So, we have already reviewed knee surgeries, its types and costs in our earlier post here. We have also resolved most of your concens about the surgery and shared a list of hospitals which offer excellent treatment. Let us now take a look at some advanced knee surgeries or knee arthroplasty.
It is important to mention here that, in early July 2017, the first-ever robotic assisted knee surgery in India was performed at the Lokmanya Group of Hospitals in Pune. The robotic surgery was a medical feat accomplished by doctors in that, the surgery was completed in 30-35 minutes. This type of surgery enables surgeons to replace the knee joint by preserving the natural knee structure. The surgery involves minimal pain and blood loss, aids faster recovery and thus enables earlier discharge. In this kind of surgery, the prosthesis placement is more fitting as the surgery brings in more precision. Patients who undergo this surgery can get better movement, sit cross-legged, squat and have a very natural feel of the new implant.
An advancement in knee surgery, knee arthroscopy is a minimally invasive technique that allows orthopaedic surgeons to assess and treat a range of conditions affecting the knee joint. As in a shoulder arthroscopy, a surgeon inserts tiny camera and fiber optics through incisions made in the affected joint. The images captured are projected on a TV. The surgeon then restores the damaged parts.
The first arthroscopy was performed way back in 1918. The present day arthroscopic knee surgery is the development of the surgery with the advent of fiber optics in the 1970s and 1980s.
Anterior Cruciate Ligament (ACL) Reconstruction
An Anterior Cruciate Ligament (ACL) reconstruction surgery is a surgery undertaken on the torn ACL in the knee. In this procedure, the torn ligament is removed and replaced with a piece of tendon from another part of the knee or from a cadaver donation. The reconstruction of the ligament thus imparts stability to the knee and restores the full range of motion in the knee.
Cruciate ligaments are one of the four ligaments present in the knee joint. These cruciate ligaments cross each other to form an ‘X’ with the anterior cruciate ligament in the front and the posterior cruciate ligament in the back. The cruciate ligaments control the back and forth motion of the knee. The ACL runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee.
An ACL reconstruction surgery becomes necessary when the ACL tears owing to reasons such as an injury during sports activities, or injuries during intense workouts or accidents to the knee. Sportspersons are more prone to damages to the ACL, which may be partial or full. Also, an ACL can be damaged due to any activity that puts excessive stress on the knee or there is a sudden jerk to the knee.
Arthroscopy for Anterior Cruciate Ligament (ACL) Surgery
An ACL is typically operated upon using an arthroscopic surgery. As in knee arthroscopy, a camera is inserted into the affected area and images are relayed on a TV monitor. This enables the surgeon to execute the reconstruction of the joint. An ACL arthroscopy is recommended when :
The patient is a young individual who may face significant risk of disability and/or further knee injury if normal knee functions are not restored.
The patient is in good health
The patient is capable and ready to follow with a comprehensive post-operative physical therapy program
The instability of the knee significantly hinders the patient from carrying out daily activities.
Medications and physical therapy are not yielding the desired results and the patient needs the aid of crutches or a brace.
There is a simultaneous injury to other structures in the knee.
Bridge-Enhanced ACL Repair (BEAR)
Doctors are still studying if a new type of ACL is a better option over the conventional ACL surgery. The Bridge-Enhanced ACL Repair (BEAR) is an advancement over the standard ACL, where BEAR helps the torn ACL heal itself so it doesn’t need to be replaced. A tiny sponge is inserted into the knee between the torn ends of the ACL. The sponge is then injected with the patient’s blood and the loose ends of the ACL are stitched into the sponge. This sponge thus becomes a support for the ACL. Over time, the torn ends heal and develop into a new healthy ACL tissue.
Attune Rotating Platform Knee Replacement
This surgery, a first in south India, was introduced by Apollo Hospitals. This surgery along with Minimally Invasive Subvastus technique is the future of TKR. In a way, it is a personalised knee as as it matches the patient’s anatomy. The patient is completely at ease as the implant enables the patient normal functioning while offering stability and mobility. In this procedure, the incision made is not as deep as in the conventional procedure. The muscles are preserved by pushing them to the side and no incision is made to them. The knee cap is not flipped and the thigh and leg bones are cut in place. This results in less pain and faster recovery.
Going by the rapid strides being made in India in medical sciences, it is not surprising that India will soon be a leading destination for medical tourism.