Bangalore, July 28, 2010: Fortis Hospitals conducts Asia’s first Custom Fit Knee Replacement Surgery in Bengaluru (formerly Bangalore). 56 and 59-year-old women suffering from degenerative disease of the knee brought to Fortis Hospitals with complications, underwent Asia’s first Custom Fit Knee Replacement Surgery. Patients were discharged within five days of the knee replacement operation. Patients started walking normally within a fortnight, unlike the usual 6-8 weeks required before resuming normal activities in the conventional surgery.

Dr. Sanjay Pai - Lead Orthopedic Surgeon, India

Dr. Sanjay Pai - Lead Orthopedic Surgeon, India

Lead orthopedic surgeon Dr. Sanjay Pai and his team at Fortis Hospitals Bangalore performed this revolutionary surgery by literally remodeling the anatomy of the patient’s knee and recreating or customizing a knee with the right kind of technology and expertise. The new custom fit knee replacement technology designs a perfect instrumentation system that matches the patient’s knee and ensures lesser pain, less tissue damage and faster mobilization.

According to Dr. Pai, “The two operations for knee replacement have been performed for the first time in Asia using the custom fit knee replacement technology. This is indeed a medical breakthrough and likely to revolutionize the way knee replacement surgeries are performed in India. We are glad to be the first adopters of this technology.”

Why Custom-Fit Knee
While conventional knee replacement surgeries retro-fit predetermined sizes of prosthetics on to the patients’ knee, this procedure is very different because it works on the principle that no two patients’ knees are similar. With this technology the patient’s knee is digitally recreated with 3D image mapping after taking into account the bone structure, weight ratios, gender, age and even mechanical alignment. Based on this 3D model the customized knee is created. Something, that just fits them right. This technology ensures far greater accuracy and reduces the operation time by almost 40% and also results in less loss of bone & tissues.

How Custom Fit Knee Works
In short there are 4 steps to building and fitting a Custom-Fit Knee:

  • Step 1: Understanding your knee
    The process starts with a CT Scan of the whole leg from the hips to the ankle which is then used to create an advanced 3D image of the leg structure. The age, weight and gender are also taken into account, creating a complete patient imaging.
  • Step 2: Processing and planning
    With the 3D plan of the leg structure in place, an anatomical model is created to determine the mechanical alignment – the basic philosophy on which the entire process rests. Virtual instrumentation is then done and the surgery is planned accordingly.
  • Step 3: Recreating the knee
    Once the surgery is approved, the Custom Fit instruments are manufactured at state-of-the-art dedicated manufacturing centers. Even the individual patient name and data are etched on each unit to confirm identification during the surgery
  • Step 4: Fitting the knee
    With the Custom Fit instrumentation in place, the knee bone is chiseled to perfection so that the prosthetics fit exactly without any requirement for later corrective surgeries. After a 60 minute surgery, the patient ill have the knee that fits you perfectly.

Benefits of Custom Fit Knee Replacement Surgery

  • Smaller incision
  • Less soft tissue damage
  • Lesser pain
  • Early and better mobilization
  • Better and pain free range of motion
  • Improves alignment and sizing by using computer generated images of the patients anatomy to determine bone cuts and implant positioning preoperatively
  • Better life span of the processes because of the accurate fit and alignment

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Getting a New Knee or Hip? Do It Right the First Time

An informative article on joint replacement by Lesley Alderman appeared in the New York Times recently. It talks about the things that a patient should keep in mind if considering a joint replacement (hip replacement or knee replacement) surgery. Following is the article as it appeared on the NY Times website.

THERE is nothing like a new hip or knee to put the spring back in your step. Patients receiving joint implants often are able to resume many of the physical activities they love, even those as vigorous as tennis and hiking. No wonder, then, that joint replacement is growing in popularity.

In the United States in 2007, surgeons performed about 806,000 hip and knee implants (the joints most commonly replaced), double the number performed a decade earlier. Though these procedures have become routine, they are not fail-safe.

