Orthopedic

Orthopaedic

Overview:-

The Apollo Institutes of Orthopaedics enjoy the reputation of being one of the pioneering bone and joint centres in the country with a legacy of innovation and excellence. The Institutes are at the forefront in offering the latest in Orthopedic treatments and Orthopedic surgical advancements on par with the best centres in the world.

The Apollo Speciality Centres for Orthopedics are at the forefront in offering the latest in orthopaedic treatments and surgical techniques. The centres perform surgical procedures which include the most current arthroscopic and reconstructive techniques – including major joint replacements including Hip, knee and shoulder surgeries, arthroscopies, laminectomies, the most delicate hand surgeries and much more. The most advanced medical equipment and a team of highly experienced surgeons are supported by computer navigation and imaging equipment.

Milestones

• North Maharashtra’s first Day Care Total Knee Replacement surgery was successfully performed by Apollo Hospitals, Nashik.
• Apollo Hospitals Nashik is well known for Polytrauma case management & Total joint replacement surgeries

Arthroscopy Or Keyhole Surgery

The arthroscope is fitted with a state-of-the-art miniature camera and a specialized lighting system that enables the structures inside the joint to be viewed on a monitor. The surgeon can attach special tools to the end of the arthroscope to shave, cut, or remove tissue or bone that are causing problems. Arthroscopic or keyhole surgeries of the joints are routinely performed.

The most common arthroscopic procedures include repairing cartilage and meniscus problems in the knee, and removing inflammation and repairing rotator cuff tears in the shoulder. Apollo Hospitals performs arthroscopies on a routine basis.

Apollo Knee Check

The Apollo Knee Check is the cornerstone of the Knee clinic and is the vital factor that pins down the exact cause and origin of the knee disorder thereby ensuring evidence based management. Apollo Hospitals has been the pioneer for the Preventive Check program in our state and has over the years launched many a need based health check package.

The Knee Check is yet another unique program specifically designed to include diagnostic tests that target knee disorders. In all, the Apollo KNEE CLINIC is a one-stop centre catering to the end-to-end needs of a patient with knee pain with a 360-degree approach. We hope that in the enduring Apollo tradition of touching lives, The Knee clinic will reach out and alleviate the burden of pain, immobility, incapacitation and impaired activity and productivity that can be caused by knee disorders.

Apollo Knee Clinic

Disease profile is undergoing rapid transformation in India and infectious diseases are fast giving way to life style diseases. Knee pain and knee related disease and disability is one such major chronic disease that incapacitates people of all age groups.

Knee pain is one of the commonest problems that many people face in their day to day lives. Indeed, over 4 million people over 60 years of age and over 6 million people across all age groups need help for knee pain and disorders.

Factors such as aspiration for a longer and more active life, increasing life expectancy and injuries are leading to an increased incidence of hospital visits due to knee pain.

While a variety of options are available today both in traditional and alternative medicine for management of knee pain, most of these options are incomplete and sub-optimal. Patients move from hospital to hospital and from doctor to doctor in search of pain relief often without desired results. The need for a comprehensive centre for managing knee disorders was therefore obvious and was also articulated by many patients.

Therefore, we at Apollo Hospitals decided to create a comprehensive solution for knee pain integrating the different elements of managing a knee disorder.

Starting from prevention through early diagnosis, medical intervention, and surgical intervention to rehabilitation, the Apollo Knee Clinic aims to offer a complete program for people suffering from knee disorders due to causes ranging from arthritis, age, sports injuries and obesity.

Research, inputs from experts in orthopaedics and physiotherapy and the expertise and experience of the entire Orthopaedic team at Apollo Hospitals has provided the inputs required for this program. Wherever possible the protocols and guidelines have been benchmarked with global institutions to ensure that the outcomes are comparable to the best institutions in the world.

