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The knee is a large and complex joint in our body. The knee connects the thigh bone called fumer to the shin bone called tibia. The small bone that goes alongside adjacent to the shinbone and the kneecap called patella are the other bones that make a knee joint. Tendons join the knee bones to the leg muscles that move a knee joint. Ligaments connect the knee bones and get stability to the knee.
The hinged type synovial joint, such as the knee joint, allows the bones to bend and stretch. Among the joints in the human body under the most stress is the knee. It is also the largest joint, highly mobile, and prone to damage. Based on research, the knee is the most commonly injured joint in the body, with an estimated 2.5 million sports-related injuries reported annually. Top knee replacement surgeons in Mumbai, India, are available to treat these kinds of injuries.
We at Dr L H Hiranandani Hospital Powai, Mumbai provide the best knee replacement treatment in Mumbai and Knee Ligament injury treatment. We have a team of a highly-trained and experienced Knee replacement surgeons in Mumbai, India. Our team is completely dedicated to providing the best orthopedic treatment and surgeries in Mumbai.
Knee replacement surgery in Mumbai, India is also known as Knee arthroplasty or total knee replacement surgery. It is a medical procedure to resurface a damaged knee by arthritis. The parts made up of metal and plastic are used to cap the end of the bones that connect the knee joint, along with the kneecap. This medical procedure is renowned for people suffering from arthritis or a severe knee injury.
Arthritis can affect the knee joint in many ways. Degenerative joint disease known as osteoarthritis, which primarily affects middle-aged and older adults, can cause the cartilage in the knees to break down as well as the surrounding bone. Rheumatoid arthritis, which can lead to severe knee pain and inflexibility as well as inflammation of the synovial membrane. One of the most well-known forms of arthritis, traumatic arthritis, can result in hard knee cartilage.
Our aim at Dr L H Hiranandani Hospital is to resurface the parts of the knee joint replacement treatment in Mumbai, India. Being the best orthopaedic hospital in Mumbai, our top knee placement experts help to increase mobility and reduce pain in people who have an injured arthritic knee joint. Studies prove, after having a knee replacement surgery more than 90 percent of people experience less pain and better mobility in their knee.
Knee replacement surgery needs a patient to stay in the hospital. Such procedures may vary based on a patient's condition and the surgeon's practice. Knee replacement surgery is commonly performed while the patient is relaxed under regional anesthesia. The anesthesiologist discusses the modalities. The patient is made fully aware of the effect of anesthesia, subsequent postoperative pain, and its management. Following is the process of a Knee ligament injury treatment or Knee Replacement Surgery in Mumbai, India:
The best Knee Replacement Surgeon in Mumbai, India creates an incision around the front of the knee to get access to the patella, often referred to as the kneecap. Traditionally, the incision is around 10 inches long. In minimally invasive knee surgery is performed in the hospital, the incision is around 4 to 6 inches long.
In the initial stage of the surgery patella (kneecap) is exposed and the surgeon rotates the patella outside the knee region. This enables a surgeon to view the region required to perform the surgical procedure.
The femur, or thighbone, is the first bone a surgeon will resurface. Following the knee joint's exposure and opening, the surgeon will use specialized instruments to precisely measure the bones and make the necessary incisions. The hospital is equipped with the most sophisticated computer navigation system available, guaranteeing extremely precise cuts. The damaged area of the femur is severed, along with the cartilage.
The edge of the femur is cut and resurfaced to set the first part of the artificial knee, the femoral component. The surgeon fixes the metal femoral component to the edge of the femur and uses bone cement to fix its places.
The next bone a surgeon resurfaces is the tibia also known as shinbone. The surgeon detaches the injured bone and cartilage from the top of the shinbone and later shapes the bone to set the metal and plastic tibial component.
The lower region of the implant, known as the tibial tray, is fixed into place using the bone cement. After the tray is fixed, the surgeon will snap in a medical-grade plastic (polyethylene) insert to fix it between the tibial tray and the femoral component, and works as a type of buffer. This insert will help to support a body as it bends and flex the knee.
Before placing the patella to its right position, the surgeon requires to flatten patella and fix it with an additional plastic component to secure a right fit with the rest of the implant. The plastic may be cemented to the underlying bone.
