Dr. A.K. Venkatachalam presents on using the I-Assist guided system and Verilast knee replacement for a young patient with advanced knee damage. The I-Assist uses sensors to precisely position the implant components for perfect alignment. It is inserted in the knee bones and validates the alignment in multiple positions. The Verilast knee uses an oxidized zirconium femoral component and cross-linked polyethylene insert, which have been shown to greatly reduce wear. This combination of the I-Assist guidance and low-wear Verilast implant materials has the potential to last over 35 years for young, active patients and avoid the need for revision surgery. This case presents the novel use of
The I-Assist personalized guidance system gives perfectly aligned knee replacements which prolongs the life of the implant. You the patient don't have to worry about your knee wearing out in the rest of your life. Get it done with once and enjoy restored mobility for the rest of your life.
Clubfoot is a complex, congenital deformity of the foot. Its treatment technique with the most scientific evidence supporting its effectiveness is the Ponseti method. This method uses several plaster casts for its correction. We suggest that we can replace plaster casts with pre-simulated 3D printed cast for better and safer treatments. We also automated 3D modeling process from unedited mesh data with computational modeling.
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Limitations & future of 3 d printing in orthopedicsVaibhav Bagaria
3D printing or Rapid prototyping is impacting Orthopaedics and Joint replacement in a significant manner. Patient Specific instruments and Implants are increasingly being issued apart from 3D printed Biomodels. The final frontier of tissue printing however remains a significant challenge.
3T's: Technology, Technique & Team work that are transforming orthopaedics todayVaibhav Bagaria
The presentation is about newer techniques, cutting edge technology and team work trends that are changing the way orthopaedics is being practiced today. Five upcoming disruptive technologies include: minimally invasive surgeries, 3D printing, Orthobiologics, Smart Implants & robotics.
The I-Assist personalized guidance system gives perfectly aligned knee replacements which prolongs the life of the implant. You the patient don't have to worry about your knee wearing out in the rest of your life. Get it done with once and enjoy restored mobility for the rest of your life.
Clubfoot is a complex, congenital deformity of the foot. Its treatment technique with the most scientific evidence supporting its effectiveness is the Ponseti method. This method uses several plaster casts for its correction. We suggest that we can replace plaster casts with pre-simulated 3D printed cast for better and safer treatments. We also automated 3D modeling process from unedited mesh data with computational modeling.
EnvisionTEC 3D printers are known for accuracy, surface finish, reliability and speed. Our machines also deliver extreme flexibility with the power to print multiple materials.
Contact Engineering Technique – an all India distributors of EnvisionTEC 3D Printers. http://www.enggtechnique.com/3D-Printers
Limitations & future of 3 d printing in orthopedicsVaibhav Bagaria
3D printing or Rapid prototyping is impacting Orthopaedics and Joint replacement in a significant manner. Patient Specific instruments and Implants are increasingly being issued apart from 3D printed Biomodels. The final frontier of tissue printing however remains a significant challenge.
3T's: Technology, Technique & Team work that are transforming orthopaedics todayVaibhav Bagaria
The presentation is about newer techniques, cutting edge technology and team work trends that are changing the way orthopaedics is being practiced today. Five upcoming disruptive technologies include: minimally invasive surgeries, 3D printing, Orthobiologics, Smart Implants & robotics.
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Successful knee replacement surgery India by experienced highly qualified surgeons & latest advanced surgical techniques with the help of Tour2india4health.
Discover the transformative world of dental implants in this informative presentation. Learn about the various types of implants, their surgical procedures, and the benefits they offer. From enhancing your smile to improving chewing ability, dental implants provide a permanent and natural-looking solution for missing teeth. Explore the latest advancements in implant technology, including materials and surgical techniques.
Total knee replacement is a salvage procedure in orthopaedic surgery to provide a painless, mobile and stable knee joint to improve quality of life of patients suffering from afvanced painful arthritis commonly osteoarthritis, rheumatoid arthritis and rarely post-traumatic arthritis. Damaged cartilages and bones are carefully removed by measured resection and the collateral ligaments are preserved and balanced for creating a equal gap both in knee flexion as well as in knee extension for restoring anatomy. the main indication for doing total knee replacement is pain relief. The overall functional outcomes in terms of functional results are good after total knee replacement. Wound infection must be prevented by strict aseptic precautions during surgery.