The Apollo Knee Clinic and Program addresses every aspect of joint health. This encompasses the entire gamut of healthcare options for knee care, including

• Prevention of knee disorders by creating awareness among the public.
• Early and precise diagnosis by the exclusive knee checks packages.
• Preventing disease progression: by our Disease Management Program that offers long term support and service to people with knee disorders.
• Effective and world class Treatment: through integrated proactive physiotherapy & exercise, Arthroscopic and minimally invasive procedures, and Knee replacement. surgery by some of the most renowned experts in Orthopedic and Joint replacement surgery.
• Rehabilitation and Physiotherapy.
• Weight management.
• Research: on the use of regenerative techniques to manage knee pain and arthritis using stem cells, cartilage transplantation etc.
• Management of sports related disorders and injuries to knee.

Apollo Shoulder Check

• Prevention of shoulder problems- young and old.
• Early and precise diagnosis to recorrect through shoulder rehab the perfect biomechanics of shoulder.
• Arthroscopy and repair of rotator cuff tear with decompression if required.
• Research into the vaguely known shoulder entities in common people.
• Dedicated shoulder therapist and innovative rehabilitation customized to patients troubles.
• Dedicated imaging of shoulder.

Shoulder Replacement

Labram is a fibro-cartilagenous tissue which increases the surface area of glenoid. When torn it leads to instability of shoulder. Recurrent dislocation or recurrent pain while using shoulder is the feature that comes due to labral tears. Labral tear’s needs to be repaired in time to prevent further tear progression and also loss of bone of socket of shoulder. These tear can be fully treated (key hole) arthroscopically. Rotator cuff are important stabilizing muscles in shoulder, which if torn has to be repaired.

After repair adequately, long rehabilitation is required for this muscle to function back. In patients with frozen shoulder who do not get back adequate movements even after 4-6 months of adequate rehabilitation can be treated with capsular releases in a targeted way to get back lost movements.

In patients whose cuff tears has over time leaded to muscle atrophy, we do provide advanced surgery in turn of reverse shoulder replacement.

• Benkarts repair
• Global tear repair

• Global capsular release for frozen shoulder or targeted release
• Rotated cuff repair
• Suprascapular nerve release
• Open Reverse Joint Replacement
• Key hole surgery for disorders of the knee, shoulder, elbow and ankle
• Trauma and Fracture surgery
• Image intensifier, confirms perfect fracture fixations
• Management of open fractures
• Infected non-union of long bones
• Correction of deformities
• Fusion of joints

Total Hip Replacement Surgery

The end portion of the thighbone affected by arthritis is replaced with a metal head that can be cemented with special glue to the stem of the thighbone (or) can be uncemented (in younger patients). The socket is replaced with a metallic cup and high density plastic is used as an insert into it. The socket is usually left uncemented (screws are used to connect to the thighbone). The Total Hip Replacement procedure enables restoration of the natural gliding motion of the joint.

What Is Total Hip Replacement?

When the hip joint has worn to the point when it no longer does its job, an artificial hip (called prosthesis) made of metal and plastic can take its place. The surgery to implant the prosthesis is termed a total hip replacement. The hip replacement recreates the normal function of the hip. While the idea of getting an artificial hip joint may be frightening to some, it is one of the safest and most effective medical procedures.

• Total hip replacement, which entails replacing the acetabulum with an artificial liner as well as replacing the proximal femur with an artificial stem, is an excellent procedure for the treatment of hip pain and arthritis. Furthermore, it provides for a more mobile hip.

Who Should Have A Total Hip Replacement?

• Total hip replacement is recommended for arthritic patients with severe pain and limited function.
• Patients at our Apollo Hospitals, Nashik affiliate are encouraged to participate in a joint replacement seminar.

Benefits

• The most apparent benefit of hip replacement is dramatic pain relief. Almost all patients have complete, or near complete, relief of pain. As the pain lessens, function also improves. Most patients have better range of motion and limp less.

Knee Replacement Surgery

Arthritis is inflammation of the joints. A gradual wearing away of the tissue on the ends of bones results in reduction of joint space and friction at the exposed bone surfaces, changing regular bone movement and causing severe pain. Knee Replacement Surgery is the best solution to treat the condition and allow resumption of normal activities in the knee.

