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Future of Joint Replacements
Dr. A K Venkatchalam
MJRC Clinic, Chennai
Needle may replace scalpel
• Regenerative medicine is an exciting field in Orthopedics.
• Possible to treat Osteoarthritis...
We have the technology, we can rebuild him…
• PRP (Platelet-Rich Plasma)
• Stem cell treatment
• Tissue engineering
Rebuil...
Joint preservation in knee
• Increasing role for osteotomies, meniscal replacement, meniscal
transplant, Osteochondral gra...
PRP (Platelet-Rich Plasma)
Cell therapies have even gone
beyond surgery to office-based
injections only.
• Stem cells and ...
Advances in Joint Replacement
• Newer materials which increase longevity of the implant.
• Cement-less fixation of knee im...
Materials
• Femoral components made
of Oxidized zirconium
• Plastic tray made of highly
cross linked polyethylene.
• Vitam...
Image-guided and Robotic Surgery
• Image-guided surgery (sometimes called computer-assisted
surgery) is a technique where ...
Smart tools
• I-Assist smart tool • Ortho align smart tool.
• Soft tissue balancing
tools
Cementless Knee Replacements
• Cemented knee replacements have been the most popular so
far, but cement-less knee replacem...
Future of joint replacements  by Dr.A.K.Venkatachalam
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Future of joint replacements by Dr.A.K.Venkatachalam

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Future of Joint replacements. This is one of the talks given by Dr.A.K.Venkatachalam at a Joint replacement conclave

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Future of joint replacements by Dr.A.K.Venkatachalam

  1. 1. Future of Joint Replacements Dr. A K Venkatchalam MJRC Clinic, Chennai
  2. 2. Needle may replace scalpel • Regenerative medicine is an exciting field in Orthopedics. • Possible to treat Osteoarthritis of knee and hip with stem cells injected through needle. • This is possible by better understanding of the pathology of osteoarthritis.
  3. 3. We have the technology, we can rebuild him… • PRP (Platelet-Rich Plasma) • Stem cell treatment • Tissue engineering Rebuild Regenerate
  4. 4. Joint preservation in knee • Increasing role for osteotomies, meniscal replacement, meniscal transplant, Osteochondral grafts, articular cartilage repair. • The joint is not replaced but the abnormal biomechanics in and around the joint are altered • These may postpone the date for a knee replacement. • Biological knee replacement possible with cadaveric menisci, synthetic menisci, cadaveric ligaments, osteo-chondral grafts.
  5. 5. PRP (Platelet-Rich Plasma) Cell therapies have even gone beyond surgery to office-based injections only. • Stem cells and growth factors, such as PRP (Platelet-Rich Plasma) are directly injected into the knee • The cell therapies are now also being used experimentally in conjunction with regenerative surgeries to enhance, and possibly accelerate the healing process
  6. 6. Advances in Joint Replacement • Newer materials which increase longevity of the implant. • Cement-less fixation of knee implants. • Smart tools like the I-Assist provide intra operative navigation. • Validated soft tissue balancing tools – E-Libra • Kinematically aligned knee replacement vs Mechanically aligned knee replacement. • Biological knee replacements – Can be done in incremental steps in India with tissue bank assistance. • Customized implants – These are available abroad.
  7. 7. Materials • Femoral components made of Oxidized zirconium • Plastic tray made of highly cross linked polyethylene. • Vitamin E incorporated durable poly inserts
  8. 8. Image-guided and Robotic Surgery • Image-guided surgery (sometimes called computer-assisted surgery) is a technique where surgery is performed with the aid of computerized images. • Latest disposable navigation devices are I Assist and Ortho align • Navigation may be useful in young patients • Only about 1 in 100 knee operations are currently performed in this way. Results so far suggest this technique offers greater accuracy in positioning the new knee joint. • However, there is no evidence that it leads to better function or survival of a knee replacement.
  9. 9. Smart tools • I-Assist smart tool • Ortho align smart tool. • Soft tissue balancing tools
  10. 10. Cementless Knee Replacements • Cemented knee replacements have been the most popular so far, but cement-less knee replacements are available • Components with a coating which has tiny holes in or which is made from crystal can be used. This allows the bone to grow on to and bond directly to the component. It’s thought that this could provide a longer-lasting bond than cement, which may break down over time. • However, there’s currently no evidence that the components themselves are better in terms of pain relief, function, or how long they last. • Research continues into the pros and cons of cementless versus cemented knee replacements.

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