Implants must sometimes be replaced, said Dr. Henrik Malchau, an orthopedic surgeon at Massachusetts General Hospital in Boston. A study published in 2007 found that 7 percent of hips implanted in Medicare patients had to be replaced within seven and a half years.

The percentage may sound low, but the finding suggests that thousands of hip patients eventually require a second operation, said Dr. Malchau. Those patients must endure additional recoveries, often painful, and increased medical expenses.

The failure rate should be lower, many experts agree. Sweden, for instance, has a failure rate estimated to be a third of that in the United States.

Sweden also has a national joint replacement registry, a database of information from which surgeons can learn how and why certain procedures go awry. A registry also helps surgeons learn quickly whether a specific type of implant is particularly problematic. “Every country that has developed a registry has been able to reduce failure rates significantly,” said Dr. Daniel Berry, chief of orthopedic surgery at the Mayo Clinic in Rochester, Minn.

A newly formed American Joint Replacement Registry will begin gathering data from hospitals in the next 12 to 18 months.

Meanwhile, if you are considering replacing a deteriorating knee or hip, here are some ways to raise the chances of success and avoid a second operation.

EXPERIENCE COUNTS Choose – or request a referral to – an experienced surgeon at a busy hospital. “The most important variable is the technical job done by the surgeon,” said Dr. Donald C. Fithian, an orthopedic surgeon and the former director of Kaiser Permanente’s joint replacement registry.

Ask for recommendations from friends who have had successful implants and from doctors you know and trust. When you meet with the surgeon, ask how many replacements he or she does each year.

VOLUME MATTERS A study published in The Journal of Bone and Joint Surgery in 2004 found that patients receiving knee replacements from doctors who performed more than 50 of the procedures a year had fewer complications than patients whose surgeons did 12 procedures or fewer a year.

The researchers documented a similar trend when it came to hospital volume. Patients at hospitals that performed more than 200 knee replacements a year fared better than patients at hospitals that performed 25 or fewer.

ADJUST EXPECTATIONS Not everyone with joint pain will benefit from a joint replacement.

An implant can help reduce pain and improve mobility if the joint surface is damaged by arthritis, for instance. But a new joint will not help pain caused by inflammation of the surrounding soft tissue, said Dr. Berry, who is also vice president of the board of the American Academy of Orthopaedic Surgeons.

Some people with mildly arthritic joints, for instance, can manage well with the judicious use of medication. “Surgery comes with complications and risks, and should not be approached lightly,” Dr. Berry said.

Joint replacement is not a minor operation. If you have uncontrolled high blood pressure or another serious chronic condition, a joint operation may simply be too risky for you.

NARROW YOUR OPTIONS “There is no one best joint,” Dr. Berry said. “A successful replacement depends on selecting the right implant for the patient.”

A good surgeon will recommend an implant that makes sense for your age, activity level and the shape of your joint. Younger or very active people who place more physical demands on the implant, for instance, may benefit from newer hard-on-hard bearing surfaces, like those made of ceramic, said Dr. Joshua J. Jacobs, chair of orthopedic surgery at Rush University Medical Center in Chicago.

In general, be wary of the latest, most advanced new joint. There is little evidence to support the use of more expensive designs over basic ones, said Dr. Tony Rankin, a clinical professor of orthopedic surgery at Howard University. One recent study found that premium implants fared about as well as standard implants over a seven- to eight-year period.

Be skeptical, too, of advertising gimmicks. “I had a 78-year-old patient with a perfectly good knee replacement come in and ask if she should have gotten the ‘gender knee,’ which she had seen advertised on TV,” Dr. Rankin recalled. “She was doing well, but was swayed by the idea of a knee made just for women.”

GATHER THE DATA Once you have a recommendation or two from a surgeon, find out how well the joint has performed in others and if there are known complications. The newer metal-on-metal hip implants, for instance, are somewhat controversial and may cause tissue and bone damage in certain patients.

Ask if the hospital has a registry that tracks joint replacements. If so, ask to see the data on the implants you are considering.

It is also helpful to understand what the operation involves, including the materials that will be used and how the surgeon plans to fix the joint to the bone. You can learn more about your operation at the American Academy of Orthopaedic Surgeon’s patient information Web site, orthoinfo.org.

