We Care, India’s leading Medical Travel facilitation company offers Low Cost, Safe and Quality Surgery and Treatment Options at Best Hospitals in India."
Trauma Society of India is a pioneering initiative to promote knowledge in the fields of orthopedics and traumatology. The society has taken a giant leap in its endeavors by launching the first ever standard guidelines for orthopedic clinicians. These guidelines would go a long way in establishing treatment protocols and providing a roadmap to clinicians that guides them in the assessment, decision-making and management of complex fracture situations.
The guidelines will be published in a series of books titled Guidelines in Fracture Management, compiled by eminent Indian and international clinicians. They illustrate all possible treatment options and latest management techniques that can be used, with special emphasis on the health scenario in the Asia-Pacific region.
Guidelines in Fracture Management--Proximal Tibia discusses the classification, assessment of personality, and planning and treatment protocols for the much-debated proximal tibia fractures.
Proximal fibular osteotomy - What is the evidence?Dr Saseendar MD
Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of case series, suggests the usefulness of the procedure in decreasing varus deformity as well as improving symptoms in medial osteoarthritis. However, large randomised controlled trials with long-term follow-up are required to establish the benefits of this procedure over other established treatment methods.
Trauma Society of India is a pioneering initiative to promote knowledge in the fields of orthopedics and traumatology. The society has taken a giant leap in its endeavors by launching the first ever standard guidelines for orthopedic clinicians. These guidelines would go a long way in establishing treatment protocols and providing a roadmap to clinicians that guides them in the assessment, decision-making and management of complex fracture situations.
The guidelines will be published in a series of books titled Guidelines in Fracture Management, compiled by eminent Indian and international clinicians. They illustrate all possible treatment options and latest management techniques that can be used, with special emphasis on the health scenario in the Asia-Pacific region.
Guidelines in Fracture Management--Proximal Tibia discusses the classification, assessment of personality, and planning and treatment protocols for the much-debated proximal tibia fractures.
Proximal fibular osteotomy - What is the evidence?Dr Saseendar MD
Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of case series, suggests the usefulness of the procedure in decreasing varus deformity as well as improving symptoms in medial osteoarthritis. However, large randomised controlled trials with long-term follow-up are required to establish the benefits of this procedure over other established treatment methods.
The first knee replacement was performed in 1968. Since then, improvements in material selection and techniques have greatly increased its effectiveness.
The study of biomaterials by biomedical engineers has led to advancements in more accurate sizing, the option of patella femoral replacement, better instrumentation as well as components that allow an increased range of motion and a lower wear rate have since been developed and implemented. During this period the collaboration between surgeons and engineers produced many developments in the design of the prosthesis. Today this procedure is safe and established even if in continuous development. The progress in technologies and the use of new materials let researches try again old-fashioned techniques from the past in order to be improved.The most common reason for knee replacement is that other treatments (weight loss, exercise/physical therapy, medicines, injections, and bracing) have failed to relieve arthritis-associated knee pain. The goal of knee replacement is to relieve pain, improve quality of life, and maintain or improve knee function
Scope
Possible disadvantages of knee replacement surgery include replacement joints wearing out over time, difficulties with some movements and numbness. A replacement knee can never be quite as good as a natural knee – most people rate the artificial joint about three-quarters average (Marian et al.,2021)
Most knee replacements aren’t designed to bend as far as your natural knee. Although it’s usually possible to kneel, some people find it uncomfortable to put weight on the scar at the front of the knee. There may be some numbness at the outer edge of the spot. This usually improves over about two years, but it’s unlikely that the feeling will ultimately return to normal. A replacement knee joint may wear out after a time or may become loose.
, total knee replacement can help relieve pain that emanates from arthritis restoring the normal mobility of an individual. The procedure involves removing the damaged bone and cartilage from the thigh bone, shin bone, and kneecap and replacing it with an artificial joint made of metal alloys, high-grade plastics and polymers. However, despite having its advantages, total knee replacement surgery carries several risks such as infection, blood clots in the leg veins or lungs, heart attack, stroke and nerve damage. The artificial knee can also wear out due to excessive use. Excess glue is squeezed out to the side as the element is pressed into place and removed. The cement hardens quickly, the incision is closed using several layers of sutures, and a bandage is applied
Bone Grafts /certified fixed orthodontic courses by Indian dental academy Indian dental academy
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Short Term Analysis of Clinical, Functional Radiological Outcome of Total Kne...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Functional outcome of Arthroscopic reconstruction of single bundle anterior c...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A prospective observational study on comparing the outcome of patellar resurf...Dr.Avinash Rao Gundavarapu
Introduction: Total Knee Arthroplasty (TKA) has been a very successful surgery in relieving pain and restoring function in osteoarthritis. Conflicting evidence in literature exists regarding the merits of patellar resurfacing during TKA over non-resurfacing. Our aim is to evaluate and compare the difference between patellar resurfaced group and non-resurfaced group in primary TKA.
Materials and Methods: This prospective obsevational study was initiated in May 2016 conducted till April 2008 (2 years) in Yashoda Superspeciality Hospital, Hyderabad. At least 14 mm of patella was ensured to be retained after patellar cut. A total of 40 patients were allocated to receive (n=20) or not to receive patellar resurfacing (n=20) during primary TKA. The data was analyzed statistically using the Student t test. Overall patient satisfaction was recorded using the SF-36 score.
Results: Of the 40 patients, 67.5% females and 32.5 % males underwent TKA. Among those who underwent resurfacement, 40% were males. 75% among the non-resurfaced group were females. Right knee was operated on 37.5% of cases. Mean operative time being 103.9 and 122.5 minutes in nonresurfaced and resurfaced cases respectively. Mean patellar thickness was 22.1mm in nonresurfaced and 23.6mm in resurfaced group. The difference in VAS score, modified HSS score, KSS scores between the two groups were statistically insignificant with p-values of 0.230, 0.0214, 0.2513 respectively at the end of two year,
but there was significant reduction of anterior knee pain in the resurfaced with p-value < 0> Conclusion: The functional outcome was not affected by whether the patella was resurfaced or nonresurfaced. There was no significant difference between the two groups with respect to the prevalence of knee-related readmission, or of subsequent patella-related surgery or patients overall satisfaction. We recommend selective patellar resurfacing at the time of primary total knee replacement.
