Kolkata Fortis Hospitals, Walk The Talk , Patient Support launch

~Fortis Malar Hospitals, Conducts Tamil Nadu’s First Custom Fit Knee Replacement Surgery in Chennai~

Case highlights –

• 59 year old patient suffering from degenerative disease of the knee
• Brought to Fortis Malar Hospital with complications, underwent Tamil Nadu’s first Custom Fit Knee Replacement Surgery
• Patient was discharged within six days of the knee replacement operation
• Patients started walking normally within a fortnight

Ushering in the latest in Joint Replacement Surgery Fortis Malar Hospital Chennai, today announced Tamil Nadu’s first ‘Custom Fit Knee Replacement Surgery’ performed on a patient with degenerative disease of the knee. Leading orthopedic surgeon Dr. Nandkumar Sundaram and his team at Fortis Malar Hospital Chennai performed this revolutionary surgery by remodeling the anatomy of the patient’s knee and recreating or customizing a knee with the right kind of technology and expertise. The new custom fit knee replacement technology designs a perfect instrumentation system that matches the patient’s knee and ensures lesser pain, less tissue damage and faster mobilization.

Speaking on the occasion Dr. Nandkumar Sundaram, Senior Consultant Orthopedic Surgeon, Fortis Malar Hospital said “This is the first time in Tamil Nadu that a surgery of this nature is being performed, and we are proud to bring this technology to our patients. Custom fit knee is set to revolutionize the way surgeries are done in India. Breakthrough surgeries like these give patients a new lease of life and provide a permanent relief to a longstanding problem that the patient suffers from. Since it is custom made, the recovery is faster and the procedure less painful. “

While conventional knee replacement surgeries retro-fit predetermined sizes of prosthetics on to the patients’ knee, this procedure is very different because it works on the principle that no two patients’ knees are similar.

With this technology the patient’s knee is digitally recreated using 3D image mapping after taking into account, the bone structure, weight ratios, gender, age and even mechanical alignment. Based on this 3D model the customized knee is created. This technology ensures far greater accuracy and reduces the operation time by almost 40 % and also results in less loss of bone & tissues. The Custom Fit instruments are manufactured at state-of-the-art dedicated manufacturing centers & individual patient name and data are etched on each unit to confirm identification during the surgery. Post this; the knee bone is chiseled to perfection so that the prosthetics fit exactly without any requirement for later corrective surgeries. After a 60 minute surgery, the patient ill have the knee that fits perfectly.

Moreover, the alignment settings exclusive to the patients’ bone structure contained within the instrumentation enabling the patient to get back on his/her feet faster after the knee replacement procedure.

About Fortis Healthcare Limited:

Fortis Healthcare Limited is committed to clinical excellence and patient-centric healthcare, which is manifest in hospital design, patient services, medical programmes and the compassionate approach of medical and non-medical hospital staff. Fortis commissioned its first hospital in 2001 at Mohali, near Chandigarh, and has expanded its operations to become a network with an 8500 bed capacity across 53  hospitals (including 10 hospitals in pipeline). The Fortis network has a large number of international accreditations, including four JCI (Joint Commission International) and six NABH (National Accreditation Board for Hospitals) certifications. The network’s capability covers multi-speciality hospitals and super-speciality centres that provide tertiary and quaternary healthcare to patients in the major medical specialities.

For more information, please contact:

Kavya                                                                                                   Samhita Buddhavarapu / Vinitha Saira Koshy

Fortis Malar Hospital                                                                    Hanmer MSL

M: (+91) 91766 88503                                                                M: (+91) 95000 18665 / 98841 25218

Moreover, the alignment settings exclusive to the patients’ bone

A 53-year-old woman from Delhi was operated for India’s first CT scan-based custom-fit total knee replacement surgery at Fortis Hospital in Mohali, near here. Even as knee replacement surgeries are considered to be the last resort and for ripe old age, doctors say CT scan-based knee replacements can be useful for younger ages as they have the right fitting making it long-lasting.Doctors at the hospital say this surgery increases the longevity of the joint replacement by more than 10 years, making it fit even for those in younger age groups, like Mohini Taneja, who was operated Wednesday.”Earlier, knee replacement surgery was taken as the last resort and only for those in very old age because its life was 10 to 15 years only. With the custom-fit knee replacement, we take up its life to 25 to 30 years, making it fit for younger ages like this 53-year-old woman,” Additional Director, Dept. of Orthopaedics and Joint Replacement at Fortis hospital, Manuj Wadhwa told IANS over phone.

“The patient developed arthritis at the age of 30. The problem went on increasing as she was overweight and finally at 53 she was not able to walk. Usually, knee replacement is not preferred for this age as the life of the artificial joint is 10 to 15 years, but with the CT scan-based total fit replacements, it is possible to find a solution for younger patients,” he said adding “a better fitting joint will always have a longer life”.The procedure uses CT scan for taking the pictures of the joint, and an artificial joint is crafted based on the pictures.”The accuracy is up to 0.1 mm and 0.1 degree. A 3D model of the knee is made through pictures taken by CT scan and the images are sent to bio-engineers in the United States where a personalized knee is created and shipped to India,” Wadhwa said.The time for surgery is also reduced considerably as fitting is easier, he said.”The surgery takes 15 to 20 minutes compared to more than an hour needed in the lengthy procedures that are required otherwise in fitting the joint.

