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Entering the Era of Computer Navigated Joint Replacement

Osteoarthritis Knee pain has emerged as the universal enemy of middle to old aged population in recent decades as every person of age 40 or above is suffering with some degree of knee pain (due to osteoarthritis of knee joint). As we know conservative treatment of osteoarthritis just delays the progression of disease but can’t cure it, joint replacement surgery has become the choice of treatment for the permanent relief from the osteoarthritis knee pain.

Osteoarthritis is a degenerative process or in general terms we can call it an irreversible process of aging which is characterized by a slow process of damage to the joint structure leading to pain and difficulty in performing day to day activities eg. Sitting cross legged, squatting, climbing or descending stairs etc. This rate of progression of degeneration be delayed by various conservative means such as exercises, life style modification, and pain can be temporarily relieved by drug therapy or interaarticular injections.

In order to get a permanent relief from such disabling pain joint replacement is the only mean. During this surgery the damaged articulating surfaces of knee joint is replaced with artificial alloy metal implant of high quality (titanium). In past one decade the field of joint replacement surgery has reached to a new level and with the introduction of computer assisted navigation system, joint replacement surgery has became much simpler and more précised.

Navigation system has an ultra modern software system which along with the help of two optical cameras and three probes creates a three dimensional structure of the patient’s knee and analysis it biomechanically, based on this analysis software guides the surgeon about the perfect size and shape of the implant which should be used during the surgery also this software gives a précised idea of varus and flexion deformity of the patient’s knee joint which enables surgeon to perform a biomechanically perfect joint replacement which precisely resembles the anatomical alignment of a natural knee joint.

image A image B

a. Pre replacement analysis of varus and flexion deformity at offending knee
b. Final analysis (post replacement) of varus and flexion deformity of same knee which is as perfect as a young knee joint

As said that navigation technology helps in achieving a biomechanically perfect replacement thus allows a much speedy recovery of the patient. As the alignment of the replaced knee is similar to the normal anatomy, this technique reduces the post operative inflammation (swelling, guarding muscle spasm etc) which allows physiotherapy rehabilitation easier and makes patient pain free and mobile faster.

Here at J.O.H we always believe in innovation driven treatment and in this order we proudfully says that we are the pioneer and the foremost centre of joint replacement not only in region of Bundelkhand but also we are among the best joint replacement unit of Northern India. The date of May 10, 2015 became a proud historic moment for JOH as we became the first hospital in entire region to use navigation technology for a successful total knee replacement also It is a moment of immense pleasure and satisfaction that our pioneer joint replacement surgeon Dr. Gaurav Kumar after completing more than 150 successful joint replacement surgery has became the first joint replacement surgeon of the region to introduce this amazing technology of computer navigation for the benefit of patients. Dr. Gaurav Kumar is a know figure in the field of joint replacement surgery he has received A.O international fellowship in joint replacement surgery from Switzerland also he had received fellowships from Germany and Mumbai.

image 3

Dr. Gaurav Kumar explaining about the navigation system

70 year old obese female with K/C/O DM and prolapsed uterus with pain both knee of 2 years duration, unable to walk for 6 months and knee ROM of 20-95*, was operated the help of navigation technology. On post op day 2 she reported her pain 3 on NPRS (minimal pain) on post op day 2 which is incredible, started moving her knee actively and walked independently with walker for about 40 meters in one stretch. On Post op day 3 she had a knee Rom of 05-90 and walked about 50 meters. She was discharged on 5th post op day, at discharge she had a knee range of motion (ROM) of 0-100* and she walked about 75 meters in a single stretch, that is maximum of distance she had walked in last 2 years.

These all parameters indicates that a biomechanically and anatomically perfect joint replacement which is facilitated by the navigation system allows a speedy recovery of patient with a pain and inflammation free post operative hospital stay. It also reduced the patient hospital stay thus reducing his/her expenses.

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