Keywords: TKA, Patellar resurfacement, Non-resurfacement, HSS score, KSS score.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. Orthopedic Surgery
Acetabular Fixation
<title>Acetabular Fixation Surgery,India Acetabular Fixation Hip Surgery
Materials and Methods
Between 1987 and 2005, a retrospective review of all THR cases using 2 independent series of hybrid
and reverse hybrid cementing techniques was performed. Four hundred fifty-nine hips received a hybrid
replacement, and 54 hips received a reverse hybrid replacement. A match-case analysis (n=54 hips in
each series) was done between the hybrid and reverse hybrid cohorts, including gender, primary
diagnosis, age, and body mass index (average follow-up, 5.8 years; range, 2-16.8 years)
Between 1997 and 2006, cementless fixation was used in 1815 hips. All acetabular cups were evaluated
for loosening and revision at a minimum of 2 years (average, 4.5 years; range, 2-10.3 years)
RESULTS:
Sixty-six patients (seventy-two hips) were living and forty-two patients (forty-eight hips) had died after
thirteen to fifteen years of follow-up. No acetabular component had been revised because of aseptic
loosening, and no acetabular component had migrated. With revision of the acetabular component for
any reason as the end point, the survival rate was 81% +/- 8% at fifteen years. With revision of the
acetabular component for clinical failure (osteolysis, wear, loosening, or dislocation) as the end point,
the survival rate was 94% +/- 8% at fifteen years. Among the seventy hips with at least thirteen years of
radiographic follow-up, five had pelvic osteolysis and three had had revision of a well-fixed acetabular
component because of pelvic osteolysis secondary to polyethylene wear. The mean linear wear rate was
0.15 mm/yr (0.12 mm/yr when one outlier was excluded)
All hybrid replacements were done using a cementless universal all-poly socket before 1997 and Trident
(Stryker, Mahwah, New Jersey), Mallory Head, or Ring Loc (Biomet, Inc, Warsaw, Indiana) cementless
sockets thereafter, as well as a cemented stem. All reverse hybrid replacements were done using a
cemented compression-molded all-polyethylene socket and a cementless stem. The auxiliary study of
cementless cup fixation was done primarily with second-generation all-polyethylene sockets. Fixation of
the acetabular component in reverse hybrid cases followed the cementing technique described by
Berend and Ritter
One hundred and twenty consecutive, nonselected primary total hip replacements were performed in
108 patients with use of a Harris-Galante-I cementless acetabular component and a cemented femoral
component with a 28-mm head. The patients were evaluated clinically with use of a standard
terminology questionnaire, and they were evaluated radiographically for loosening, component
migration, wear, and osteolysis. The rates of revision for aseptic loosening and radiographic evidence of
2. loosening for this cohort were compared with the rates for four previously reviewed consecutive series
of hips in which the acetabular component had been inserted with cement. All patients were managed
by the same surgeon, were followed for thirteen to fifteen years, and were evaluated with use of the
same two criteria (revision and loosening) as the end points for Kaplan-Meier analysis.
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Arthroscopy
<title>Arthroscopy Surgery,Arthroscopy India,India Knee Arthroscopy Surgery
DESCRIPTION" ="Arthroscopy Surgery offers info on cost Arthroscopy Surgery India,Arthroscopy Surgery
surgeons in India,Arthroscopy Surgery hospitals abroad in India.
Article
Torn meniscal cartilage.
Loose fragments of bone or cartilage.
Damaged joint surfaces or softening of the articular cartilage, known as chondromalacia.
Inflammation of the synovial membrane, such as rheumatoid or gouty (crystalline arthropathy)
arthritis.
Abnormal alignment or instability of the kneecap.
Torn ligaments, including the anterior and posterior cruciate ligaments.
What is arthroscopy?
Arthroscopy is a surgical procedure by which the internal structure of a joint is examined for diagnosis
and/or treatment using a tube-like viewing instrument called an arthroscope. Arthroscopy was
popularized in the 1960s and is now commonplace throughout the world. Typically, it is performed by
orthopedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can
usually return home after the procedure.
The technique of arthroscopy involves inserting the arthroscope, a small tube that contains optical fibers
and lenses, through tiny incisions in the skin into the joint to be examined. The arthroscope is connected
to a video camera and the interior of the joint is seen on a television monitor. The size of the
arthroscope varies with the size of the joint being examined. For example, the knee is examined with an
3. arthroscope that is approximately 5 millimeters in diameter. There are arthroscopes as small as 0.5
millimeters in diameter to examine small joints such as the wrist.
If procedures are performed in addition to examining the joint with the arthroscope, this is called
arthroscopic surgery. There are a number of procedures that are done in this fashion. If a procedure can
be done arthroscopically instead of by traditional surgical techniques, it usually causes less tissue
trauma, results in less pain, and may promote a quicker recovery.
Knee Arthroscopy in india
Arthroscopy refers to a procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. It
allows an orthopaedic surgeon to diagnose and treat knee disorders by providing a clear view of the
inside of the knee.
With improvements of arthroscopes and higher resolution cameras, the procedure has become highly
effective for both the accurate diagnosis and proper treatment of knee problems.
Anatomy
Arthroscopy Surgery, India Arthroscopic Surgery, Arthroscopic Procedure
The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower
end of the thigh bone (femur), the upper end of the shin bone (tibia), and the knee cap (patella), which
slides in a groove on the end of the femur. Four bands of tissue-the anterior and posterior cruciate
ligaments and the medial and lateral collateral ligaments-connect the femur and the tibia and provide
joint stability. Strong thigh muscles give the knee strength and mobility.
The surfaces where the femur, tibia, and patella touch are covered with articular cartilage. Articular
cartilage is a smooth substance that cushions the bones and enables them to glide freely. Semicircular
rings of tough fibrous cartilage tissue, called the lateral and medial menisci, act as shock absorbers and
stabilizers.
Arthroscopic Procedure, Minimally Invasive Surgical Procedure
The bones of the knee are surrounded by a thin, smooth tissue capsule lined by a thin synovial
membrane. The synovium releases a special fluid that lubricates the knee, reducing friction to nearly
zero in a healthy knee.
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4. For more information, medical assessment and medical quote send your detailed medical history and
medical reports
as email attachment to
Email : - info@wecareindia.com
Call: +91 9029304141 (10 am. To 8 pm. IST)
(Only for international patients seeking treatment in India)
KEYWORDS" "Arthroscopy Surgery, India Arthroscopic Surgery, Arthroscopic Procedure, Minimally
Invasive Surgical Procedure, Arthroscopy Surgery India, Physical Therapy, Sports Medicine, Knee
Arthroscopy, Arthroscopy Facts, Knee Problem, Orthopedic Medical Opinions, Arthroscopic Surgery
Definition, Arthroscopic Surgery Purpose, Demographics, Arthroscopic Surgery Description,
Arthroscopicsurgery, Arthroscopic Knee Surgery
Both Hip Replacement Together
title>Simultaneous Bilateral Hip Replacement Resurfacing India Surgery Abroad
Dicrip : Simultaneous Bilateral Hip Replacement, both hip replacement together info experienced
simultaneous bilateral hip replacement surgeon in India
In a total hip replacement, both the thigh bone (femur) and the socket are replaced with implant
prostheses. Specifically, a metal stem is inserted into your thighbone. Attached to the neck of the stem
is a hip ball, just over an inch in diameter. The hip ball fits into a liner. Together, the ball and liner create
the new joint. The liner is inserted into a metal shell that in turn is anchored to your pelvis. But there are
a number of different approaches a surgeon can take, depending on her analysis of your particular case.
Who Should Have Hip Replacement Surgery ?
The most common reason that people have hip replacement surgery is the wearing down of the hip joint
that results from osteoarthritis. Other conditions, such as rheumatoid arthritis (a chronic inflammatory
disease that causes joint pain, stiffness, and swelling), avascular necrosis (loss of bone caused by
insufficient blood supply), injury, and bone tumors also may lead to breakdown of the hip joint and the
need for hip replacement surgery.
Before suggesting hip replacement surgery, the doctor is likely to try walking aids such as a cane, or non-
surgical therapies such as medication and physical therapy. These therapies are not always effective in
relieving pain and improving the function of the hip joint. Hip replacement may be an option if
persistent pain and disability interfere with daily activities. Before a doctor recommends hip
replacement, joint damage should be detectable on x rays.
5. In the past, hip replacement surgery was an option primarily for people over 60 years of age. Typically,
older people are less active and put less strain on the artificial hip than do younger, more active people.
In recent years, however, doctors have found that hip replacement surgery can be very successful in
younger people as well. New technology has improved the artificial parts, allowing them to withstand
more stress and strain. A more important factor than age in determining the success of hip replacement
is the overall health and activity level of the patient.
For some people who would otherwise qualify, hip replacement may be problematic. For example,
people with chronic diseases such as those that result in severe muscle weakness or Parkinson's disease
are more likely than people without chronic diseases to damage or dislocate an artificial hip. Because
people who are at high risk for infections or in poor health are less likely to recover successfully, doctors
may not recommend hip replacement surgery for these patients.