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Knee Replacement Surgery in Indore - Understanding Knee Replacement SurgeryGokuldas Hospital
Knee replacement surgery, also known as knee arthroplasty, is a surgical procedure that aims to alleviate pain and restore function in patients with severe knee joint damage. Indore, a thriving city in Central India, boasts advanced medical facilities, and knee replacement surgery in Indore has gained prominence due to its success rates and improved quality of life for patients.
In this comprehensive guide, we will delve into the world of knee replacement surgery in Indore. From understanding the procedure to exploring the benefits and recovery process, we will provide valuable insights and expert advice to help you make an informed decision about your knee health. Knee replacement surgery is recommended for individuals with chronic knee pain and limited mobility caused by conditions like osteoarthritis, rheumatoid arthritis, or post-traumatic injuries. During the procedure, the damaged joint surfaces are replaced with artificial implants, restoring the natural movement of the knee.
Latest advances in Joint replacements higlkights rane of procedures currently performed by Dr. Venkatachalam. This list is not exhaustive and newer procedures are introduced frequently. Patients seeking value medical care abroad will benefit from this knowledge
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The CS 3800 gives you a whole new experience in acquiring impressions: Freedom. Freedom from cables; freedom to pursue your preferred workflow; freedom to pay only for what you use; and freedom to interact with partners, how you prefer, when you prefer. Plus, as the result of a renewed collaboration with Studio F. A. Porsche, the CS 3800 displays a timeless, ergonomic design that ensures a high- performance scanning experience.
• High-performance wireless intraoral scanner for optimal mobility
• One of the lightest and most compact intraoral scanners on the market
• Fast and smooth scanning thanks to a large and deep field of view
• Easier for you and end-to-end workflows provide a seamless user experience
Successful knee replacement surgery India by experienced highly qualified surgeons & latest advanced surgical techniques with the help of Tour2india4health.
Discover the transformative world of dental implants in this informative presentation. Learn about the various types of implants, their surgical procedures, and the benefits they offer. From enhancing your smile to improving chewing ability, dental implants provide a permanent and natural-looking solution for missing teeth. Explore the latest advancements in implant technology, including materials and surgical techniques.
Total knee replacement is a salvage procedure in orthopaedic surgery to provide a painless, mobile and stable knee joint to improve quality of life of patients suffering from afvanced painful arthritis commonly osteoarthritis, rheumatoid arthritis and rarely post-traumatic arthritis. Damaged cartilages and bones are carefully removed by measured resection and the collateral ligaments are preserved and balanced for creating a equal gap both in knee flexion as well as in knee extension for restoring anatomy. the main indication for doing total knee replacement is pain relief. The overall functional outcomes in terms of functional results are good after total knee replacement. Wound infection must be prevented by strict aseptic precautions during surgery.
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Knee Replacement Surgery in Indore - Understanding Knee Replacement SurgeryGokuldas Hospital
Knee replacement surgery, also known as knee arthroplasty, is a surgical procedure that aims to alleviate pain and restore function in patients with severe knee joint damage. Indore, a thriving city in Central India, boasts advanced medical facilities, and knee replacement surgery in Indore has gained prominence due to its success rates and improved quality of life for patients.
In this comprehensive guide, we will delve into the world of knee replacement surgery in Indore. From understanding the procedure to exploring the benefits and recovery process, we will provide valuable insights and expert advice to help you make an informed decision about your knee health. Knee replacement surgery is recommended for individuals with chronic knee pain and limited mobility caused by conditions like osteoarthritis, rheumatoid arthritis, or post-traumatic injuries. During the procedure, the damaged joint surfaces are replaced with artificial implants, restoring the natural movement of the knee.
Latest advances in Joint replacements higlkights rane of procedures currently performed by Dr. Venkatachalam. This list is not exhaustive and newer procedures are introduced frequently. Patients seeking value medical care abroad will benefit from this knowledge
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Knee joint pain and deformities are no longer just amongst the very old aged
people but also found amongst people post 50 years of age in the current scenario.
