Best Knee Replacement Surgery Hospital in Mumbai
Pinnacle Orthocentre Hospital is leading one of the Best Joint Replacement services & treatment for total knee, Hip & Shoulders Replacement Surgery in Thane, Maharashtra, India. Ultimately, your best knee replacement surgeon in thane will recommend using whichever implant or implants he feels is right for your Arthritis, Age and Lifestyle and whichever product he has a successful track record.
Pinnacle Orthocentre Hospital is India’s most advanced orthopaedic hospital with state of the art facilities and provides all types of Total Knee Replacement Surgeries in Thane Maharashtra, India. With advanced technology, our top Orthopaedic surgeons perform the best ligament.
Types of Total Knee Replacement Implants
There are a few different kinds of knee implants used in Total Knee Replacement Surgery/Arthroplasty. The different types are categorized by the materials that are used in the manufacturing of implants.
Metal or plastic.
This is the most common type of implant articulation. It involves a Metallic Femoral component that rides on a Polyethylene plastic spacer attached to the Tibial component.
The metals commonly used include
Least expensive type of implant
Longest track record for safety and implant life span.
An immune reaction triggered by tiny particles that wear away from the spacer. It can cause the bone to break down, leading to loosening and failure of the Osteolysis implant. Advances in manufacturing have significantly reduced the rate of wear in the plastic. Development of Highly Cross-linked Polyethylene or Vitamin E Poly has highly reduced the wear.
Cobalt chrome is one of the most widely used metals in knee implants.
Although the percentage of patients having allergic reactions related to the use of cobalt-chromium alloys is very low, one area of concern is the issue of tiny particles (metal ions) that may be released into the body as a result of joint movement. These particles can sometimes cause reactions in the human body, especially in those who have an allergy to certain metals like nickel.
Titanium and Titanium Alloys
Pure titanium is generally used in implants where high strength is not necessary. Titanium alloys are bio-compatible in nature. The most used titanium alloy in knee implants is Ti6Al4V.
Titanium and titanium alloys have great corrosion resistance, making them inert biomaterial (which means they will not change after being implanted in the body). The elastic nature of titanium and titanium alloys is lower than that of the other metals used in knee implants. Because of this, the titanium implant acts more like the natural joint.
Zirconium alloy is similar to ceramic knee implant. The zirconium alloy is combined with an all-plastic tibial component, replacing the metal tray and plastic insert used in other knee replacements.
It is believed that this new knee could last for 20-25 years, substantially more than the 15-20 years that cobalt-chromium alloy and polyethene implants are useful.
Another essential characteristic of this material is that it is biocompatible. People who have nickel allergies and cannot have knee implants made of cobalt-chromium alloy (because nickel is an ingredient of cobalt-chromium alloy). Zirconium alloy implants eliminate the risk to nickel-allergic patients because this new material contains no nickel.
The main indications for Oxinium knee implants:
1 Young Arthritis Patients.
2 Patients with metal allergies.
Knee implants may be “cemented” or “cement less” depending on the type of fixation used to hold the implant in place. The majority of knee replacements are generally cemented into place. There are also implants designed to attach directly to the bone without the use of cement.
These cement less designs rely on bone in growth into the surface of the implant for fixation. Most implant surfaces are textured or coated with Hydroxyapatite so that the new bone grows into the implant’s surface. In India, currently, we have only cemented implants as far as Knee Replacement Surgery in Thane is concerned.
Placed in between the tibial and the femoral components is the Polyethylene insert. The tibia and patellar components in knee replacements are made of polyethylene.
The use of Ultra Highly Cross Linked Polyethylene (UHXLPE) or Ultra High Molecular Weight Polyethylene (UHMWPE) or Vitamin E reduces even the minimal wear enabling the knee implants to last for a much longer time.
Oxinium (Oxidised Zirconium)
Oxinium oxidized zirconium is a new material used in knee implants since 2001. It is a transformed metal alloy that has a ceramic bearing surface. This metal’s advantage is that just the body has been changed, so the rest of the implant component is a high tensile metal.
Although it is twice as hard as cobalt-chromium alloys, it provides half the friction thus performs with higher quality and lasts for a longer time.
Golden Knee Replacement-
The golden knee replacement surgery in thane is a blessing for the people who have metal allergy. These knee implants have enhanced surface coating of Titanium Niobium Nitride (TiNiN). This coating gives the implant a golden colored look & improves Hip & knee replacement surgery’s longevity and performance.
We at Pinnacle Orthocentre Hospital in Thane, one of the Best Hospital for Hip & Joints Knee Replacement Surgery Hospital in Thane Maharashtra, India. We have Dr Yogesh Vaidya, who specialises in Computer Navigated Minimally Invasive Knee Replacement Surgery.
Computer Navigated Minimally Invasive Total Knee Replacement-
Total knee replacement (TKR) surgery has become a commonly performed and highly successful surgical procedure for end stage knee arthritis. Recent technological innovations have improved both early and long term results and survivorship of the implanted joints. New implant designs have provided for greater and more normal range of motion and more natural feel. Better understanding of the role of the ligaments about the knee has resulted in improved joint stability and balancing. Minimally invasive surgical techniques are evolving to speed the rehabilitation process, shorter hospital stays, less time on a walker, and a quicker return to normal function. Less postoperative pain and a smaller scar (improved cosmesis) are also by-products of minimally invasive surgery.