Because of the advances in the last thirty years, several types of implant materials have also been found
useful in hip replacement procedures. Each material has its own advantages and disadvantages, but it is
ultimately up to your surgeon which type of implant to use.
Choosing Hip Replacement Implant Material
The main issue that doctors and patients confront when choosing implant material revolves around the
wear debris that is released into your body from any of the implant materials. Even the materials with
the most wear debris (metal ball and polyethylene liners) show up only after many years (10-15).
Nevertheless, it is important to educate yourself about the various options for hip replacement surgery.
Be sure to ask your surgeon whether he or she uses metal-on-polyethylene, metal-on-metal, ceramic-
on-polyethylene or ceramic-on-ceramic implants
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KEYWORDS" content="Simultaneous Bilateral Hip Replacement surgery, Simultaneous Bilateral Hip
Replacement surgery India, Simultaneous Bilateral Hip Replacement surgery abroad, Both Hip
Replacement Surgery, Hip Replacement Surgery, Hip Replacement, Hip, Hip Arthroplasty, Hip Joint,
Implant, India Hospital Tour, Overview Of Hip Surgical Procedure, Total Hip Replacement, Exercises,
Operation, Hip Replacement Failure, Hip Implant, Total Hip Replacement Surgery Information, Doctor,
Surgeon, Hip Replacement Surgery Hospital, Clinic, Overview Total Hip Replacement, Hip Replacement
Surgery India
6. BHR
<Title> Birmingham Hip Resurfacing Surgery, India Birmingham Hip Resurfacing
DESCRIPTION" Birmingham Hip Resurfacing Surgery abroad in India offers info on Birmingham Hip
Resurfacing Surgery surgeon, hip surgery hospital abroad in India
Article
The principle of hip joint resurfacing is replacement of diseased joint surfaces and simultaneous
restoration of the normal anatomy and biomechanical function to the maximal degree possible. This
concept offers several theoretical advantages over conventional total hip joint replacement and the
clinical results in this series of 426 cases appears to confirm the value of both the method and the
concept. Successful joint resurfacing surgery with attention to detail. Most problems can be anticipated
and handled appropriately. Complications are few. The operation should only be done in cases of severe
hip disability, when the patient's level of suffering demands operative intervention and when the only
reasonable alternatives are fusion, total joint replacement or head and neck resection. It is an operation
designed and recommended as an "in-between" procedure to gain time against the progressive disease.
Resurfacing should not be performed if conservative measures or classic hip osteotomies offer
significant benefit. The principal advantages of this procedure relate directly to the prosthetic design.
Only the joint surfaces are removed during surgery, most of the normal bone is preserved, the
medullary canal is not opened, and the implants utilized are of small volume. As a result the risk of
infection is low compared to other implant arthroplasty techniques and clinical statistics confirm this
anticipated advantage. The operation is designed to interfere minimally with the normal joint mechanics
so it is also anticipated that prosthesis longevity will be greater than when rigid stem prostheses are
placed in elastic bone. As yet follow-up is too short to make valid judgments on this point. The technique
is applicable to younger patients, however, because if it should, in time, fail and other surgical treatment
becomes necessary the original alternatives of total hip replacement, arthrodesis, or head and neck
resection remain available. Relief of pain is predictable and almost all patients have experienced
significant improvement in function. The procedure has a broader indication in cases of prior bone or
joint infection and is definitely a preferable procedure in young individuals with severe hip disability
KEYWORDS" "Birmingham Hip Resurfacing Surgery, Birmingham Hip Resurfacing India, Hip Resurfacing
abroad, Hip Nerve Pain, Birmingham Hip Replacement, Birmingham Hip Resurfacing Surgery India, India
Hospital Tour, Birmingham Hip Resurfacing Treatment, Birmingham Hip Replacement India, Hip
Resurfacing Surgery India, Hip Resurfacing Surgery In India, Birmingham Hip Resurfacing Surgery
Hospitals, Hip Resurfacing Surgery Belgium
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7. BHR With Stem
Title>Birmingham Hip Resurfacing Stem Surgery,India Birmingham Hip Resurface
DESCRIPTION" content="Birmingham Hip Resurfacing Stem Surgery abroad in India offers info on cost
Birmingham Hip Resurfacing Surgery with stem abroad in India
Article
BHR restores the natural shape of the joint meaning better stability, longevity and higher levels of
patient activity than a traditional hip replacement. The BHR has enabled thousands of patients -
including many high profile athletes - to leave behind the pain and immobility of an arthritic hip,
restoring their quality of life.
With Total Hip Replacements, the femoral head (ball joint of the hip) is removed and replaced by a long,
stemmed device. Very little of the femur is retained - as shown in the diagram below. The procedure is
reasonably successful in elderly, relatively inactive patients. However, total hips wear out quickly in
younger, more active patients, leading to the inevitable saga of revision surgery and associated
complications.
With the BHR procedure, however, just a few millimetres from the two articulating surfaces of the hip.
The procedure is bone-conserving because most of the joint is retained (see diagram). The femoral head
is shaped to accept a low-wear metal sphere. This sphere matches the patient's anatomy, meaning there
is a low risk of dislocation, a broad range of movement and excellent stability. The acetabular socket
(cup joint of the hip) is then fitted with a corresponding metal cup. Since the metal femoral component
articulates within a metal acetabular cup, the BHR is referred to as a Metal-on-Metal (MoM) hip joint.
Hip resurfacing is ideal for many younger, active patients who suffer from hip pain. Many people stay
physically active far into their late fifties and beyond so there's an increased need for an alternative to
total hip replacement that accommodates their age and lifestyle.
What Is the BIRMINGHAM HIP Resurfacing Device ?
Your hip is a socket and ball joint where the thighbone and pelvis come together. As your leg moves,
the ball of your thighbone (called the femoral head) moves and rotates against the socket portion of
your pelvic bone (called the acetabulum). If your hip joint is diseased due to certain kinds of
arthritis, or previous damage, it will become less functional and more painful over time. When your
hip pain increases to the point that it can not be helped by usual measures such as pain medicine
and exercises (physical therapy) and your ability to move your hip decreases, affecting your ability
to do your daily activities, it may become necessary to surgically replace the hip joint.
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BMHR
<title>Birmingham Mid Head Resection Prosthesis (BMHR),India Hip Resurfacing
DESCRIPTION" "Birmingham Mid Head Resection Prosthesis (BMHR) offers info on cost Birmingham Mid
Head Resection Prosthesis resurfacing abroad in India.
Article
How mobile will I be following surgery?
Following your operation a physiotherapist will visit you every day. They will enable you to get out of
bed and take a few steps the day after the operation. Following this you will make steady progress
under their supervision, walking along the corridor with two elbow crutches. You will be shown how to
get in and out of bed on your own and go up and down stairs safely on your own. Most patients are
instructed to use two elbow crutches for three to four weeks after operation. You will then be advised
to use one walking stick on the unoperated side for a further three to four weeks. This timetable
depends on the extent of reconstruction that was necessary and the quality of bone before operation
and may need to be modified to suit each individual. For more information about recovery following
your operation,
What is the BMHR and Why do we need it?
Birmingham Mid Head Resection prosthesis and its applied use in patients with Avascular Necrosis.
Birmingham Mid Head Resurfacing Surgery
Birmingham Mid Head Resection Prosthesis (BMHR) India,Hip For patients with osteonecrosis involving a
larger volume of the femoral head, an uncemented short-stemmed prosthesis, the Birmingham Mid
Head Resection, BMHR, (MMT Ltd, Birmingham, United Kingdom, now Smith and Nephew Orthopaedics
Ltd, Bromsgrove, United Kingdom) was developed.
