Udai OMNI Orthopaedic consultants specialise in knee surgery offering treatments to all problems associated with the knee in adults and children deriving from accidents, sport injuries and all aspects of arthritis.

Treatment of knee problems often begin with simple treatments, and becomes more complex if the condition persists.

TOTAL KNEE REPLACEMENT (TKR)

There are a number of conditions that can result in a patient having to undergo knee replacement surgery. Perhaps the most common condition is osteoarthritis, commonly referred to as ‘wear and tear’ arthritis. If the pain in your knee affects your quality of life, and you can’t be as active as you would like to be, it’s time to take a look into a knee replacement.

Total knee replacement in its current form has been around for over 25 years. In India, popularity has grown over the last 10 years. This is a good operation for pain and correction of deformity in the knee. Results of total knee replacement are excellent with survivorship of almost 95% at 10 years and 85% at 20 years. Like with any profession, the job has to be well done for the knee to survive long and the implant material has to be good too. Most knee implants in India are imported, although of late, one particular Indian brand has been showing promising results.

Most foreign knee implants are broadly similar in design although there are significant subtle differences. Overall functional results are broadly similar no matter what implant is used. More recently, some companies are making many sizes available so that the fit is optimal. These implants tend to be more expensive.

The most common technique of knee replacement is using standard company supplied instruments, which are very accurate. However, to increase accuracy computer guided knee replacement is available but not commonly used, as the functional results have not been found to be any better. Custom made jigs can also be made available for more accurate implantation. This technique has not been very popular as it involves additional cost of an MRI and the lead time is 3 weeks for the jigs to be made in USA and then sent over here.

PARTIAL(UNICONDYLAR) KNEE REPLACEMENT

This is an excellent procedure when arthritis affects just one or two compartments out of the three. It is a minimally invasive procedure performed through a small incision of 6 cms or less. The joint therefore feels and behaves more like a normal knee. Recovery is rapid and the patient is often discharged within 2 – 3 days of surgery.

PATELLO-FEMORAL REPLACEMENT

This is a relatively new procedure. It is indicated in patients with primarily patello-femoral (Arthritis of the knee cap). Recovery is usually rapid & patients are often discharged within 2 – 3 days of surgery.

REVISION KNEE REPLACEMENT

Primary knee replacements do fail in for a number of reasons. Regular follow-up is essential for people with primary joint replacements. Revising them is highly specialised surgery requiring extensive training and access to sophisticated implants and hospital facilities. The old implant is removed and replaced with new. Surgery may involve use of bonegraft and/ or custom made implants. Identifying failing joint replacements early is crucial for a successful outcome and therefore a regular follow-up by an orthopedic surgeon is advised. Dr Udai Prakash has a particular interest in Revision hip and knee surgery and has been fellowship trained in this work.

MINIMALLY INVASIVE SURGERY

Udai Clinic has expertise to provide true minimally invasive procedures like knee and ankle arthroscopy (keyhole surgery). Hip and knee replacements are also done using smaller incisions (minimal incision surgery or MIS) and advanced anaesthetic pain relieving techniques. Hip resurfacing surgery in particular, is done through a minimally invasive muscle sparing technique. This technique allows for a more rapid recovery with minimal postoperative discomfort.

KNEE ARTHROSCOPY (KEY HOLE SURGERY)

This is one of most common procedures performed on the knee. Generally performed under anaesthetic as a day procedure, recovery is rapid and results gratifying.

Surgeons at Udai OMNI are specially trained to perform this procedure for many conditions including:

  • Meniscal tears (cartilage tears)
  • Knee debridement and microfractures
  • Synovitis
  • Anterior Cruciate Ligament tears (ACL)
  • Loose bodies

PARTIAL KNEE REPLACEMENT

I was turning 55 but instead of celebrating, I was in mourning! My knees had finally packed in. I was not able to enjoy even a gentle walk. I was struggling. I was told repeatedly that total knee replacement was the only answer for me. However, Dr. Udai Prakash convinced me to go for partial knee replacement, which is a unique and rare procedure in our city. I learnt that he has over 12 years experience with this procedure with excellent results. I underwent surgery of both knees simultaneously.

My recovery was surprisingly smooth and I was walking with a walker from day one. I went home on day five and started walking outside without a stick within two weeks. By four weeks, I could sit on the floor and climb steps normally. My knee now feels natural and I have no pain. I have been told horror stories of pain after knee replacement but I can honestly say that pain was not an issue at all. I highly recommend this procedure for those who are suitable for it.

MRS. MR, 62 YEARS, BILATERAL TOTAL KNEE REPLACEMENT

At 62, Mrs CK wanted to be very active but her knees were not letting her do even everyday things like shopping and walking more than a couple of hundred yards. Even her sleep was getting disturbed due to severe osteoarthritis of her knees.

She was referred to us by other happy patients from Kolkata and she flew all the way to Hyderabad for bilateral total knee replacement. Within 3 months she was walking unlimited distance and shopping to her heart’s content. As you can see from the video taken at 3 months post-operatively she barely has a limp.

TOTAL KNEE REPLACEMENT

This 65 year old gentleman was suffering from quite severe pain in his knee which interfered with almost all his daily activities including sleep at night. He was constantly taking painkillers to get by. Examination showed deformity of his knee with a limited range of movement. X-ray confirmed severe arthritis with almost complete loss of joint space in two out of the three compartments of the knee. A total knee replacement corrected the deformity and relieved the pain. By 3 months he had cut down his painkillers to the odd one perhaps once a week.

PARTIAL KNEE REPLACEMENT

In many cases a total knee replacement is totally un-necessary. A partial knee replacement can be done for limited arthritis of the knee. As one would expect, this is a less invasive operation with a quicker recovery. These replacements last just as long as the total knee replacements and in our opinion give better functional results. Below is a typical case of a patient with limited arthritis of the knee affecting just one of the 3 compartments.

PATELLO-FEMORAL KNEE REPLACEMENT

Sometimes the arthritis just affects the knee cap and the surface on which it glides (Patello-femoral arthritis) In such cases, a partial replacement may be performed. The advantages of such a replacement include a quicker recovery and preservation of most of the natural knee. Patients generally have a better range of movement and of course, if a full knee is required in the conversion is easy. Below is an example of a 55 year old lady who complained of pain in front of knee on sitting for any length of time and  also when going up and down stairs. She was generally not in a great deal of pain when walking on the flat.

REVISION KNEE REPLACEMENT

Primary knee replacements do fail in for a number of reasons. Regular follow-up is essential for people with primary joint replacements. Revising them is highly specialised surgery requiring extensive training and access to sophisticated implants and hospital facilities. The old implant removed and replaced with new. Surgery may involve use of bonegraft and/or custom made implants. Identifying failing joint replacements early is crucial for a successful outcome and therefore a regular follow-up by an orthopedic surgeon is advised. Dr Udai Prakash has a particular interest in Revision hip and knee surgery and has been fellowship trained in this work.

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