfacing preserves more bone

than a replacement. Approach is less invasive than

that for shoulder resurfacing.

Shoulder resurfacing



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Shoulder resurfacing

Short video

http://localhost/var/www/apps/conversion/tmp/scratch_1/Shoulder%20resurfacing%20surgery%20in%20India-%20South%20African%20patient's%20story.mp4http://localhost/var/www/apps/conversion/tmp/scratch_1/Shoulder%20resurfacing%20surgery%20in%20India-%20South%20African%20patient's%20story.mp4


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Cartilage & Bone renegeration

Cartilage regeneration possible for smallto medium cartilage defects

Young patients with post traumaticcartilage lesions will benefit.

3 step procedure Cartilage harvest from

knee, culture in lab and re implantationAll steps are done in India



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Cartilage regeneration

Chondron therapy- Suited for Posttraumatic cartilage lesions, osteochondritisdissecans,

Lesions measuring 2- 8 cm are ideallytreated

Regeneration of normal cartilage occurs May prevent progression to end stage

osteoarthritis



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Bone regeneration

Bone forming cells can heal Non unions offractures, avascular necrosis

Bone regeneration done in 3 stepprocedure.

Biological alternative to Hip resurfacing in

early cases of Avascular necrosis.



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Our Unique selling points

Well Qualified & experienced surgeon Direct access to Doctors instead of going thro

marketing department- hence personalized care.

Affiliated hospitals have state of the art infrastructure Fountain head of Progress in Joint Replacements

& Cartilage surgery

Costs are 1/5th

to 18th

of cost in Canada/ US Highly personalized care vs generic treatment inother centers.



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Hospital

Short hospital video

http://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/hospital_0001.wmvhttp://localhost/var/www/apps/conversion/tmp/My%20Documents/My%20Videos/hospital_0001.wmv


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