As much as the disease has advancement in the age factor, so does the treatment.
About a fewyears ago total knee replacementwas the only better solution,which in
itself was the evolution in medical science. However, evolution being the ultimate
factofmedical science, knee resurfacingisnowthe league.
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Cost effective Vertebroplasty surgery now available in IndiaHealth Service
Vertebroplasty surgery in India is available at leading medical institutions concerning spine surgery that gives our overseas clients the opportunity to access world class quality medical treatments at a very affordable price. India is a leading player in the medical tourism/healthcare facilitation industry. It is increasingly emerging as the destination of choice for a wide range of medical procedures. India offers internationally accredited medical facilities using the latest technologies, highly qualified physicians/surgeons and hospital support staff. The cost of Vertebroplasty surgery in India is lower by 35-40% when compared to similar procedures in North America and the UK.
Vertebroplasty surgery is a spine treatment procedure where bone cement is injected into a fractured spine vertebra to stabilize it. The procedure of vertebroplasty is typically used for a spine fracture caused by osteoporosis, a disease that causes weakening of the bones and can lead to fractures in the spine vertebra. An osteoporotic spine fracture can become the cause of extreme back pain along with other symptoms such as decreased height and spinal deformity or a hunchback appearance. The primary aim of vertebroplasty is to reduce pain caused by spine fracture by stabilizing the bone. Vertebroplasty surgery is typically performed by a spine surgeon or interventional radiologist. It is a minimally invasive procedure and patients usually go home the same day after the completion of the procedure.
Right candidates for Vertebroplasty surgery:
Right candidates for vertebroplasty include:
1. Elderly patients who are suffering from osteoporosis, compression fractures or a weakened vertebrae due to cancer.
2. Younger patients who have developed osteoporosis after long-term use of steroid treatment, cigarettes or metabolic disorder.
3. Individuals with malignant tumors on the spine.
Some common use of Vertebroplasty surgery procedure:
Vertebroplasty surgery is used to treat pain caused by vertebral compression fractures in the spine. Typically, vertebroplasty is recommended after simpler treatment such as bed rest, a back brace or pain medication have been ineffective or once medications have begun to cause other problems such as stomach ulcers. Vertebroplasty can be performed immediately in patients who have severe pain requiring hospitalization or conditions that limit bed rest and medications.
How does the procedure work?
Vertebroplasty surgery involves injecting a special cement mixture into the small holes in weakened vertebrae to strengthen the spinal bones making them less likely to fracture again and providing relief from pain. Using image-guidance, a hollow needle called a trocar is passed through the skin into the spinal bone and a cement mixture is then injected into the vertebra.
Vertebroplasty surgery procedure:
Since Vertebroplasty main indication is to treat osteoporosis, which is the weakening of the bones due to tiny porous holes that form as a result of genetics, ethnicity or diet. Medical-grade spine cement is inserted into the fractured vertebral body with a tiny needle, filling up the porous areas of the bone.
Recovery from Vertebroplasty surgery:
Most patients prefer Vertebroplasty surgery over any other orthopedic procedure that treats the spine because there is no incision. Only a tiny prick in the skin is made for the special needle-like camera to be inserted for optimum visualization. Stitches are not needed. Recovery time is minimal. Normally the pain from osteoporosis or slightly fractured vertebrae is relieved immediately after this procedure.
Result:
Success rates for treating osteoporotic fractures are high. The percentage of individuals who experience complications after Vertebroplasty surgery is less than 1%.
Why India:
Getting outpatient Vertebroplasty surgery in India doesn’t require much trouble as medical tourism in India has affiliations with the most reliable spine surgery institutions i
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1. I-Assist guided Verilast Knee
replacement
Durable knee replacement for young patients
Dr.A.K.Venkatachalam
FRCS, M.Ch Orth, DNB Orth, MS Orth
www.kneeindia.com
E mail-drvenkat@kneeindia.com
2. Patient details
• Ms. PM from Gujarat
• 32 years
• Suffering from Avascular
necrosis of Right knee
• Had consulted several
surgeons elsewhere.
