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Knee care
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  • 1. Taking good care of your knees Dr Vinay JoshiMS,DNB,FCPS,D’ORTH,FRCS,FRCS (ORTH) Consultant Orthopaedic Surgeon KDAH
  • 2. Knee Anatomy
  • 3. Maintain a Healthy Weight• Excess weight puts undue stress on your joints and speed up the deterioration of joint cartilage.• For those who have OA, excess weight can exacerbate the symptoms.• Losing weight has been proven to reduce pain in legs and hips.
  • 4. Exercise• Exercise is essential to slowing and preventing osteoarthritis.• It maintains healthy joints, relieves stiffness, reduces pain and fatigue, and increases muscle and bone strength.• Arthritis experts recommend low-impact exercises that involve aerobic activity, strength training, and stretching
  • 5. Diet• A diet low in saturated fat and high in fiber- rich food.• whole grains, Fresh fruits, and vegetables will optimize nutrition and help you avoid excess weight.• Avoid processed and fried food.
  • 6. Rest• While exercise can help develop healthy joints and muscles, excessive overuse of joints can increase the risk of developing OA.• The key is balance. Also, for those who have OA, fatigue has been shown to increase pain.• Make sure you get eight to 10 hours of sleep every night.
  • 7. Stages of Osteoarthritis
  • 8. Progression of Osteoarthritis
  • 9. Non Surgical management of knee arthritis• Reduction of weight.• Use of cane• Limitation of activity• Intraarticular cortisone injection.• Swimming / bicycle.• Knee cap / braces.• NSAIDs.• Physiotherapy and SWD.
  • 10. When to consider a Total knee replacement• Only patient can make a informed decision.• Constant pain / wheelchair bound – Needs TKR.• Responding to non operative treatment and can walk long distance without a stick – Do not need a TKR.
  • 11. SOME FACTS ABOUT KNEE ARTHRITIS• Grade 4 arthritis will never get better or remains same but will gradually get worse.• Gradually star affecting other knee and lower back.• Delay of surgery may start affecting other side.• Longer you sit around with arthritis softer your bones and weaker your muscles.• Total knee replacement has 96% success rate.
  • 12. Metal used is CobaltChromium.High Density Polythelenein the middle.
  • 13. MIS ( Minimally Invasive Surgery) knee • Small Skin Insertion • Minimal disruption of extensor mechanism • Shorter hospital stay • Early mobilisation and quick recovery • Less blood loss
  • 14. High Flex TKRSpecifically designed to safely accommodate Flexionupto 155.
  • 15. Why a woman’s knee? Gender Total KneeOrthopaedic surgeons have reported anatomical •differences in women’s and men’s knees for years.Orthopaedic surgeons often have to considerintraoperative adjustments during knee surgery toaccommodate women’s anatomical differences.Women account for nearly two-thirds of kneearthroplasties performed annually .Women are three times more likely to need kneearthroplasty.
  • 16. • CT data documents distinctive shape differences in female and male distal femurs.12,13 Female femurs are:• More trapezoidal-shaped. Narrower in the M/L dimension when compared to a male femur of the same A/P dimension
  • 17. MIS ( Minimally Invasive Surgery)
  • 18. Unicondylar Knee ReplacementsLocalised Knee arthritisPreservation of uninvolvedtissues and bone.With appropriate patientselection, careful surgicaltechnique, and proper implantdesign long term excellentresults.
  • 19. PatellofemoralReplacementSevere isolatedpatellofemoral arthritisA PFR is a much smalleroperation than a total kneereplacement.The incision is much smallerand all knee ligaments arepreserved. The recovery from a PFR isthe quickest of all partialknee replacements.
  • 20. Computer Navigation in TKRMechanical Axis • The use of computer navigation in total knee replacement (TKR) has resulted in consistently accurate alignment of prosthetic components. • Helps surgeon in soft tissue balancing in difficult TKR
  • 21. Computer Navigation in TKR
  • 22. THANK YOU

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