Advanced Hip and Knee Clinic

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Knee replacement, designed specially for women.

For over four decades, total knee replacement surgery has evolved to better serve patient needs. Improvements in surgical procedures, implant design and materials, and better surgeon and patient education have all combined to ensure that patient outcomes are better than ever before. Elimination of knee pain and vastly increased mobility after surgery has contributed to the restoration of lifestyles following knee replacement surgery. The longevity of knee replacement is over 95-98% after 25 years.

More than 70% of knee replacements are performed in women as they are more prone to arthritis. There are lot of anatomic differences in the anatomy and alignment of bone and soft tissues around the knee joint in men and women. Anthropologists, medical examiners, and observant surgeons have long known that there are visible differences between male and female knees. Yet, all knee replacement implants till recently were designed based on an average size of both women's and men’s knees combined. Thus a standard knee implant may not have the perfect fit in women as it does in men.

Over the last few years, a knee implant design especially for women has been developed. The newer gender specific knee implant was designed keeping in mind the subtle differences in bony structure of knees amongst males and females. The design is based on sound scientific principles and is proportioned to the female knee anatomy.

The Gender Knee is contoured to fit the unique shape and size of women's knees. It has 3 distinct differences from all other knee implants. 1) It has a thinner profile for women, so the knee feels more natural and has a greater range of motion (bends beyond 130-140 deg.) 2) It allows more natural movement of the knee cap which eliminates pain and discomfort in front of the knee during activities requiring high bending, like stair climbing, squatting and sitting cross legged on floor and 3) Has a shape specially contoured for women, so the implant does not overhang the bone and potentially press on, or damage or irritate the surrounding soft tissues.

With the latest surgical techniques of reduced tissue trauma surgery, rapid mobilization and recovery and gender knee, patients have potential for early recovery of function, better knee bending, early discharge and an excellent long term result.

   Over a month ago

Total Knee Replacement with rapid recovery program.

For more than four decades, knee arthritis has been treated successfully with knee replacement surgery. Total knee replacement surgery reliably relieves joint pain and stiffness and restores function for many years after surgery. Many patients fear the recovery process and have a notion that pain after surgery is unbearable and recovery can take months together. Few patients believe that they would be bed bound for weeks together and dependant on others for normal daily activities after surgery.

Recently, new strategies for post operative pain management have been developed to provide better pain control and facilitate faster recovery. With advanced surgical techniques, pre-emptive analgesia and modern pain control protocols, pain after surgery is minimal and recovery after knee replacement is a smooth process. Our aim is to make the recovery after total knee replacement a pain free and pleasant experience.

Patient can expect to be mobile and walk within 6-8 hours of surgery with minimal discomfort. Majority of patients can manage their daily activities like getting in and out of bed, walking with support, going to toilet independently and sitting on a chair within 2-3 days. Vast majority of our patients walk without any support (like stick or walker) within 5-7 days of surgery. Over 90% of patients can go home within 2-3 days after knee replacement.

Most patients can expect to walk 1-2 km without any support within a month of surgery. Complete recover, which means, no pain, no support for walking, no limp and unlimited walking takes around 6-8 weeks in most patients.

This is what the patients can expect after surgery with Rapid Recovery Protocol:

Few days before Surgery:

● You will be taught a set of 2-3 exercises which you would be performing after surgery. It is much easier for patients to learn and start practicing the knee exercises before surgery than after surgery.
● Also a thorough assessment is made of home environment, support available, sufficient space to walk around after surgery etc.

Day of Surgery:

● Within 4-6 hours of surgery, as the effect of spinal anaesthesia wears off, you would be advised to start ankle pumps (moving both your ankles up and down). Also you can start doing static quadriceps exercises (pressing your knee down against a towel or pillow).

● Depending on the amount of pain you have and your comfort level, you might be told to sit by the side of the bed and start moving you knee joint and also get out of bed and walk a few steps.

The 1st day after surgery:

● The day after surgery, pain in the knee joint is considerably less and you would be advised to apply ice packs to the knee joint every 4-6 hours.

● The ankle and knee exercise will continue but the number of repetitions will increase. Also you would be made to do bedside knee bending exercises and walk at least 3-4 times during the day with the help of a walker. You would be taught on the correct usage of the walker or walking stick.

● You can also resume the straight leg raising exercises at this time.

The 2nd day after surgery:

● This day is dedicated to making you independent in daily activities and prepare you for discharge

● You will be encouraged to get in and out of the bed without any help and walk to the washroom with the help of a walker. The target will be to make you walk up to 50-60 steps at a time and also to make sure you can stand for at least 10-12 minutes at a time (to enable you to do a few household and kitchen activities).

● You will also be taught the correct method for climbing the stars up and down.

Day of discharge:

A dressing is usually done before discharge and patient is reinforced on all the precautions, exercises and medications.

Weeks after Surgery:

The pain and stiffness from surgery comes down gradually over a period of 2-4 weeks. As the pain comes down, patients notice an increased ability to do the exercises and ability to walk without any pain and support. Most patients can shift from a walker to a cane within 5-7 days after surgery and can leave the cane within 2-4 weeks after surgery. The sutures are generally remover at day 14-16 after surgery.