Illustration showing the three types of prostheses implanted in patients with femoral head avascular
necrosis.
Birmingham Mid Head Resurfacing Surgery, Birmingham Mid Head Resection Prosthesis (BMHR) India
Birmingham Mid Head Resection Prosthesis (BMHR) India,Hip, BirminghamResurfacing, Surgery India,
Birmingham
9. Birmingham Mid Head Resection prosthesis is an advancement in the BHR and will expand the
indications for hip resurfacing surgery. Birmingham Mid Head Resection prosthesis (BMHR) helps
advanced aged patients to have Birmingham Hip Resurfacing.
The BMHR has specifically been designed for patients who have weaker bone in the head of the femur.
In the BMHR more of the weak bone is resected and is replaced with metal. This will dramatically
increase the range of patients who can have this surgery.X-ray wise it looks almost like the BHR but the
amount of bone removed is more. Thus the risk of fracture in post-op is reduced or eliminated for
borderline patients.
Indications for the Mid Head Resection Prosthesis : -
Developmental dysplasia with shortened femoral head-neck segment
Extensive avascular necrosis of the femoral head
Large cysts of the femoral head
Abnormalities through Epiphyseolyses and Morbus Perthes (femoral head necrosis of children)
Reduction of bone substance due to arthroses
Marked bone involution through inactivity but with regression potential
Birmingham Mid Head Resection Prosthesis (BMHR) India, Surgery India, Birmingham
In cases of advanced arthrosis, a defect of the femoral head occurs which prevents the reliable
anchoring of the resurfacing component. The titanium stem grows into the healthy part of the femoral
head and neck, and is a safe base for the head component.
Resurfacing is only advisable when the stability of the bone and the shape of the femoral head offer
sufficient support for the prosthesis. With healthy and active patients who do not meet these
requirements but who can benefit from a bone conserving process, the Mid Head Resection can be an
alternative to a standard prosthesis.
With this prosthesis, the fixation of the femoral component depends less on the bone of the femoral
head but more on the stability of a titanium stem with bone ingrowth in the femoral neck.
Those parts of the femoral head which have been destroyed by cysts, circulatory disorders,
malformations or involution due to arthrosis are removed. A titanium stem adjusted to size is implanted
into the healthy part of the femoral head and neck, which is fixed by bone ingrowth (combines with the
bone) and strengthens the femoral neck. In this way the implant-bone compound can withstand bending
and torque forces.
10. Through the use of this implant, an opening of the femoral medullary cavity can often be avoided by
implanting a prosthesis stem. The advantage of resurfacing is retained
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Bilateral Knee Replacement
<title>Bilateral Knee Replacement Surgery India,Bilateral Total Knee India
DESCRIPTION" "Bilateral Knee Replacement Surgery India offers info cost Bilateral Knee Replacement
Surgery abroad in India,Knee Replacement Surgeon,Hospital India.
Article
Who should consider bilateral knee replacement?
Patients who have severe knee arthritis in both knees may be candidates for bilateral knee replacement
surgery. The same criteria used to determine if a single knee requires replacement are used to
determine if both should be done:
What are the risks of a simultaneous bilateral knee replacement?
There are concerns about performing a simultaneous knee replacement because it is a longer surgery
and is more demanding on the body. Because of this, patients who have cardiovascular problems,
pulmonary disease, or are over the age of 80 are often advised against a simultaneous knee
replacement procedure.
Studies have shown patients undergoing simultaneous knee replacement have a slightly higher risk of
cardiac events and needing blood transfusion. Overall, the risk of severe complications such as infection,
blood clots, pulmonary embolism or death is about the same for both simultaneous and bilateral
procedures.
Another disadvantage of the simultaneous knee replacement is that the early rehabilitation can be more
difficult as patients do not have a "good leg" to work with.
What are the benefits of a bilateral knee replacement?
The benefit of simultaneous knee replacement is that both problems are taken care of at one time. The
overall rehabilitation is a shorter time, and there is only one hospitalization. Patients also only require
one anesthesia.
11. What will happen before the operation?
A couple of weeks before the operation you'll usually be asked to attend a pre-operative assessment
clinic to meet your surgeon and other members of the surgical team.
They will take a medical history, examine you and organise any tests, such as blood and urine tests, ECG
and X-rays needed, to make sure you're healthy enough for an anaesthetic and surgery. They will also
give you advice on anything you can do to prepare for surgery and ask you about your home
circumstances so your discharge from hospital can be planned. If you live alone, have a carer, or feel you
need extra support, tell the surgical team so that any help or support can be arranged before you go
into hospital.
Take a list or packets of any medication you're taking. Some (rheumatoid) arthritis medications suppress
the immune system, which can affect healing. For this reason you may be asked to stop taking your
medication before surgery. Your surgeon can advise on alternative medications. There may be leaflets,
booklets and videos to look at or take away that can help to inform you further about the operation.
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Both Knee Replacement Together
<title>Simultaneous Bilateral Knee Replacement,Both Knee Surgery Together
DESCRIPTION" Simultaneous Bilateral Knee Replacement or Replacing Both Knee in single surgery info
on knee replacement surgeon,knee replacement hospitals India.
Article
Significantly fewer prosthetic joint infections as well as other revision knee operation complications
occurred within one year after surgery if a person gets both knees replaced at the same time instead of
stretching out the operations over time. Simultaneous replacement may be the way to go according to a
new study, instead of doing one at a time on separate occasions.
According to the American Academy of Orthopedic Surgeons (AAOS), there are about 270,000 knee
replacement operations performed each year in the United States. Although about 70% of these
operations are performed in people over the age of 65, a growing number of knee replacements are
being done in younger patients. Orthopedic surgeons evaluate patients individually. Recommendations
for surgery are based on a patient's pain and disability, not age. Total knee replacements have been
12. performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient
with degenerative arthritis
Both Knee Replacement (Bilateral) Together in India
Knee replacement surgery is the most common joint replacement procedure. Many people have knee
arthritis, but it can be difficult to know when the right time to have a knee replacement surgery is.
Furthermore, there is confusion about what to expect from knee replacement surgery. Do you have
questions? Look no further. You can find all you need to know about knee replacement surgery right
here.
What Is Knee Arthritis?
Both Knee Replacement Together Surgery, Knee Replacement Surgery The word 'arthritis' means
'inflammation of the joint.' Most people think of arthritis as the wearing away of cartilage in a joint - this
is the end result of inflammation within the joint. Over time, the inflammation can lead to cartilage loss
and exposed bone, instead of a normal, smooth joint surface.
The most common type of knee arthritis is osteoarthritis. This is often referred to as "wear-and-tear"
arthritis, and it results in the wearing away of the normal smooth cartilage until bare bone is exposed.
Other types of arthritis include rheumatoid arthritis, gouty arthritis, and lupus arthritis
Knee Replacement Implants
Knee replacement surgery removes the damaged joint lining and replaces the joint surfaces with a metal
and plastic implant that functions similar to a normal knee. These implants will wear out over time, and
knee replacements are done infrequently in younger patients because of the concern of the implant
wearing out too quickly.
Knee replacement implants have been modified in order to provide the best possible functioning with
long-lasting results. This effort to perfect knee replacement implants is constantly taking place. Some
newer implants have promise, others may not turn out to be better.
