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  • Joint Replacement
  • Orthopedic and Trauma
  • Pediatrics and Neonatology
 

We offer state-of-art joint replacement techniques for our patients.

There is a variety of knee joint options to choose from to suit every need and budget. There is the Superflex knee joint, which allows full flexion and rotation for high demand activities like squatting and sitting on the ground, High flexion knee joint, which allows full range of movement at knee. There are all poly knee joints for low demand patients with budget constraints. There is uni-condylar knee replacement for arthritis of only half of the knee joint. Our in-house physiotherapy department ensures a successful and pain-free joint for every patient.

Similarly, there are a variety of options for hip joint replacement to suit every need and budget. Cemented, Uncemented, Surface Replacement, Large heads, Metal-on-plastic, ceramic-on-ceramic and metal-on-metal are but a few of the options. Large heads offer nearly full range of motion in the hip. Surface replacement in selected individuals restores complete normalcy.

Computer Navigation

In a car, alignment of all four wheels is essential for better life of tyres and less energy (petrol) consumption. In the human body, the centres of the hip, knee and ankle joint are in a straight line. If the knee is out of alignment, the joint wears out early. When the natural knee joint is not in a straight line, the patient suffers from early arthritis and later may need a joint replacement. Similarly, when the artificial knee joint replacement is not in perfect alignment, the plastic parts wear out quickly, leading to pain and the need for revision surgery arises. Malalignment is the single most common factor for failure of knee joint replacement surgery other than infection. Therefore, it is very important at the time of knee replacement surgery to get the perfect alignment. An experienced surgeon, on an average, gets it right 75- 80% of the time. Tools like computer navigation help the surgeon place the knee in the right alignment 100% of the time. In olden times, when X-rays were not available, surgeons used to treat the patients without X-rays. However, its presence has improved the accuracy and functional results of fracture treatment. In the present times, it would be considered negligence if X-rays were not taken. Then,

why compromise on accuracy in knee joint replacement ?

The computer navigation for knee replacement is like GPS for aircrafts and other vehicles. The GPS device sends signals to the nearest receiver, which in turn tells the vehicle its current position and guides it to its destination. The computer navigation guides the surgeon about the angle, depth of the bone cuts, and helps achieve the perfect alignment.

The earlier generation of computer navigation required two pins to be inserted in the thigh and two in the leg through separate incisions. The latest generation of computer navigation (pinless ASM) guides the surgeon directly from the joint surface without the need for extra wounds and thus less pain and no risk of fracture through the pin holes.

Shah Hospital has the first Articular Surface Mounted (ASM) pinless, computer navigation in Gujaratfor 100% accurate knee joint replacements.

Minimally invasive surgery

Total knee replacements were earlier carried out with 8 to10 inch incisions. This led to greater bleeding, longer hospital stay and more pain in the early post-operative period. Minimally invasive surgery is carried out with typically half the length of earlier incisions. Computer navigation facilitates minimally invasive approaches without compromising on accuracy.

At Shah Hospital, we routinely follow minimally invasive surgery principles in knee replacement surgery with computer navigation.

Dedicated joint replacement theatre with class 100 laminar air flow

As we have seen earlier, the most common cause of mid- term and long-term failure of knee joint replacement is poor alignment of knee. However, the most common cause of immediate failure of knee joint replacement is infection. Commonly, the following precautions need to be taken:

  • Dedicated joint replacement theatre with jointless flooring : A clean theatre where no other surgery except joint replacement is carried out, is necessary for reducing infection rate. Jointless flooring prevents dust collection in the joints and thus reduces chances of infection.

  • Class 100 laminar air flow system : The laminar air flow system cleans the air of all dust particles. It pushes the clean air with positive pressure directly over the wounds and so, prevents any airborne dust from moving into the area near the wound. This area should be at least 10 x 10 feet wide. It should maintain a positive pressure in the entire isolated area so that dust from outside does not move in. Ideally, it should have at least 200 air changes every hour.

  • Space suits worn by the surgeon and his team eliminate complete contact between the surgeon and the patient. It reduces contamination and chances of infection.

  • Horizontal pre-vacuum autoclave sterilization : This machine creates a vacuum in the sterilization chamber and so when steam is pushed at a high pressure, it ensures complete sterilization of the instruments.

  • Water-repellant clothes and drapes : During surgery, water repellant clothes and drapes are used which reduce water-borne contamination of wounds and thus, reduces infection rate.

Shah Hospital has all the above facilities which meet the most stringent world standards.

Thus, we take care to minimize all possible chances of immediate (infection), short-term and long-term (malalignment) failures of total knee replacement.

Bone Bank

During knee replacement, the bone ends are shaved and cut. During hip replacements, the ball of hip joint is removed and replaced with a metal joint. The removed bone is routinely thrown away. This bone can be preserved. If ever a revision joint replacement surgery is required, dealing with bone loss is the biggest challenge. World over, the saved bone from primary replacements is the best answer for bone loss at revision joint replacement surgery.

Shah Hospital has a minus eighty degree centigrade deep freezer where fresh bone can be safely frozen and stored for at least five years. Primary replacement should be done at a centre, which can take care of revision surgery, if ever the need arises.

 
 
Joint Reconstruction
Adult and Pediatric
For a young patient, we offer numerous joint reconstruction options like osteotomies, angular corrections, limb lengthening. We are a tertiary centre (top referral centre) for Ilizarov methodology for limb and joint reconstruction. Pediatric joint deformities and deficiencies are treated with great care. An in-house pediatrician ensures complete medical and orthopedic solutions.
Trauma
Fresh fractures, fracture-dislocations, old ununited fractures, infected non-unions, limb length issues are treated in equal numbers with very gratifying results.
Our pediatric and neonatology department runs a comprehensive vaccination program. They take care of neonates and young children in a warm and cordial atmosphere.
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