In order to ensure proper implant functioning and proper alignment, sizing, and positioning, our team of expert knee replacement surgeons in Mumbai, India will bend and flex the knee joint. The surgeon will close the incision with stitches or staples to complete the procedure, then bandage it and get the patient ready for recovery. After surgery, the patient may have to leave the room with a leg in a continuous passive motion (CPM) machine, which will allow the new knee to bend and flex naturally for a while.
An Orthopaedic expert will explain to you the complete procedure and provide you an opportunity to ask any sort of question that you would like to know about the procedure.
A consent form is signed by the patient which gives the Orthopaedic surgeon's permission to do the procedure. It is important to read the form carefully and ask questions if certain things are not clear.
A full-body physical examination is done before the procedure to ensure a patient is healthy to undergo the surgical procedure. The patient might have to give blood tests or other diagnostic tests.
Patients are required to share information if they are sensitive to or are allergic to any medication. Also, inform your Orthopaedic doctors in Mumbai about all prescribed and medications and herbal supplements that you consume. The patient is asked to avoid food eight-hour before the procedure, normally after midnight. The patient will be provided a sedative before the procedure. A physical therapist will consultant to discuss rehabilitation, before and also after the surgical procedure.
After getting discharged from the hospital, it is important to have the surgical area clean and dry. Our top Orthopaedic doctors in Mumbai at DR L H Hiranandani hospital provide some bathing instructions to the patient, patient's family and caretaker. At the follow-up appointment, the sutures or surgical staples will be taken out. Orthopaedic doctors in Mumbai advise elevating the leg or applying ice to the knee to lessen swelling. Medical professionals also advise using a pain reliever for soreness. Adhering to the advice of an orthopaedic surgeon is preferable as taking aspirin or certain other medications may increase the risk of bleeding.
The patient has to report to the doctor if there is a case of fever, redness, swelling, bleeding, or other drainages. Also, increased pain around the incision site.
The patient can resume a normal diet after receiving the doctor's permission. Driving should be completely avoided under such circumstances. Other hyper activities should be avoided. Full recovery can take around 4 to 6 months or up to an entire year for complete recovery depending upon the general condition of the patient.
There are four prime types of Knee replacement surgeries in Mumbai, India and they are:
The total knee replacement is a method of medical treatment for a damaged knee. Total Knee Replacement Surgery involves the replacement of both sides of the patient's knee joint. The surgeon removes complete weight-bearing and affected knee cartilage and bone. The surgeon replaces it with a handmade metal or plastic quality prosthetic joint that replicates the knee function.
Partial knee replacement is also known as Uni Compartmental Knee replacement is an option if certain part or compartment of the knee joint is completely damaged. In Partial knee replacement, the orthopaedic doctors in Mumbai, India removes the arthritic region of the knee such as the bone and cartilage. Replacing it with metal or plastic made components. This knee replacement surgery is common among people below the age of 65.
Minimally Invasive Knee Replacement requires specialized surgical techniques that allow a 3 to 5-inch incision. Minimally Invasive Knee Replacement helps in reducing trauma to tissues, lowering pain, and reducing blood loss-consequently speeding recovery. The incidence now has increased in performing Minimally Invasive Knee Replacement. However, it may not be suitable for all.
Revision knee replacement is eliminating and resurface a prosthetic knee joint that is damaged or that is affected. It can be performed multiple times. But due to scar tissue formation future surgeries can be difficult. With each replacement surgery.
Dr L H Hiranandani is one of the most technologically advanced hospitals in the country which makes it the best orthopaedic hospital in Mumbai, India. As India is one of the top medical hubs for countries across the world, we have the best team of Orthopaedic surgeons in India. There are numerous benefits for knee replacement surgery in the country. The two prime benefits of a Knee ligament injury treatment or knee replacement surgery in Mumbai, India are:
Dr L H Hiranandani is one the most renowned multi-specialty tertiary and quaternary care hospital in the country. We are the best Orthopaedic hospital in Mumbai, India and our team of top Orthopaedic Surgeons are committed to providing the best orthopaedic treatment of global standards. We have handled from simplest to the most complex knee cases, at our hospital. We are equipped with the top medical equipment for providing the best orthopaedic care in the country.
Total knee replacement through medial para-patellar approach is an established technique across the world. In recent times, there has an endeavour to minimise soft tissue damage while performing knee replacement surgery. Also, with popularisation of Unicompartmental knee replacement over last decade led to requirement of a surgical exposure which would be less traumatic. Medial subvastus approach is a minimally invasive technique which spares cutting of quadriceps muscle while approaching the knee for replacement surgery.