Partial Knee Replacements
Rotating Knee Replacements
Gender Specific Knee Replacements
Custom Knee Replacements
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Cemented Total Hip Replacement
title>Cemented Total Hip Replacement,India Cemented Total Hip Replacement
DESCRIPTION" Cemented Total Hip Replacement India offers info on cost Cemented Total Hip
Replacement, Cemented Total Hip Replacement surgeon and hospital in India
Article
Cementless Design
Cement had traditionally been used but in the 1980's a cementless design was developed. The
cementless design is a porous implant. The intent is, through biologic fixation, that bone grows into and
through the pores in the implant, thereby securing it.
In theory the cementless joint replacements are expected to reduce the chance of infection and
loosening of the prosthesis, which are the two major complications of hip replacement surgery. Recent
research, however, indicates that both the cemented and cementless joints do very well.
Loosening
The problem of loosening is the focus of current research. Some researchers feel the way the bone is
prepared or where the bone contacts the cement may be the problem and cause a breakdown. Other
researchers believe that as cement flakes into microscopic particles it creates an inflammatory response
in the body which leads to bone loss where bone meets cement. Yet another problem may involve the
wearing down of the plastic liner.
In spite of potential loosening, the patient can expect many years of excellent results before a problem
possibly occurs. 90% or more of patients having hip replacement surgery experience significant pain
relief and improved range of motion. The surgery is considered highly successful.
Cementing Technique
Bone preparation is critical for long-term survivorship of both the cemented stem and the cup.4 The aim
is to provide a clean, stable bony bed for cement interdigitation into the remaining cancellous bone and
to maintain stable interfaces between the implant and cement, and the cement and the bone.
Most investigators would agree that a surgeon should remove all loose cancellous bone but leave the
remaining dense bone nearest to the cortex to enhance interdigitation of the cement into the remaining
bone. This increases the shear strength of the cement and gives the best contact of the cement mantle
to the remaining bone stock. Reaming with cylindrical or tapered reamers in the femur is often
performed to remove the loosest bone but should be done by hand to leave a remnant of cancellous
14. bone. It is important not to ream away all cancellous bone, as this will leave a smooth inner cortex and
diminish the ability for the cement to bond to the bone.
Some implant systems are designed to be reamer-less and all bone preparation is meant to be done by a
broach. Broaching, which compacts the bone rather than removes it as a reamer does, is an important
step in the femoral preparation. The broaches, which in many systems are also used for sizing and
trialing of the femoral implant, create a reproducibly larger envelope of 2 mm to 3 mm circumferentially
around the stem. This allows for a uniform thickness of the cement mantle around the stem. Aggressive
broaching should be avoided to prevent denuding of the inner cortical bone.
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KEYWORDS" content="Cemented Total Hip Replacement, Cemented Total Hip Replacement in India,
Cementless Hip Replacements, Cemented Hip Implants, Cementless Implants, Hip Implants, Total Hip
Replacement, Cemented Total Hip Replacement Surgery, Cemented Total Hip Arthroplasty, Technique
Of Cemented Total Hip Replacement, Cemented Total Hip Replacement India, Life Of A Replaced Hip,
Hip Joint Replacement Surgery
Elbow Replacement
<title>Elbow Replacement Surgery, Elbow Replacement India ,India Cost Elbow
DESCRIPTION" content="Elbow Replacement Surgery Abroad in India offers info on Cost Elbow
Replacement Surgery India, Elbow Arthroplasty Replacement Surgeons ,Hospitals India
Total elbow replacement surgery (arthroplasty) can help restore comfort and function to elbows
damaged by rheumatoid arthritis.
In elbow arthritis the joint surface is destroyed by wear and tear, inflammation, injury, or previous
surgery. This joint destruction makes the elbow stiff, painful, and unable to carry out its normal
functions. Elbow joint replacement can be effective primarily in the management of severe elbow
involvement from rheumatoid arthritis.
After performing a clinical examination, an elbow surgeon experienced in joint replacement can
determine if rheumatoid arthritis is the cause of the problem and if surgery is likely to be helpful.
Patients are most likely to benefit from this surgery if they are well motivated and in optimal health.
15. The goal of elbow replacement arthroplasty is to restore functional mechanics to the joint by removing
scar tissue, balancing muscles, and inserting a joint replacement in the place of the destroyed elbow.
One part of the artificial joint is fixed to the inside of the humerus (arm bone) and the other part to the
inside of the ulna (one of the forearm bones). The two parts are then connected using a hinge pin that
gives the joint stability.
Total elbow joint replacement arthroplasty is a highly technical procedure and is best performed by a
surgical team who performs this surgery regularly. Such a team can optimize the benefits and minimize
the risks. The two-hour procedure is performed under general or nerve block anesthesia.
Elbow motion is started on the second day after the procedure, as soon as the incision is ready. Patients
learn to do their own physical therapy and are usually discharged three to four days after surgery when
they are comfortable and have a good range of passive motion. The recovery of strength and function
may continue for up to a year after surgery.
The upper extremities include the wrist, elbow, and shoulder. While these joints are among the least
likely to develop conditions requiring joint replacement, there are implants that can reduce or eliminate
pain and restore motion. The word replacement makes one think that surgeons remove the entire joint.
In truth, surgeons resurface the damaged bone and cartilage at the ends of the bones in the joint.
Shoulder, elbow, and wrist replacement implants use metal alloys and polyethylene (plastic) to restore
motion and reduce or eliminate pain. The implants are designed to create a new, smoothly functioning
joint that can prevent painful bone-on-bone contact. Your surgeon may elect to replace all or part of a
joint, depending on physical condition and the extent to which the joint is affected by arthritis.
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KEYWORDS" Elbow Replacement Surgery, Elbow Replacement, Elbow, Relive Pain, Elbow Replacement
India, India Hospital Tour, Elbow Surgery, Elbow Replacement Treatment, Elbow Arthroplasty, Elbow
Replacement Surgery India, Elbow, Elbow Pain, Elbow Implant, Elbow Problems, Operation, Elbow Joint
Replacement, Elbow Replacement Surgery Hospitals, Total Elbow Replacement Surgery, Benefits Of
Elbow Replacement, Elbow Replacement Information
16. Hip Replacement With Computer Navigation
title>Computer Hip Replacement,India Hip Surgery Through Computer Navigation
DESCRIPTION" Computer navigation assisted hip replacement surgery India info on computer hip
replacement surgery in India,Hip replacement surgeon hospital India
How does computer navigation work ?
In the operating room infrared optics and tracking software continually monitor the position and
mechanical alignment of the joint replacement components relative to your specific anatomy.
Minimally invasive smart wireless instruments send data about to the joint movements (kinematics)
to a computer.
The computer analyzes and displays the kinematic data on the screen in the form of charts and
graphs.
These images provide your surgeon with the angles, lines, and measurement needed to best align
your hip or knee implant.
Some of the latest technology in joint replacement includes not only implant material advances, but also
advances in how we place the components during the reconstructive surgery. As other articles on this
site discuss, there are different surgical approaches in hip replacement that can make significant
differences in early and late outcomes. Another technology that is attempting to improve early and late
outcomes by making implant placement more accurate is computer aided surgery or CAS.
Currently all primary hip and knee replacements in my practice are being done utilizing computer
guidance for implant placement. I’ve used this technology since August 2006 for hip replacement. Nearly
all patients are candidates for CAS except the very morbidly obese. The technology itself has been
available in limited markets for a few years and mainly in knee replacement. Recent software
developments have expanded the technology to hip replacement, however
Thus far CAS has been very successful in achieving the above goals. In the hip, leg length prediction is
very precise decreasing my need for x-ray during the case and avoiding any surprises post operatively.
It is important to understand that CAS is not robotic surgery. The surgeon obtains highly accurate
information from the computer, but the surgeon ultimately has complete control and must apply the
17. information correctly. The information obtained is highly precise but could be inaccurate if input
information into the computer is incorrect.