• Had advanced damage to the
knee with bone loss from the
lower end of the thigh bone
• Was unable to walk without
support for few preceding
years.
• Underwent I Assist guided
Verilast Knee replacement in
September 2014.
E mail-drvenkat@kneeindia.com
3. Key concepts in this presentation
• I –Assist
• Verilast knee– What is it? How does it reduce
wear?
• How I-Assist and Verilast combine to lower
wear and increase durability in young
patients?
E mail-drvenkat@kneeindia.com
4. 1. What is the I-Assist?
• It is a Personalized guidance system designed to
assist the surgeon in positioning a total knee
arthroplasty implant components intra
operatively.
• It uses surgical instruments and position sensors
to determine alignment axes in relation to
anatomical landmarks
• To thus precisely position alignment instruments
& implant components relative to these axes.
E mail-drvenkat@kneeindia.com
5. I Assist components – 4 pods initially,
now only 2 pods.
E mail-drvenkat@kneeindia.com
6. What is inside it?
• It consists of 4 half palm sized pods with
electronic apps like
• Wi-Fi found in smart phones.
• Gyroscope found in air planes.
• The electronic sensors inside calculate the
alignment. The blinking lights on the display
face indicate the correct position.
• Red light means improper position and Green
light means proper position.
E mail-drvenkat@kneeindia.com
7. How does it work?
• It is inserted into the bones of the knee joint
itself.
E mail-drvenkat@kneeindia.com
8. How does it work?
• After connecting it to the knee the surgeon moves the
femur (thigh bone) in 13 different positions and the tibia (
leg bone) in 4 positions.
• It calculates the position by the electronic devices inside it.
• The surgeon makes fine adjustments so that
red lights turn to green.
• Blinking green lights indicate zero percent error.
• The surgeon can proceed to cut the bone confident that his
cuts will be perfectly aligned.
• He can then finally place the implant components in the
correct alignment achieved and validated in the previous
steps.
E mail-drvenkat@kneeindia.com
9. Advantages
• It guides the surgeon to get perfectly aligned cuts intra
operatively.
• It gives zero error cuts and again validates it in the next
step.
• Thus the surgeon gets the right fit during the surgery
itself.
• This ensures that the implant components are
positioned perfectly in correct alignment.
• Surgeon focusses his eyes in the operating field itself
and not take his eyes away.
• It thus saves time.
E mail-drvenkat@kneeindia.com
10. What does it differ from?
• Patient specific instrumentation
• Computer assisted knee replacement
E mail-drvenkat@kneeindia.com
11. Alignment in Knee replacement
• It is one of the factors that
ensures long life of the
implant.
• A proper alignment means
the implant is perpendicular
to the ground.
• Mal aligned knee
replacements tend to wear
out sooner than normal.
• Even experienced surgeons
can make errors in
placement of the
components.
Mal-aligned car tyre
Wear on the inside
E mail-drvenkat@kneeindia.com
12. Properly aligned Knee replacements
Implant is perpendicular to the ground
E mail-drvenkat@kneeindia.com
13. Why do young patients need a knee
replacement ?
• Rheumatoid arthritis (common)
• Post traumatic arthritis (common in India and
developing countries
• Avascular necrosis (rare)
E mail-drvenkat@kneeindia.com
14. Less than 65 years 12 %
65 – 75 years 10 %
75 years 4 %
Total knees fail more often in young patients
Age and failure rates
Robertsson, Thesis Lund 2000 , Swedish arthroplasty registerE mail-drvenkat@kneeindia.com
15. Why ?
Young patients wear away their total joints more
• than their older colleagues
• Wear is proportional to
usage.
• Young patients walk on
average up to 50% more
than older patients.
• Usage leads to increased
poly wear
• Poly wear leads to aseptic
loosening
Patient age Average of
steps/year
< 60 years 1200,00
> 60 years 800,00
Age & activity after THR/TKR
E mail-drvenkat@kneeindia.com
16. Problems of knee replacement in
young
• Previous two slides indicates that there is a
higher risk of failure in young patients and
they may require a revision within 10 years
• We also know that the Redo operation will be
technically a difficult operation than the
primary. Result also will be inferior.