Those patients who have got minimal deformity in the knee and have got mobile soft tissues are the best candidate. Every patient needs to be assessed methodically to assess suitability of this approach. A surgeon should be familiar with knee anatomy and must have received adequate training before using this approach, as at times, it may not be possible to have full exposure on lateral side without damaging quadriceps mechanism. Also, inadequate exposure can cause wrong placement of implants thus jeopardising the final outcome of knee replacement surgery. Every surgeon has a different learning curve and he should strive to achieve perfection before embarking on it.
Medial subvastus approach allows quicker rehabilitation and lesser pain at the operated site, thus allowing early discharge from hospital.
Gluteus medius muscle around hip and vastus lateralis muscle of thigh are in functional continuityover greater trochanter of femur. This anatomic knowledge was used by McFarland and Osborne in 1954 to approach hip joint through direct approach. Subsequently, Hardinge in 1982, publicized his technique using anterior half of this musculo-tendinous composite. This technique avoided chiseling out part trochanteric bone. Surgical technique of Hardinge also allowed easy correction of limb length discrepancy and orientation of hip implants. In this modified approach, muscles are split (gluteal-vastus flap) rather than cutting and injuring them. Also, partial detachment of gluteus medius and minimus is done to expose the hip joint all around.
Any approach to joint should ideally be less traumatic to soft tissues, easy visualization of all structures around joint and avoid any major neurovascular structure crossing the hip joint. Apart from this general consideration, it should have technical benefit in terms of minimizing risks like post-operative dislocation, limb length discrepancy and sciatic nerve injury. When compared to posterior approach to hip joint, these abovementioned risks are considerably minimized while performing total hip replacement with antero-lateral approach. Closure of hip joint, from capsule onwards till gluteal-vastus flap, should be done meticulously layer by layer anatomically.
Soft tissue care around hip, during exposure and closure, is of paramount importance in order to prevent infection, soft tissue dehiscence or dislocation of hip following replacement surgery. Intactness of posterior capsule of hip further protects transplanted hips from getting dislocated in Hardinge’s approach.
Total knee replacement surgery is one of the most widely performed surgeries across the world. There have been continuous ongoing advancements in technique and methodology to achieve near normal perfection and early rehabilitation for patients undergoing TKR. Computer assisted orthopaedic surgery (CAOS) allows proper alignment of limb, component sizing and positioning of implants, especially in those patients who have deformities around the knee joint. Malalignment and improper positioning of implants reduces success rate of TKR. Polyethylene wear and implant loosening can rapidly progress if there is any compromise in technique. It’s a cost-effective procedure in long term as risk of performing revision surgery in future is reduced.
Over last 25 years, continuous advancements have occurred in the field of computer assisted Total knee replacement surgery and it is ever evolving field. This is allowing surgeons to achieve near normal surgical perfection and quicker surgery. This further allows early rehabilitation and discharge from the hospital. More and more patients are opting nowadays for computer assisted surgeries.
Dr Ujjwalraj Dudhedia (Consultant Anesthesiologist and Pain Specialist)
Managing the pain after Knee Replacement surgery is an integral part of skill of Anesthesiologists. The Team of Anesthesiologistat Dr L H Hiranandanideals with this postoperative pain with a multi pronged approach. Team of trained doctors and nurses addresses the pain individually as per the patients’ tolerance and pain scores. Pain is graded as Visual Analogue Score (VAS) and depending on severity different medications and procedures are used to address it. This is called as Multimodal analgesia. This includes oral and intravenous Analgesic medications + Transdermal Patches + Neuraxial Blocks / Nerve blocks .
Neuraxial blocks and nerve blocks are special skilled procedures performed by the Anesthesiologist to numb the nerves carrying sensations from and around the Knee joint. These procedures are performed using various imaging technologies like Ultrasound where in we identify the nerves supplying the area and deposit the drugs around it.We can also place a thin catheter for continuous drug delivery. Uninterrupted pain relief is assured using continuous delivery of medication using infusion pumps or Patient Controlled Analgesia(PCA) pumps. Patient controlled Analgesia pumps give the patients ease and liberty to take bolus of medications themselves without waiting for the Doctors and nurses. These are preprogrammed drug delivery pumps to prevent Adverse Drug reactions and over dosage.