There are very few downsides using CAS. Four additional 5mm wounds are made to place pins in the
pelvis. There has been very little pain from these wounds reported by patients In my experience, there
have only been improvements using CAS. No reconstructions have been adversely affected in my hands
with this technology. Again, CAS is an additional tool not the only tool used to properly reconstruct hips.
At this point I have no reason to return to non-navigated replacements. Both in the knee and the hip
CAS is another check in an effort to make every joint replacement as close to perfect as possible.
Individual patient considerations at times force certain limitations in replacement surgery, but with
proper pre-operative planning and additional intra-operative information from technologies such as
CAS, surprises during and after surgery can be minimized.
For general information regarding hip replacement surgery or further details regarding the minimal
anterior approach contact our office.
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KEYWORDS" Computer Navigation Hip Replacement, Computer Navigation assisted Hip Replacement
India, acetabular Component Position, Computer Navigation, Utilizing Computer Navigation, India
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Patient, Information
High Flex Knee Replacement
Title>High Flex Knee Replacement Surgery ,India High Flex Knee Replacement
DESCRIPTION" High Flex Knee Replacement Surgery offers info cost High Flex Knee Replacement
Surgery abroad in India, High Flex Knee Implant, Surgeon, Hospitals India
High flexion knee prosthesis
18. Special knee implants are now available which provide more flexion or bending at the knee to
suit Indian, and South Asian habits of kneeling for prayer, or sitting cross legged on the ground
for meals or social purposes. Muslims in particular need this to offer prayers. Japanese customs
also require high knee flexion. Even westerners have begun to appreciate the benefits of high
flexion knee prosthesis as they can pursue hobbies like gardening and are also gratified for the
ability to do recreational activities. The prosthesis used allows high flexion from 130 degrees to
155 degrees. Rotating platform prosthesis alone does not allow high flexion as claimed by many
centers. These centers are monopolizing a particular brand which does not allow high flexion.
Minimally invasive technique
Traditionally knee replacements have been done through incisions in the skin about 14- 20 cm
long. Special instrumentation allows the operation to be performed through a modified new
surgical approach without dividing the thigh muscles (Quadriceps). By down sizing the incision
to 9 cm (3 inches), the amount of postoperative pain is less, hospital stay is shorter (5 days) and
return to function is faster.
As post op pain is less the patient will cooperate with the physiotherapist to do the required
exercises regularly.
Recent advances in knee replacement have occurred in the lat one year driven by higher patient
expectations. The introduction of the High flex prosthesis in the market will spur many more
people who have suffered in the last decade from knee arthritis to undergo a Total Knee
replacement in Chennai.
The author is a knee surgeon in Chennai and has performed the first High flexion knee
replacement with the Nex gen prosthesis from Zimmer. Please visit www.kneeindiablogspot.com
for videos and photos of patients with unilateral and bilateral High flex knee replacements.
Knee Implants After Attachment
Closing the Wound
If necessary, the surgeon may adjust the ligaments that surround the knee to achieve the best possible
knee function.
When all of the implants are in place and the ligaments are properly adjusted, the surgeon sews the
layers of tissue back into their proper position. A plastic tube may be inserted into the wound to allow
liquids to drain from the site during the first few hours after surgery. The edges of the skin are then
sewn together, and the knee is wrapped in a sterile bandage. The patient is then taken to the recovery
room.
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Hip Replacement
Title>Hip Replacement India,Hip Replacement Surgery India,Hip Arthroplasty
DESCRIPTION" Hip Replacement surgery India offers info on low cost hip replacement India,hip
replacement surgeons India,hip implant replacement hospitals in India
Whether you have just begun exploring treatment options or have already decided to undergo hip
replacement surgery, this information will help you understand the benefits and limitations of
total hip replacement. This article describes how a normal hip works, the causes of hip pain,
what to expect from hip replacement surgery, and what exercises and activities will help restore
your mobility and strength, and enable you to return to everyday activities.
If your hip has been damaged by arthritis, a fracture, or other conditions, common activities such
as walking or getting in and out of a chair may be painful and difficult. Your hip may be stiff,
and it may be hard to put on your shoes and socks. You may even feel uncomfortable while
resting.
If medications, changes in your everyday activities, and the use of walking supports do not
adequately help your symptoms, you may consider hip replacement surgery. Hip replacement
surgery is a safe and effective procedure that can relieve your pain, increase motion, and help
you get back to enjoying normal, everyday activities.
Who Should Have Hip Replacement Surgery?
People with hip joint damage that causes pain and interferes with daily activities despite
treatment may be candidates for hip replacement surgery. Osteoarthritis is the most common
cause of this type of damage. However, other conditions, such as rheumatoid arthritis (a chronic
inflammatory disease that causes joint pain, stiffness, and swelling), osteonecrosis (or avascular
necrosis, which is the death of bone caused by insufficient blood supply), injury, fracture, and
bone tumors also may lead to breakdown of the hip joint and the need for hip replacement
surgery.
20. In the past, doctors reserved hip replacement surgery primarily for people over 60 years of age.
The thinking was that older people typically are less active and put less stress on the artificial hip
than do younger people. In more recent years, however, doctors have found that hip replacement
surgery can be very successful in younger people as well. New technology has improved the
artificial parts, allowing them to withstand more stress and strain and last longer.
Today, a person’s overall health and activity level are more important than age in predicting a
hip replacement’s success. Hip replacement may be problematic for people with some health
problems, regardless of their age. For example, people who have chronic disorders such as
Parkinson’s disease, or conditions that result in severe muscle weakness, are more likely than
people without chronic diseases to damage or dislocate an artificial hip. People who are at high
risk for infections or in poor health are less likely to recover successfully. Therefore they may
not be good candidates for this surgery. Recent studies also suggest that people who elect to have
surgery before advanced joint deterioration occurs tend to recover more easily and have better
outcomes.
Two Types of Hip Fixation
There are two main types of fixation philosophies-cemented and porous. Both can be effective in the
replacement of hip joints.` The physician (and the patient) will choose the best solution that is specific to
the patient's needs.
Cemented Hip Implants
The cemented hip implant is designed to be implanted using bone cement (a grout that helps position
the implant within the bone). Bone cement is injected into the prepared femoral canal. The surgeon
then positions the implant within the canal and the grout helps to hold it in the desired position.
Porous Hip Implants
The porous hip implant is designed to be inserted into he prepared femoral canal without the use of
bone cement. Initially, the femoral canal is prepared so that the implant fits tightly within it. The porous
surfaces on the hip implant are designed to engage the bone within the canal and permit bone to grow
into the porous surface. Eventually, this bone ingrowths can provide additional fixation to hold the
implant in the desired position.
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21. KEYWORDS" Hip Replacement Surgery India, Hip Replacement India, Joint, Joint Disease, Hip
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Minimally Invasive Hip Replacement
Title>Minimally Invasive Hip Replacement Surgery, India Minimally Invasive
DESCRIPTION" Minimally Invasive Hip Replacement Surgery abroad in India offers cost Minimally
Invasive Hip Replacement Surgery ,MI Surgeon, MI Hospital in India
Osteoarthritis and Hip Replacement
Osteoarthritis of the hip is the most common reason for a hip replacement. Osteoarthritis is caused by
the wear and tear of aging. It causes the cartilage covering the joint surfaces to wear out, resulting in
pain and stiffness.
Other conditions that can cause destruction of the hip joint include loss of the blood supply to the head
of the thighbone (osteonecrosis), rheumatoid arthritis, injury, infection, and developmental
abnormalities of the hip. Patients with arthritis may also have brittle bones (osteoporosis), but there is
no direct relationship between bone density and the development of arthritis of the hip.
