Friday, 15 August 2014

We are one of the first centers in Gurgaon to offer knee replacement using Patient Specific instrumentation (PSI) or Custom made instruments.

PSI uses advanced imaging to generate one-time-use instruments specific to each patient. A computed tomography (CT) or magnetic resonance imaging (MRI) scan is taken of the patient’s leg. A three dimensional bone model of the patient's knee is created based on the CT/MRI images. Dr Arora will then plan your surgery on this 3D image regarding overall alignment, femoral and tibial bone cuts and size of the implant needed. The detailed plan is then sent to the implant manufacturing unit based in USA and an engineer uses the data to fabricates a corresponding set of disposable cutting blocks or pin guides designed to help the surgeon position and align the implant during surgery. These jigs are then shipped to us for use during surgery.

These patient-specific surgical instruments are custom made for the precise alignment of patient’s knee.There are several distinct advantages of this technology. It removes multiple steps from the traditional surgical technique and shortens surgical time as most of the planning about size and placement of implants takes place preoperatively using computer software programme. This may lead to less blood loss and a lower risk of infection.

Patients are counseled about this technique at the clinic and once they have decided to proceed with custom made implants, an MRI/CT scan of the knee(s) is arranged at a designated center in Gurgaon.
The images are sent to USA/ Belgium for fabrication of patient matched bone cutting instruments. They are received after 2-3 weeks, following which the surgery can be done.

Video below explains the process of PSI in detail.

Monday, 10 February 2014

Oxynium Knee Replacement in Gurgaon by Dr Jayant Arora

Rheumatoid arthritis can lead to crippling deformities in joints and unlike osteoarthritis which is seen in elderly population, it can affect us at any age. Rheumatoid arthritis is the second commonest type of arthritis due to which patients require a knee replacement surgery world wide.

Despite many advances in the medical treatment if this disease, severe joint damage can happen in-spite of medications and often such patients have to undergo  replacement surgery of multiple joints for pain relief and to regain normal functional life.

We would like to share a story of thirty seven year old courageous school teacher suffering from crippling rheumatoid arthritis, that affected her at the age of seventeen.

The disease was aggressive and inspite of regular medications, she developed painful and stiff joints. She braved her condition with steely determination and a smile on her face. The disease progressed relentlessly, affecting both the knees. Gradually, the knees developed deformities, became very stiff and remained painful even at rest. Both the knees lost all the movement and were fixed in a bent position. She had started walking laboriously with a marked limp. This was affecting her physically as well as emotionally and she had started losing the mental battle against the crippling disease. In her quest to remain mobile, she tried rigorous physiotherapy and even took injections in the knee joints,  all without any improvement in her condition. She visited us at Gurgaon Knee and Shoulder Clinic to consult Dr Jayant Arora, where the option of knee replacement surgery was discussed with her as a last resort to restore movements, relieve pain and improve walking. She was explained, that unlike most knee replacements, her surgery was not going to be straightforward and there were several issues that needed to be addressed. Since, she was nearly half the age as compared to a typical patient under going knee replacement, knee replacement made from a special material (Oxynium) was used instead of a standard metal implant. Oxynium implants are preferred in young patients undergoing knee replacement as that are stronger than metal implants and are expected to last longer. Our vastly experienced Surgeon performed the replacement of both knees  at Columbia Asia Hospital using a modified surgical technique to account for stiff and  tight muscles,deformed and weak bones. The rehabilitation was carefully planned and done under regular supervision, leading to a very quick recovery. Her colleagues were left amazed when she resumed working three months after surgery, able to walk normally, climb stairs and drive, as if there was never anything wrong in her knees. The only thing that didn't change was her infectious smile!