This new technique eliminates 22 steps during the surgery as compared to a conventional surgery. “It also means reduced infections, anaesthesia requirements, blood loss, faster recovery and a longer lasting implant solution,” he said.These tailor-made joints are, however, heavier on the pocket of the patient as an extra expenditure of approximately Rs.50,000 is required to order the joint. The doctor added that this technique is more accurate compared to the MRI-based surgeries wherein MRI is used for taking the images. “So far, MRI was used for the imaging, however, while MRI is good for imaging tissues, CT scan is best for imaging bones and gives the most accurate picture of the joint. The CT scan procedure is new and was launched only six months back in the USA,” Wadhwa added.

Fortis Hospitals perform a specialized surgery on a young Nigerian girl who suffered arthritis of multiple joints due to Sickle cell disease

“For the First time in Mumbai, a special Zirconium ceramic knee replacement from a particular company was used along with computerized navigation to treat a young patient”

Mumbai, September 6, 2010: Dr. Sachin Bhonsle at Fortis Hospitals Mulund performs a multiple joint replacement surgery on a 26 year old Nigerian girl Rebecca who suffered arthritis of multiple joints due to Sickle Cell disease- a rare genetic disorder. Dr Sachin Bhonsle, Orthopedic surgeon used a special Zirconium ceramic knee replacement which was used along with a computerized navigation. This technology from a particular company was used for the First time in Mumbai.

Rebecca underwent Shoulder & hip Joint surgery 3 months ago under care of Dr Sachin Bhonsle at Fortis Hospitals Mulund and revisited Fortis Hospitals to undergo a Complex Knee Replacement surgery.
According to Dr Sachin Bhonsle, “She came to us with severely affected Shoulder, Hip and Knee joints. It is unusual to consider a Total hip replacement (THR), Total Knee (TKR) and a shoulder replacement at the same time as after a THR/TKR patient normally need to use a walker or crutches for few days. A shoulder replacement would not allow the patient to mobilize satisfactorily.

Unless the THR is very stable the shoulder could not be done. She sailed through the HIP and Shoulder replacement three months back. Now she came for the treatment of her knees. The Left knee was very bad and a Total Knee replacement was the only possible option to give her a painless stable and mobile knee

In Rebecca’s case sickle disease was severe to the degree that 93% of her haemoglobin was abnormal. There were major challenges faced by Dr Bhonsle before he decided to go ahead with the Total Knee Replacement surgery:
- The knee was completely worn out (advanced osteo arthritis)
- The knee had no movement in it. Normally a knee bends 135 degrees, because of scarring of her muscles the knee had become very stiff.
- The other knee has also started to deteriorate. It became important to surgically treat her left knee or else she would be bedridden again.
- 26 years of age is normally too young to have a joint replacement, so a special robust and durable design had to be sought out.

A special Zirconium ceramic coated knee replacement was used along with computerized navigation to treat the case. Ceramic coating of the metal components has a twofold advantage.

1. Normal metal component no matter how smoothly polished would cause some wearing out of the high quality joint bearings. A ceramic coating is ultra smooth and this wear is reduced to bare minimum.

2. There are individuals with allergy to metals in alloys. This used to prevent them from having a joint replacement. Ceramic coating prevents such allergies as the metal is not directly exposed.

Dr. Bhonsle added, ‘Although I used a minimally invasive approach to her hip and shoulder the knee needed extensive soft tissue refashioning so as to provide a bend in the knee as well as a long lasting stable knee replacement’

Following the surgery her pain has stopped completely. She had a speedy recovery and was able to get back to her normal course of life within few weeks of the surgery.

About Sickle cell disease
1.Sickle-shaped cells block small blood vessels resulting in less amount of blood reaching a particular part of the body.
2.People with the disease have red blood cells that contain mostly haemoglobin* S, an abnormal type of haemoglobin.
3.Tissues that do not receive a normal blood flow eventually become damaged.
4.This is what causes the complications of sickle cell disease.
5.There is currently no permanent cure for this disease but the effects can be very well controlled.

Fortis Hospitals,Mulund Mumbai launches the five day recovery program for ‘ Knee Replacement” To know how our 5 day recovery process works and what you would expect on all 5 days. Click here to know all about the 5 day recovery and our specialist doctors

Total Knee Replacements: Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material.

Knee Replacement At Fortis Hospitals,Mulund Mumbai ,surgeries are conducted in special environments called Space Theaters that are created and constructed for knee replacements. This special environment is a combination of expert surgeons and their team, Clean Air Laminar Air Flow System, and Space suits.

The Laminar Air Flow System helps keep the air clean of dust and micro-organisms. The HEPA (High efficiency particulate absolute) filter, which is the filtration of air on control velocity condition, cleans the air as per the specifications of the federal standard 209E. The efficiency of HEPA filters is 99.999% of all particles larger than 0.3 micron ensure that the laminar air flow is ultra cleaned over the entire operating area and instantly the theatre is bacteria free.

During the surgery, the surgeon and the immediate assistant wear specially designed space suits to assure absolute sterile handling of Bones and Joints. This suit comprises of a helmet worn and covered by a space gown.

Computer aided surgery facilitates current placement of artificial joint Prostheses to match the normal human anatomy. A normative anatomical data is already established in the computer. Based on the intra-operative findings during the surgery, the surgeon can control the outcomes by precisely implementing the 3D plans while collecting and analyzing detailed treatment data. This information reduces the risk of complications, surgery time, hospitalization time, and artificial joints wear through suboptimal selection and position of the implant.