Minimally invasive hip substitution surgical procedure permits the surgeon to do hip replacement
throughout 1 or 2 little incisions. Candidates intended to negligible incision procedure are usually
younger, healthier, and thinner and are motivated to have rapid recovery compared to patients who
have undergone traditional surgery. Before deciding to undergo less invasive hip replacement, secure a
comprehensive evaluation from the surgeon. The risks and benefits of the surgery must be discussed
thoroughly. Both the minimally invasive hip replacement and traditional procedures are strictly
demanding. It is required that the doctor doing the surgery and the operating team must have
significant experiences.
22. Small Incisions Offer Big Potential Benefits
Two of the most significant advances in total hip replacement are the most prominent minimally
invasive techniques—mini-incision and direct two-incision. Minimally invasive hip replacement allows
surgeons to implant traditional hip components through one or two small (1.5 to 4 inch) incisions rather
than the traditional 10 to 12 inch incision. The goal of minimally invasive hip replacement is to minimize
the amount of soft tissue damage that occurs when a surgeon reconstructs a hip. The potential benefits
of this approach include:
Less bleeding during surgery
Less post-operative pain
Shorter recovery time
Smaller scars for improved cosmetics
The Direct Two-Incision Technique
Because of the small exposure associated with preparation of the femoral canal (leg bone) with the
small incision technique, the two-incision approach was developed to provide more precision in
preparing the femoral (leg bone) canal for the new ball component. This technique uses one incision for
preparing and inserting the socket. The second incision is used to prepare and insert the thighbone
component. Only one muscle structure is cut, while other soft tissue structures such as ligaments and
tendons are moved aside instead of being cut. In addition, another important benefit of this technique is
the sparing of the fascia latae (deep sheet tissue surrounding the thigh muscle). As a result, this may
reduce the occurrence of localized pain over the greater trochanter and provide greater hip stability
immediately after surgery.
The performance of a hip replacement depends on your age, weight, activity level and other factors.
There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should
not have this surgery. Only an orthopaedic surgeon can determine whether you are a candidate for the
minimally invasive hip replacement procedure. Also, a mini-incision may need to be converted into a
traditional incision during surgery. There are many surgeons that may still prefer to perform traditional
hip replacement surgery
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Invasive Surgery, Hip Replacement Surgery India
24. Minimal Invasive Hip Resurfacing
Title>Minimally Invasive Hip Resurfacing Surgery, India MI Hip Resurfacing
DESCRIPTION" Minimally Invasive Hip Resurfacing Surgery abroad in India offers info on cost
Minimally Invasive Hip Resurfacing Surgery Surgeon, Hospitals in India
Minimally invasive hip resurfacing replacement surgery and navigation
Instruments have been designed that allow for smaller incision surgery. This is reflected in less
tissue damage and slightly quicker recovery rates. The wounds are also a little smaller. It must be
pointed out, however, that six months following the surgery there is no difference in the outcome
between a standard incision hip and a mini incision hip.
Navigation is the latest technology that allows more accurate placement of the components to re-
establish the normal hip biomechanics. This new technology is still evolving.
The hip resurfacing procedure is more technically demanding than conventional THR and may
require longer operating times. In addition, hip surgery is more difficult through a minimal incision
and the technique is difficult to learn. Enhanced training and specialized instruments are necessary
for accurate, reproducible results. Gaining proficiency with the procedure may be challenging, as
potential candidates for hip resurfacing make up 10% to 20% of a typical surgeon s patient
population. A limited number of Canadian surgeons have the necessary skills. Computer navigation
systems and fluoroscopic imaging may allow improved visualization and hip implant positioning
with mini-incisions, which may encourage more surgeons to attempt minimally invasive hip
resurfacing. There are disadvantages to navigational systems, including increased cost and
operating time; and the possibility of error from computer malfunction or inappropriate
commands. It is unknown if increased costs would be offset by savings from a shorter hospital stay.
Outcome-based research and long-term followup are necessary to assess the clinical and economic
impact of a minimally invasive approach to hip resurfacing. There is also a need for defined criteria
to determine which patients might benefit from this surgical approach
Minimally invasive hip resurfacing
(MIS) is total or partial hip surgery that can be carried out through an incision of less than 10 cm
without imparting great forces on the anatomy or compromising component positioning"
The modified posterior MIS approach to hip resurfacing and Total Hip Arthoplasty displays a
host of advantages to the patient:
1. Less post-operative pain
2. Less soft tissue damage and pressure on muscle fibres.
3. Shorter hospital stay
4. Lower blood loss
5. Smaller incision
6. Quicker return to work and functional activities
25. The process of shortening the operative field (mini-incision) for hip resurfacing from the
conventional open approach (15–30 cm), to a mini-incision approach (7–15 cm) has been well
documented in the realm of hip surgery. It has been suggested by some surgeons, however, that
in doing this one runs the risk of implanting the components incorrectly, especially the
acetabular component. It has also noted that during femoral head reaming (drilling of the femoral
head) with the surgical site being so small, the conventional instruments can damage the soft
tissues.
Having accepted this, the essential criterion for minimally invasive hip resurfacing are:
1. An implant designed for MIS delivery
2. MIS instruments for tissue protection
3. Specialised instrumentation for femoral neck targeting, acetabular reaming, acetabular
impaction and retractors that are soft tissue friendly
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26. Minimally Invasive Knee Replacement
Title>Minimally Invasive Knee Replacement Surgery India,Minimal Knee Surgery
DESCRIPTION" Minimally Invasive Knee Replacement Surgery India,cost Minimally Invasive Knee
Replacement Surgery abroad in India,MI Knee surgeons,hospitals in India.
minimal-incision knee replacement?
We're not 100% sure quite yet, and that is the concern many orthopedic surgeons have about
minimal-incision surgery. It has to be remembered that while the aforementioned benefits of
minimal-incision surgery are terrific, the most important goal of a knee replacement surgery is to
provide the patient with a pain-free joint that will last a long time. The concern with performing
a knee replacement though a tiny incision is that the implants may not be placed as precisely and
as snug, and could therefore wear out more quickly.
A recent study found that patients requiring a second surgery had this procedure much sooner
when they had minimal-incision surgery. Patients who required the revision surgery after
minimal-incision knee replacement had their revision on average 15 months after their initial
procedure. This compares to an average of 80 months after traditional knee replacements. That is
a very striking difference.
Minimally Invasive Knee Replacement Preparation
Being educated about what to expect is important after minimally invasive knee replacement
surgery. Patients should have realistic goals for their recovery. Keep in mind that each person
recovers differently. In fact, people who undergo knee replacements of both knees at once often
experience somewhat different recoveries on each side.
The term minimally invasive is somewhat misleading and overused. It is still a surgery, and any
surgery is invasive. The human response to injury includes discomfort, altered emotions, and a
recovery period until healing occurs. Minimally invasive surgery can reduce, but not eliminate,
these normal responses to the trauma of surgery. Minimally invasive surgery also does not mean
risk-free surgery. Knee replacement surgery, regardless of technique, is associated with risk of
infection, nerve injury, deep blood clots, premature implant loosening and failure, unexpected
knee stiffness, continued pain, unpredictable medical complications, and even death. While these
complications are uncommon, people undergoing knee replacement surgery need to be aware of
them before undergoing any type of reconstructive procedure.
Usually, minimally invasive surgery simply means performing a big operation through a small
incision. In other words, the deep muscle injury is often unchanged, but the scar is smaller.
Surgeons who perform at least 100 knee replacement procedures per year are most able to
progressively begin shortening the incision, while keeping the procedure the same. Many
orthopedic implant companies have developed special instruments and training for surgeons.