E mail-drvenkat@kneeindia.com
17. How to prolong the life of a knee
replacement in a young patient ?
• The surgeon can do a TKR with a prosthesis
that wears out slowly.
• Use of materials, techniques, activity
modification can lead to better implant
survivorship.
E mail-drvenkat@kneeindia.com
18. Prosthetic life prolongation
Wear is an issue. Steps to reduce wear
• Bearings- alternate bearings like oxidized
zirconium.
• Poly ethylene – X LP poly, anti oxidants, thickness.
• Accuracy of component placement- ? Navigated
surgery
E mail-drvenkat@kneeindia.com
19. Options for change
• Change femoral
counter-face (
Oxidized zirconium
instead of routine
Cobalt Chrome )
• Change Poly insert
( XLPE)
Combination is known as
Verilast knee.
E mail-drvenkat@kneeindia.com
20. Oxidised Zirconium
• Meets requirements for ideal TKR
• Smoother
• ↓ Coefficient of friction
• More scratch resistant
• Less wear against both conventional and
highly cross linked poly ethylene.
E mail-drvenkat@kneeindia.com
21. What is it?
• Zirconium- metallic element
• Zirconia- ceramic
• Zr-2.5 Nb Metallic alloy
• Super heating zirconium to
500+°C in Oxygen presence
• Surface transformation into
zirconia ( ceramic oxide)
• Chemically bonded ceramic oxide
surface 5μ thick
Ceramic Oxide
Original Surface
Air
500oC
Oxygen
Diffusion
Oxygen Enriched Metal
Metal Substrate
E mail-drvenkat@kneeindia.com
22. Oxidized Zirconium properties
• It is a metal component
• Thin layer of ceramic like material that is part of its innate
structure. This is not a coating.
• Ceramic oxide is 5 μ thick
• Biocompatibility is excellent, matches titanium
• Very low coefficient of friction vs Cobalt chrome.
• Extremely abrasion resistant.
• Hard like ceramic
• Equivalent strength properties to Cobalt chrome.
• Adverse to chipping that can occur at insertion and over time.
• Lack of Nickel allergy.
E mail-drvenkat@kneeindia.com
23. Wear properties of Oxidized zirconium
• Oxidized zirconium
reduces volumetric
wear by upto 89% in an
abraded environment
when compared to
Cobalt Chrome
E mail-drvenkat@kneeindia.com
24. Oxidized Zirconium- Best of both worlds
(Ceramic & Metal)
• Strength of Cobalt chrome
• Low coefficient and scratch resistance of
ceramic
• Non brittle as the ceramic layer is part of the
innate structure.
• Decrease wear is the main advantage.4900
less volumetric wear.
• 160 times smoother.
E mail-drvenkat@kneeindia.com
26. Verilast CR knee
• Femoral component made of Oxidized
Zirconium
• Plastic insert made of Cross linked poly
ethylene (XLPE)
• Cruciate retaining or CR knee removes less
bone than other knee.
E mail-drvenkat@kneeindia.com
27. Verilast knee has the potential to last
35 years
• Potential has to be harnessed by perfect
alignment.
E mail-drvenkat@kneeindia.com
28. I Assist + Verilast knee
• Gives perfect alignment
during surgery itself.
• Alignment along with
durable materials like
Zirconium and Cross
linked poly-etheylene
increases life of a knee
replacement to 35 years.
• No need for future
revision surgery in young
patients.
E mail-drvenkat@kneeindia.com
29. What is innovative in my procedure?
• Earlier Verilast knee was implanted with an earlier smart tool called
“ Visionaire” patient specific instruments from the same company.
• Patient specific instruments manufacturing take time.
• Technique is operator dependent.
• Also used with Computer navigation – Surgeon has to keep shifting
his gaze from the operating field to the computer and back.
• This is the first time that it is used with a user friendly I –Assist
smart tool.
• I-Assist and Verilast belong to different companies.
• This is the first time that high end products from different
companies have been combined to hopefully give a high end
durable product.
E mail-drvenkat@kneeindia.com