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Latest advances in Joint replacement & Knee Implant surgery

Dr.A.K.Venkatachalam

MS Orth, DNB Orth, FRCS, M.Ch Orth,

Consultant Orthopedic surgeon

www.kneeindia.com www.hipsurgery.in www.shoulderindia.com

Madras Joint Replacement Center

Madras Joint Replacement Center

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Madras Joint Replacement Center

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MJRC on the web

www.kneeindia.com
www.shoulderindia.com www.hipsurgery.in

www.kneereplacement.co.in
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MJRC on the Web

akvenkat
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MJRC on the web

Second live Oxinium knee replacement on

Twitter First Live knee replacement Tweetcast from India.

First result for Knee replacement India in

Madras Joint Replacement Center

Madras Joint Replacement Center

M J R C

Exclusive center for Joint replacements and

arthroscopy Zero wait time for Joint replacement ORs have Laminar air flow/ guided air flow to eliminate infection Choice of rooms catering to all budgets Performing Joint Replacements for more than 15 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 young patients.

Madras Joint Replacement Center

Latest advances in Joint Replacements

M J R C

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

Madras Joint Replacement Center

Cartilage & bone regenerative procedures

M J R C

Cartilage regeneration Bone regeneration for non unions, AVN Cartilage repair

Madras Joint Replacement Center

Knee Replacements
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Pioneered flexible

knee replacements in South India. Flexible knee replacements allow knee bending Full bending required for activities like kneeling, gardening recreation.
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Patients with High flexion Knees

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All patients had High flex knee replacements

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Minimally invasive Hip & Knee surgery - What is it?

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Skin incisions are smaller than

conventional surgery It is not Key hole or arthroscopic surgery Inside soft tissue dissection is less. More Bone, tendons, soft tissues are preserved
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Madras Joint Replacement Center

Minimally invasive knee replacements

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Small incisions that

measure 4- 5 inches Cause less pain Less blood loss Less requirement for analgesics Faster recovery

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Madras Joint Replacement Center

Minimally invasive knee replacements

M J R C

Standard TKR incision

Minimally invasive TKR incision

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Madras Joint Replacement Center

Minimally invasive knee replacements

M J R C

Incision for MIS knee

4 inch incision for TKR

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Madras Joint Replacement Center

Painless knee replacements

M J R C

Advanced Regional & Local anesthesia allows painless knee replacements Short Video

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Madras Joint Replacement Center

Knee replacements for young patients

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Increasing number of

patients < 50 years seeking knee replacements. Youngest patient so far is 34 years. Patient of 24 years is on waiting list for knee replacement. Special considerations of material, technique needed. Oxinium knee is an example of a TKR for young patients.

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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 matched instrumentation ( PMI) allowing accurate implantation
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Madras Joint Replacement Center

Computer assisted Knee replacement

M J R C

Used for outliers Patients with Pre

existing bony deformities in the femur or tibia.

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Madras Joint Replacement Center

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Patient matched instrumentation( PMI)

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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Alternative to Computer assisted knee replacement

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Hip Resurfacing
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Madras Joint Replacement Center

Hip resurfacing- Initial considerations

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Longevity of any primary THA cannot be

predicted Revision remains an issue Young/active patient may outlive primary THA. Hip resurfacing extends continuum of care in young patients with hip disease as a hip replacement is still possible in future.

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Madras Joint Replacement Center

Who is a candidate for hip resurfacing?

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Young and middle aged patients

with hip arthritis Pain is severe to need a Hip replacement X-rays show evidence of hip arthritis Bone density is normal Anatomy of hip is normal Limb lengths are equal

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Madras Joint Replacement Center

Advantages of Hip resurfacing

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Metal on metal bearings

have longevity More bone preservation in comparison to a total hip replacement Full range of movement & less chance of dislocation. Revision to a total hip replacement is possible later on.

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Surgical technique Femoral reaming

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Madras Joint Replacement Center

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Technique- Femoral head cemented

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Acetabular reaming & component insertion

Uncemented cup Fixationby

circumferential fins (Durom) Hydoxy apatite coating Cobalt chrome molybdenum High carbon content
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www.hipsurgery.in
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www.hipsurgery.in

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www.hipsurgery.in

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Birmingham Hip Resurfacing American patient story

Short Video

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Indications for Proxima or short stem Hip replacement

hip replacement is the permanent solution but Proxima will preserve more bone than a total hip replacement. Bone stock should be intact. Those patients with disease in the head which is more extensive making Resurfacing unsuitable. For eg- Avascular necrosis

Any patient with Hip arthritis for whom a total

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Short Stem Hip replacement

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Proxima is a bone preserving hip replacement

Neck portion of

femur is preserved Only head is removed. The shaft of the femur is not entered or reamed, once again preserving bone.

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Mini or short stem hip replacement

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Alternative to hip resurfacing &

total hip replacement. Head portion of the femur is not anatomical Short stem is impacted into the upper portion of the femur. No thigh pain vs THR Versatility- Can assemble variety of head size and material Less incidence of dislocation Minimally invasive procedure

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Comparison of total hip & Proxima

Total hip removes the

neck portion In short stem replacement neck portion is preserved

Reaming of the upper

femur.

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Advantages of Proxima

Less soft tissue dissection Less bony resection Large diameter Head- less chance of

dislocation 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 replacementAmerican patient story

Short Video

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Shoulder resurfacing
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Shoulder resurfacing is an

effective alternative to replacement Most patients with shoulder arthritis can have a resurfacing rather than a replacement Resurfacing preserves more bone than a replacement. Approach is less invasive than that for shoulder resurfacing.
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Shoulder resurfacing

Short video

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Cartilage & Bone renegeration

Cartilage regeneration possible for small

to medium cartilage defects Young patients with post traumatic cartilage lesions will benefit. 3 step procedure Cartilage harvest from knee, culture in lab and re implantation All steps are done in India
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Cartilage regeneration

Chondron therapy- Suited for Post

traumatic cartilage lesions, osteochondritis dissecans, Lesions measuring 2- 8 cm are ideally treated 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 of

fractures, avascular necrosis Bone regeneration done in 3 step procedure. 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 infra structure 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 in other centers.
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Hospital

Short hospital video

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