The Types of Arthritis Are:

Osteoarthritis

This occurs after the age of 50 in individuals with a family history of arthritis. The tissue that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.

Rheumatoid Arthritis

This is a disease in which the inner membrane of joints is thickened and inflamed. This results in excessive production of the fluid that lubricates these joints. This chronic inflammation can damage the tissue covering the ends of the bones and eventually result in loss of the tissue, pain and stiffness.

Traumatic Arthritis

It can result from a serious knee injury. A knee fracture or severe tears of the knee’s connective tissue may damage the tissue covering the ends of the bones over time, causing knee pain and limiting knee function.

Symptoms of Arthritis

• Severe pain in the joint that restricts everyday activities such as walking, climbing stairs and getting up from chairs.
• Severe pain while resting.
• Inflammation and swelling of the joint that does not improve with medication and rest.
• Deformity in the joint.
• Joint stiffness or inability to move the joint in a normal manner.

Knee

ACL surgery is to reconstruct the torn ACL in knee. Commonly 3 grafts are used:

• Hamstring tendons.
• Bone tendon Bone graft.
• Central Quadriceps tendon.

These grafts are fixed in anatomical positions using various implant options.

Anatomical ACL Reconstruction

The standard ACL reconstruction has provided great stability to knee but has been now proved to not halt progression of osteoarthritis. So, in order to provide stability to knee and also prevent or retard the development of osteoarthritis, a new concept with ACL evolved around mid of 2005 in USA. This new concept is called the Anatomical Reconstruction of ACL. With the advent of higher technology in arthroscopy, it became very safe to go into highly difficult places in the knee.

We routinely not just do Anatomical ACL reconstruction with Bone tendon Bone graft but also Hamstring tendons are used. In patient whose graft quality is good and not yet any osteoarthritis, knee is considered for Anatomical double bundle ACL reconstruction.

Combined Ligamentous Injuries

When ACL, PCL & PLC (posterolateral complex) is torn, we reconstruct all ligaments using arthroscopic and open techniques to restore knee stability. Isolated PCL is also treated surgically if ER III laxity is found with Anatomical PCL reconstruction.

Partial Knee Replacement

This minimally invasive procedure is an option for arthritis patients in whom only one part of the knee has been affected.

In a Partial Knee Replacement, the diseased portion is removed and replaced with a metal implant.

Revision Hip Surgery

Revision surgery is different in that the original components are removed and new components are implanted. The technical aspects of the surgery are more complex than the original total hip replacement. However, the preparation for surgery and hospital experience tends to be very similar to the primary total hip replacement. The choices for implant are also the same; both cemented and cementless components are used depending on the patient’s needs and the quality of bone present at surgery.

Possible Complications

The most common complications of total hip surgery can now largely be avoided. Before surgery each patient receives a complete medical examination by a doctor, as well as routine testing. Donation of one’s own blood prior to surgery can eliminate the problem of HIV and Hepatitis completely.

Possible local complications include: loosening, wear or breakage of the prosthesis, hip dislocation, infection, pain, stiffness, leg length inequality, delayed healing of bone and soft tissues, and heterotopic bone formation. Other rare complications include fracture of the femur or acetabulum, nerve and vascular injury.

Medical complications include: thrombophlebitis, pulmonary embolism (blood clot), urological complications and even death (0.1%) Other rare complications, which can be encountered with any surgery, include cardiac, digestive and lung problems.

Total Knee Replacement Surgery

For patients suffering from severe arthritis that can cause acute pain and make even routine activities difficult, Total Knee Replacement is the best solution. The procedure involves removing all diseased portions of bone and tissue on their ends, and replacing them with metal and high density plastic components shaped to create a structure that allows normal movement of the joint. Other knee deformities will also be corrected during the Surgery.

High Tibial Osteotomy

An osteotomy is Surgery that involves shaping and realigning of bones at a joint. It is usually used to treat arthritis in young patients, and is particularly recommended for those with very shallow joint sockets.

In High Tibial Osteotomy the upper part of the tibia – one of the limbs forming the lower leg – is resurrected, mostly by removing a small part of bone in the area.