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Joint Replacement & Arthritis

Overview:

Joint pain, swelling, and stiffness can be caused by many conditions that impact the health of a joint. At the GBH American Arthritis and Joint Replacement Center, we are dedicated to providing the latest strategies for joint preservation through both surgical and non-surgical therapies.

Services offered:

  • Total knee replacement - primary
  • Unicondylar knee replacement
  • Bicruciate retaining knee replacement
  • Revision knee replacements
  • Total hip replacements
  • Bipolar hip replacements
  • Dual mobility hip replacements
  • Revision hip replacements
  • Computer assisted joint replacements
  • Patient specific knee replacements
  • Shoulder hemiarthroplasty
  • Total shoulder replacement
  • Reverse shoulder arthroplasty
  • Total elbow replacement
  • Tumour prosthesis - limb salvage surgeries

Total knee replacement-
The knee is one of the largest working joints of the body. When something goes wrong with your knee, the problem can seriously impact your entire body and your ability to perform normal activities. When the joint is severely damaged due to arthritis or other problems, knee replacement surgery may be recommended. Annually, more than 250,000 Indians undergo joint replacement surgery for a new knee. This procedure can greatly improve your quality of life by relieving pain associated with a knee problem, allowing you to live a fuller, more active life.
The Orthopedic Arthroplasty Service at GBH American Hospital includes a team of orthopedic surgeons with expertise in joint replacement of the hip, knee and shoulder called arthroplasty. In addition, there are physician’s assistants, nurses and physical therapists who are specially trained in the care of patients with joint replacements. We all work together to provide comprehensive management of arthritis in these joints, including total joint replacement.
We are pioneers of joint replacement surgeries in Udaipur region and have been providing arthroplasty services since the year 2005. Over the years, the technology has continued to evolve, and we currently offer the latest advancements in joint replacement therapy — many of which aren’t available at other medical centers. In addition, GBH hospital is providing all this in world-class infrastructure at a very affordable cost.

FAQs

Joint Replacement :

Q. What is Joint Replacement?
Arthritic or damaged bones surfaces are removed and resurfaced with an artificial joint known as a prosthesis. Knee and hip replacements are most common, but joint replacement can be performed on other joint such as the shoulder, elbow, etc.

Q. Why Joint Replacement is necessary?
When the 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. The total joint replacement that is also called as Arthroplasty is one of the most successful and innovative surgeries of 19th Century. 

Q. How is Total Joint Replacement performed?
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 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 biomaterials 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 a metal prosthesis, leg side (tibia) is replaced with metal and plastic, and the knee cap (patella) is replaced with a plastic prosthesis. Results and durability of this surgery is excellent.
There is a breakthrough technology with high flexion –Knee designs where a patient can get complete knee bending and can sit cross-legged after surgery. This has been done regularly in GBH American hospital. Knee replacement surgery in our hospital regularly done using computer navigation system.

Unicondylar Knee Replacement
When one compartment of the knee joint is arthritic then replacing this part with metal and plastic joint through a small incision (skin cut) provides excellent quick recovery. The 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.

Q. How post-operative pain management is done?
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. 

Q. How long is hospital stay?
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. 

Q. What about physiotherapy?
In general physiotherapy program is neither strenuous nor painful. Few simple actions of exercises are taught to the patients by a physiotherapist. They have been also taught proper gait training with the use of walker and crutches or canes.

Q. Whether both knee replacements can be done together?
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

  • Complete relieve from pain. 
  • Correction of deformities. 
  • Increase range of movements of the joint & stability. 
  • Improvement in walking ability. 
  • Better quality of life.

Q. What are the complications?
• Infection: This is avoided by performing surgery in special joint replacement operation theatre having laminar air flow, use of body exhaust gown and appropriate antibiotics. 
• Loosening and Dislocation: This is avoided by a proper instruction to patients, proper surgical technique and use of appropriate designs of implants. 
• The risk of clot formation: This clot formation in leg blood vessels can be avoided by proper precautions in high-risk patients.

Specialist:

Dr. Rahul Khanna
MBBS, MS ORTHO
FIA (DEPUY), FIASM (S&N),
Consultant Arthroplasty (Joint Replacement) and Arthroscopy Surgeon