Learning more about the procedure by reviewing the patient educational materials provided on
an orthopedic
27. Minimally Invasive Knee Replacement Surgery in India
Total knee replacement (knee arthroplasty) is a surgery that is performed for severe degenerative
disease of the knee joint. More than 300,000 people undergo the procedure each year.
Minimally invasive total knee replacement involves the use of a smaller incision than the one used in
traditional knee replacement. In the traditional method, the incision averages 8 to 10 inches in length. In
minimally invasive knee surgery, the incision is only 4 to 6 inches long. Because there is less damage to
the tissue around the knee, patients who undergo this procedure may expect a shorter hospital stay, a
shorter recovery, and a better looking scar.
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28. Revision Hip Replacement
title>Revision Hip Replacement,Revision Hip Replacement Surgery India Abroad
DESCRIPTION" content="Revision Hip Replacement Surgery abroad in India offers info on cost revision
hip replacement abroad in India,revision hi surgeon and hospitals India.
Revision Hip Replacement in India
Modern hip replacement has resulted in huge benefit for patients with arthritic hip disease
providing them with reduction of pain, return of function and consequently an improved quality
of life. The clinical success of total hip replacement is often taken for granted by the general
population.
There is evidence of increased longevity (twenty years or more) with some total joint
replacements, but many of these mechanical joints fail at around fifteen years when the hip joint
loosens. Revision hip surgery is technically extremely difficult and few orthopaedic surgeons
have extensive experience in this field.
Hip revision surgery has three major purposes: relieving pain in the affected hip; restoring the
patient's mobility; and removing a loose or damaged prosthesis before irreversible harm is done
to the joint. Hip prostheses that contain parts made of polyethylene typically become loose
because wear and tear on the prosthesis gradually produces tiny particles from the plastic that
irritate the soft tissue around the prosthesis. The inflamed tissue begins to dissolve the
underlying bone in a process known as osteolysis. Eventually, the soft tissue expands around the
prosthesis to the point at which the prosthesis loses contact with the bone.
In general, a surgeon will consider revision surgery for pain relief only when more conservative
measures, such as medication and changes in the patient's lifestyle, have not helped. In some
cases, revision surgery is performed when x-ray studies show loosening of the prosthesis,
wearing of the surfaces of the hip joint, or loss of bone tissue even though the patient may not
have experienced any discomfort. In most cases, however, increasing pain in the affected hip is
one of the first indications that revision surgery is necessary.
Other less common reasons for hip revision surgery include fracture of the hip, the presence of
infection, or dislocation of the prosthesis. In these cases the prosthesis must be removed in order
to prevent long-term damage to the hip itself.
Hip Replacement Procedure
The hip replacement surgery will remove the diseased or damaged hip joints and replace them
with new, artificial joints or prosthesis. The ball and socket joints are removed and the new
implants are fitted in their place. The femoral head or the ball section of the hip joint is sawed off
with a special power saw and the rest of the femur has a cavity dug in the soft tissue. This cavity
is where the new ball joint implant stem will be fitted. It is important to get the size of the ball
and socket right so that dislocation does not occur and make revision hip replacement necessary.
29. The acetabulum or socket joint will be scraped to remove the damaged tissue and moulded to
receive the new socket joint insert, usually made from a durable plastic.
Implant Fixation
These implants can be held in place by cement, or fitted so tightly that they stay in position
naturally. In the latter case, the prosthesis surface is porous and the bone begins to grow into it
and further strengthening the implant fixation. The cement option is usually recommended for
older patients due to the cheaper cost.
Hip Replacement Complications
The most common hip replacement complication is by far hip dislocation. The ball socket
becomes dislocated from the socket and the only remedy is revision hip replacement surgery,
where the hip joint is surgically re-entered and fixed. Hip revision surgery may also be required
if the new prosthesis are not properly fitted or measured and begin to cause pain and or stiffness.
In some cases osteolysis occurs, where the cement used to bond the implant into the surrounding
bone, looses microscopic particles. These particles trigger a reaction that leads to cells eating into
healthy bone to the point that the implants begin to work themselves loose. In this case revision
hip replacement surgery is necessary to rectify the problem
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KEYWORDS" content="Revision Hip Replacement, Repeat Hip Replacement India, Revision, Hip
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30. Revision Knee Replacement
title>Revision Knee Replacement Surgery,India Knee Revision Surgery Abroad
DESCRIPTION" content="Revision Knee Replacement Surgery abroad in India offers info on Cost Revision
Knee Replacement Surgery in India,Knee Surgeons,Hospitals India.
Why does a Knee need to be revised ?
Pain is the primary reason for revision. Usually the cause is clear but not always. Those knees without an
obvious cause for pain in general do not do as well after surgery.
Plastic (polyethylene) wear. This is one of the easier revisions where only the plastic insert is changed
Instability which means the knee is not stable and may be giving way or not feel safe when you walk
Loosening of either the femoral, tibial or patella component. This usually presents as pain but may be
asymptomatic. It is for this reason why you must have your joint followed up for life as there can be
changes on X-ray that indicate that the knee should be revised despite having no symptoms.
Infection- usually presents as pain but may present as swelling or an acute fever.
Osteolysis (bone loss). This can occur due to particles being released into the knee joint which result in
bone being destroyed
Stiffness- this is difficult to improve with revision but can help in the right indications
What is Revision Total Knee Replacement?
Revision Total Knee Replacement is the replacement of the previous failed total knee prosthesis
with a new prosthesis. It is a complex procedure that requires extensive preoperative planning,
specialized implants and tools, prolonged operating times, and mastery of difficult surgical
techniques to achieve a good result.
Physical Examination
The history and physical examination will identify patients who have a change in their pain level.
Also, information can be obtained regarding activity levels and use of assistive devices, such as
crutches or a cane. Pain of the hip may present as either groin or buttock pain. In addition, pain
of the hip can sometimes be perceived of as knee pain, and vice versa. Swelling of the knee can
be assessed easily, but swelling of the hip area may be more subtle. Mechanical failure or
infection may also present with redness and warmth of the affected joint. A limp or deformity
may be identified.
X-Rays
X-rays taken of the area around the joint replacement yield important clues regarding stability of
the implant. Failure due to the most common cause, aseptic loosening, can be identified by
several findings. For example, the implant may have moved, compared to previous X-rays, or
there may be a lucent line between the component and the cement or bone, signifying that the
bond between the bone and implant has degraded. Areas of bone loss, or lysis, can be identified.
Mechanical failure with broken implants or severe wear is also assessed by comparison to
previous X-rays. For these reasons, serial follow-up radiographs are recommended to catch joint
failure at an early stage.
31. Laboratory Tests
Common laboratory tests for possible failed joints include a complete blood count, an
erythrocyte sedimentation rate (ESR), and a C-reactive protein test (CRP). These studies are
most helpful in the detection of infected joint replacements. The blood count may identify an
anemia from chronic disease, and rarely may detect an elevated white blood cell count. The ESR
and CRP may be abnormal in the presence of an inflammatory process, such as infection.
What happens after surgery?
You may also have physical therapy treatments once or twice each day as long as you are in the
hospital. Therapy treatments will address the range of motion in the knee. Your therapist may
also demonstrate exercises to improve knee mobility and engage the thigh and hip muscles.
Ankle movements help pump swelling out of the leg and prevent the possibility of a blood clot.
When you are stabilized, your therapist will help you up for a short outing using your crutches or
walker. After surgery, you may not be allowed to put weight on the affected leg for a period of
time. This varies from surgeon to surgeon.
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KEYWORDS Revision knee Replacement, Repeat knee Replacement India, Revision Surgery India,
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Revision