Patients can start driving their car within 2-4 weeks after knee replacement. Patients can resume going to office (sitting job) within 2-4 weeks after surgery. Going for a morning walk can be resumed at 6 weeks after surgery.

Long term results:

The long term result of the surgery is well documented and vast majority of patients can expect the new knee to serve them a lifetime. A well performed knee replacement can last upto 20-30 years depending on your body weight and usage.

The overall benefits of total knee replacement surgery with the Rapid Recovery program include:
● "Next Generation, " advanced pain management.
● Early ambulation, with progressive rehabilitation and faster recovery.
● Comprehensive pre-operative education program.
● Potential for discharge on post-operative day two to three.

Further queries, Contact: Dr. Vineet Sharma, Advanced Hip and Knee Clinic. SCO 101, Sector 47-C, Chandigarh. Ph. 97813-98113, 99159-33663

   Over a month ago

Surgeon profile.

Dr. Vineet Sharma is renowned joint replacement surgeon of India. His practice is dedicated exclusively to Joint Replacement of the hip and knee. He performs over 600 primary and revision hip and knee replacement every year. He is one the few surgeons in the country with Clinical Fellowship training in USA in the field of Joint Replacement. He has an active medical license to practice in India and USA.

Education and Training.

Dr. Vineet Sharma has done his MBBS from JIPMER, Pondicherry and MS in Orthopedics from Seth GS medical college and KEM Hospital in Mumbai.

He has done 2 clinical fellowship is the field of Hip and Knee reconstructive surgery. The 1st fellowship was at the University of Minnesota Medical centre in Minneapolis, USA. He trained with world renowned Joint replacement surgeons like Dr. Edward Cheng, Dr. Harry Robinson, Dr. Ruby Thompson and Dr. Terence Gioe. He learned the art of primary and revision hip and knee replacement during the 1 year ACGME ACCREDITED Fellowship. He also trained in complex reconstruction after tumor resection d hip resurfacing during the fellowship.

He did another clinical fellowship with Dr. Chitranjan S. Ranawat at the Ranawat Orthopedic Centre at the Lenox hill Hospital in New York. He also had opportunity to word with renowned masters of knee and hip replacement like Dr. Jose Rodriquez. Dr. Amar Ranawat and Dr. Vijay Rasquniha. During the 1 year fellowship at an extremely high volume centre for joint replacement, Dr. Vineet Sharma learnt the basics and advanced techniques in the field of hip and knee replacement. He also leant the art of reduced tissue trauma surgery with rapid recovery protocols.

He has also done visiting fellowship at the Rush University Medical Center in Chicago with Dr. Aaron Rosenberg, Dr. Wayne Paparosky and Dr. Richard Berger. The centre is world famous in the field of minimally invasive joint replacement and pioneers in the quadriceps sparing knee replacement. This technique enables very rapid recovery of patient function after surgery and lets them go home in the evening of surgery.
Also this centre is pioneer in the field of revision hip and knee replacement. Dr. Sharma trained in the most advanced techniques in the field of minimally invasive joint replacement and revision joint replacement.

Dr Sharma has also done a visiting fellowship at the Hospital for Special Surgery in New York in the field of Arthroscopy and sports medicine.

   Over a month ago

Knee Replacement in Obese patients.

Knee replacement is an extremely successful surgery for patients with knee arthritis with a proven long term success beyond 20-25 years. A major risk factor for developing osteoarthritis of the knee is obesity. Obese patients put more stress on their knee joint and thus the degeneration occurs at a faster rate compared to people with normal weight.
Also patients with advanced arthritis of the knee become less mobile and are likely to gain significant weight due to inactivity. This in turn leads to more stress on the knee joint and more pain. A vicious cycle thus ensues.

Inactivity and resultant obesity predisposes the patient to variety of other medical problems like hypertension, diabetes, heart problems etc. It is unrealistic to expect a patient with knee arthritis to loose weight before knee surgery.

Many a times, obese patients are denied knee replacement on the pretext that surgery is more risky, difficult and results suboptimal in overweight patients. Surgeons often fear the short term and long term complications of knee replacement in obese patients. The risks include wound healing problems, blood clots and early failure of the implant.

Contrary to such belief, knee replacement in obese patients is as successful as in normal population. With modern surgical techniques and rapid mobilization and recovery, these patients have a very low risk of having any complication during the hospital stay and after surgery. Once complete recovery happens in 4-8 weeks after surgery, these patients become much more mobile compared to before surgery and thus are likely to loose weight.

We routinely perform knee replacement on patients with weight up to 120-130 kg. Many of these patients have lost up to 10-20 kg weight with regular walk and exercise within a year of surgery. Thus, it is irrational to deny knee replacement to obese patients as the benefits of surgery and pain free mobility far outweigh the presumed risks involved.

Further queries, Contact: Dr. Vineet Sharma. Advanced Hip & Knee Clinic. SCO 101, Sector 47-C, Chandigarh. Ph. 97813-98114, 99159-33663.

   Over a month ago