Knee and Joint Replacement Surgery

Knee and Joint Replacement surgery In India Total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thigh bone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic "button" may also be added under the kneecap surface.

The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thigh bone. In total knee replacement surgery, this ligament is retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its benefits and risks.

Arthroscopic Knee Surgery is a procedure performed through small incisions in the skin to repair injuries to tissues such as ligaments, cartilage, or bone within the knee joint area. The surgery is conducted with the aid of an arthroscope, which a very small instrument is guided by a lighted scope attached to a television monitor. Other instruments are inserted through three incisions around the knee. Arthroscopic surgeries range from minor procedures such as flushing or smoothing out bone surfaces or tissue fragments (lavage and debridement ) associated with osteoarthritis, to the realignment of a dislocated knee and ligament grafting surgeries. The range of surgeries represents very different procedures, risks, and aftercare requirements. While the clear advantages of arthrocopic surgery lie in surgery with less anesthetic, less cutting, and less recovery time, this surgery nonetheless requires a very thorough examination of the causes of knee injury or pain prior to a decision for surgery.

Hip Replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. The normal hip joint is a ball and socket joint. The socket is a "cup-shaped" bone of the pelvis called the acetabulum. The ball is the head of the thigh bone (femur). Total hip joint replacement involves surgical removal of the diseased ball and socket and replacing them with a metal ball and stem inserted into the femur bone and an artificial plastic cup socket. The metallic artificial ball and stem are referred to as the "prosthesis." Upon inserting the prosthesis into the central core of the femur, it is fixed with a bony cement called methylmethacrylate. Alternatively, a "cementless" prosthesis is used which has microscopic pores that allow bony ingrowth from the normal femur into the prosthesis stem. This "cementless" hip is felt to have a longer duration and is considered especially for younger patients.

Hip Resurfacing is intended to produce pain relief in young and middle aged active patients with hip arthritis. It is not advised in advanced bone loss, altered anatomy, limb length discrepancy, women of child bearing age, kidney disease and metal allergy. Patients younger than 55 to 60 years are the ideal candidates.

It is a bone preserving operation as most of the head and neck portion of the femur bone is retained. The head portion alone is sculpted to a cylindrical stump and not chopped off. A metal ball like cap is fixed with cement over this stump. On the socket side, the worn out cartilage lining is scraped out and a metal implant or shell is impacted. Conversion to a total hip replacement after resurfacing is easy as femoral bone is preserved.The surface components are made of metal. The outer side of the socket is lined with either a porous metal or hydroxyapatite coating. The components match the normal size of the natural bone unlike a total hip replacement.

The lining surfaces are highly polished to give a low friction finish thus leading to reduced wear :

Artificial Discs Shoulder Procedures Individuals with degenerated discs in the lower (lumbar) spine may suffer from chronic low back pain. Most patients with symptomatic degenerative conditions in the spine are treated non-surgically with anti-inflammatory medications such as NSAIDS, physical therapy and corticosteroid injections. Many of these patients have a positive response to non-surgical methods of treatment, but there are a number of patients who continue to experience "chonic" and disabling pain. The chronic nature of back pain may interfere with the patient's ability to work and participate in regular daily activities. As a result, patient may turn to surgery to alleviate his symptoms.
There are many different conservative and minimally invasive surgical treatment options available to manage degenerative disc disease. In most cases when surgery is recommended, the treatment of choice has traditionally been lumbar spinal fusion. As with any surgery, spinal fusion also has a number of drawbacks. First, the ability of the bone to heal or "fuse" varies from patient to patient. The average success rate of a lumbar spinal fusion is approximately 75%-80%. Failure of the fusion to heal may be associated with continued symptoms. Second, a spinal fusion at one or more levels will cause stiffness and decreased motion of the spine. Third, having a spinal fusion at one or more levels will cause more stress to be transferred to adjacent levels. The problem with the transferred stress is that it may cause new problems to develop at the other levels, which may also lead to additional back surgery.