A breakthrough in the knee replacement surgery is a mix of benefits of minimally invasive surgery, patient-specific high performance implants, higher flexibility, modified pain control concepts and less bleeding.
Dr Manuj Wadhwa, Director and Head of Max Elite Institute of Orthopaedics and Joint Replacement, Max Hospital, Mohali, has performed a bilateral total knee replacement surgery on a 90-year-old patient Madhulika Saran (name changed), who was suffering from end-stage knee arthritis, in a single sitting. The modified concept resulted in minimal blood loss with advanced muscle sparing surgical exposure, specialised latest techniques such as digital surgery and patient-specific implants.
A new minimally invasive procedure may help people with advanced osteoarthritis of knee and hip continuing in `keeping pace with life.’ Tissue preserving total knee replacement goes beyond general scope of conventional TKR surgeries, using smaller incision and special instruments to approach the knee from front with minimal trauma to the soft tissue, muscles and tendons. The technique, perfected by Dr Wadhwa, allows satisfactory surgical exposure in all patients including obese people, with easy implantation. “We have stopped using blood transfusions for knee surgery, even for operations on both knees in one sitting,” says Dr. Wadhwa.
Overall impact of tissue preserving TKR surgery is that there is less soft tissue sacrificed during surgery. Post-surgery pain is reduced and theres is less bleeding. This technique allows faster rehabilitation, better muscle strength and early return of knee motion. After surgery recovery time is less than one third of that with conventional TKR technique.
If pain during and after surgery can be controlled, it will be comfortable for patients and will lead to fast recovery. The ultimate concept at best centres, globally, is based on reduced tissue trauma surgery and pain control using cocktail of medicines to be injected in soft tissues around the knee during surgery.
New ways to open knee may be more important than length of incision. These are called ‘quad-sparing’ as they protect the quadriceps. MIS knee surgery results in less blood loss, shorter hospital stay, better motion, and faster recovery. Apart from MIS, there is an increased demand for patient-specific high-flexion implants, in Asian population, giving higher flexibility and ability to sit cross-legged or squat post-surgery. This comes with additional durability for younger population where longevity of implant is a serious concern.
A mix of less invasive techniques, better implants and modified concepts in pain control with less bleeding available with Dr. Wadhwa at Max Hospital are a drive for a more international patients coming to North India for these surgeries.