Computer navigation guiding the surgeon through the journey of implantation of a total knee replacement just like the GPS enabled navigation guiding the driver throughout the journey . Through infrared sensing of patient anatomy using trackers attached intraoperatively to patients thigh(Femur) and the leg (Tibia) bone, the computer can precisely advise the surgeon as to the exact location new knee implants should be positioned. This technology carries the promise of improving the precision of total knee replacement surgery, thus, improving the short and long-term performance of the knee replacement as one of the most important cause of failure of a Total Joint Arthroplasty is Malalignment.
The surgical technique of computer navigation starts with the use of an infrared sensor marking and mapping the anatomy of the arthritic knee and adjacent bony structures (the femur and tibia) called Registration. Through the use of sophisticated software the computer is able to create a 3D image of the patients knee joint and ascertain the position of the knee in space and detect and quantify any deformities or bone loss. It then, with input from the surgeon, can determine what changes need be made via bone cuts and ligament balancing so as to position the new artificial knee in the proper anatomic alignment. The computer gathers a three dimensional image of the anatomy of the knee preoperatively and the intended anatomy of the knee at the completion of surgery. It is the surgeon’s job to interpret this data so that at the completion of the procedure normal patient anatomy is established as precisely as possible. This will provide the opportunity for the patient to regain the maximum function and motion possible.
Computer Navigation Advantages-
There are several potential advantages of computer navigation in knee replacement surgery.
1- Incisions can be made smaller and the soft tissue dissection can be kept less invasive with computer navigation guidance. The use of computer navigation augments other minimally invasive surgical techniques. The net result is greater protection of the quadriceps muscle and tendon during surgery. It is the protection of the quadriceps mechanism that is the key component of minimally invasive surgery. Studies show that bone cuts can be made more accurately and more reproducibly when guided by computer navigation versus other systems.
2- Computer navigation guidance eliminates the need for a rod to be placed inside the intramedullary (IM) canal of the bone which in turn reduces the risks of fat embolism. For the last two decades use of an IM rod has been the standard method of aligning cuts and has proved quite effective. The elimination of this rod, however, furthers efforts at keeping the procedure “minimally invasive”.
3- At the completion of total knee replacement surgery balancing the ligaments surrounding the knee has always been the most difficult and “subjective” part of knee arthroplasty. In conventional surgery the knee ligaments are balanced chiefly by the surgeons “feel” to determine if the ligaments are appropriately taut. Though experienced surgeons can achieve excellent ligament balance in most cases, reproducibility is difficult and results are subjective. With computer navigation, ligament balancing can potentially be quantified to the nearest millimetre of ligament laxity or tautness. This, in the end, may prove to be computer navigation’s greatest advantage over conventional surgery.
4- In Total Knee Replacement surgery if there is significant deformity in the femur above the knee or in the tibia below the knee (Extra Articular Deformity) conventional alignment systems can be difficult or impossible to use. This is due to the fact that intramedullary systems require an unobstructed femoral and tibial canal. Similarly if as a result of previous surgery any hardware is present such as plates, screws or rods in the bone blocking the femoral or tibial canal, conventional alignment systems often cannot be utilized. With computer navigation systems deformity and /or the presence of hardware provides no obstacle since access to the intramedullary canal is not a requirement. Thus, patients with bony deformity or hardware above or below the knee are ideal candidates for utilizing computer navigation guidance systems.
5- Studies have shown that computer navigation eliminates alignment “outliers”. Experienced surgeons using conventional alignment systems and Occular Navigation can accurately align the knee replacement in over 90 – 95% of cases. However, studies show that in as much as 5 to 10% of surgeries, postoperative knee alignment will be less than ideal. These patients in this 5 to 10% group are considered “outliers”. It is felt that computer navigation’s accuracy can help the surgeon shrink this percentage of postoperative alignment outliers.
Computer Navigation Disadvantages
There are some concerns regarding use of computer navigation TKR.
1- The chief disadvantage of computer navigation surgery is the increased cost of the procedure. There is considerable upfront capital expense to the hospital to purchase these computer navigation systems. Many leading joint replacement hospitals, in an effort to provide cutting edge technology and best available care to patients, have indeed acquired navigation systems. These costs are not passed on to patients (computer navigation surgery does not cost the patient anything additional). And since insurance companies and Medicare typically do not reimburse the hospitals more for surgery utilizing computer navigation, hospitals are forced to absorb the additional expense. Though this is not necessarily the problem of any individual patient facing surgery, the increased costs of technologic advances adding to overall health care costs are of concern to us all.
2- A second disadvantage of computer navigation surgery is the potential increased surgical time required to perform the procedure. Increasing surgical time theoretically increases infection risk due to the surgical wound being opened longer. Surgeons experienced in the use of computer navigation systems may increase the length of the surgical procedure by about 10 to 15 minutes. Though it is well known that dramatic increases in surgical time do increase the risk of infection, studies thus far have not shown a greater infection rate in computer navigation surgeries (presumably due to the relatively modest increase in surgical time).
Computer navigation in knee replacement surgery is the technological innovation aimed at improving the accuracy of prosthetic implantation and at minimizing the surgical exposure. Though conventional surgical techniques have been extremely successful, use of computer navigation may improve the already excellent results benefiting thousands of patients annually.
At Pinnacle Orthocentre Hospital we have Dr Yogesh Vaidya who is a fellowship trained Joint Replacement Surgeon, using Aesculapius Orth pilot Navigation System for all Primary and Revision Knee Replacement Surgeries.
For more information on Computer Assisted Minimally Invasive Total Knee Replacement Surgery contact us on- 08879970811 to schedule an appointment with Dr Yogesh Vaidya.
Visit our website- https://pinnacleorthocentre.com/ for a detailed information.