If you want to delve deeper, look at a large national registry from another country, like Australia. The annual report of Australia’s registry lists knee and hip implants that had a “higher than anticipated revision rate.”

A caveat: the information can be difficult to parse for a layperson. “A surgeon can provide perspective on information that, taken out of context, could be misleading,” Dr. Rankin said. So discuss it with your surgeon.

PLAN YOUR RECOVERY To avoid complications during your final stage of recuperation, discuss with your doctor in advance the support you will need when you return home, Dr. Berry advised.

Recovery takes a different course for each patient, depending on the type of procedure and implant. In general, expect mild to moderate pain for the first few weeks. Some patients are able to return to work in one to two weeks, but full recovery can take six to 12 months, Dr. Jacobs said.

Make sure you have the help you need in the initial stages of recuperation. Since you may have difficulty getting around and won’t be able to drive right away, you may want to have a friend or family member stay with you. You may even need to hire an aide or visiting nurse.

Follow your doctor’s orders, and don’t rush your recovery. You don’t want your new joint to fail because you couldn’t resist carrying loads of laundry up and down stairs, or felt compelled to rearrange the patio furniture.

If the new joint is given time to heal, you will find plenty of opportunities for all that in the future.

Related links

  • Affordable joint replacement surgery overseas
  • Cost of knee replacement or hip replacement surgery
  • What joint replacement surgery patients are saying
  • Medical tourism
  • Healthbase, the leading US-based medical tourism provider, has partnered with a JCI accredited German hospital in order to bring wider options and greater convenience to Americans, Canadians, Europeans and others looking for affordable, timely and high quality medical and dental treatments.

    Healthbase Online Inc., the leading and award-winning medical tourism facilitator based in Boston, MA, has announced partnership with a Joint Commission International accredited hospital in Germany. With the addition of this JCI accredited hospital, Healthbase now has a network of over 100 health care and dental care providers spread across 18 countries. For the medical tourist it means more choices, wider variety and greater convenience.

    According to Saroja Mohanasundaram, CEO of Healthbase, “With growing demands from our consumer base for a quality tertiary medical care center in Europe, we are excited to have our newest Germany-based healthcare provider onboard. Our new member provider is JCI-accredited thereby giving the peace of mind to our patients regarding the high standards of quality that will be delivered by it. Our German provider offers a full complement of services and is an excellent choice for patients looking for orthopedic, spinal and bariatric treatments at a much discounted rate compared to USA and much faster access to service compared to that offered by public health care systems in Canada or the UK.”

    For patients from Europe, especially from the European Union (EU), this would be as good as going to a local hospital with the advantage of high or higher standard of service and without the inconvenience of the infamous waitlists as seen in government-sponsored healthcare systems such as the National Health Service or NHS in the United Kingdom.

    The hospital offers procedures like joint replacement procedures (such as hip replacement surgery and knee replacement surgery), spinal procedures (such as spine fusion surgery and artificial disc replacement surgery), and weight-loss procedures (such as lap band surgery, gastric bypass or RNY procedure and gastric sleeve surgery), among hundreds of other procedures.

    The favorable geographical location of Germany means that for patients coming from North America the flight times are shorter compared to other famous medical tourism destinations such as those in Asia. For those traveling from other European countries it is at a stone’s throw.

    Mohanasundaram adds, “We have carefully chosen our German provider after a rigorous selection process keeping in mind all aspects of affordable, safe and top quality medical tourism care. Patients can expect as much as 50 to 70% less cost compared to the cost of care in other developed countries such as the United States. Also, the staffs at our German provider speak English, thus, making communication easy.”

    Healthbase has the biggest and geographically most expanded network of healthcare and dental care providers in the industry. Patients have a wide selection of destinations to choose from for their low cost high quality medical care and dental care needs. These include Germany, India, Thailand, Singapore, South Korea, Malaysia, Philippines, New Zealand, Jordan, Turkey, Hungary, Belgium, Spain, Costa Rica, Panama, Brazil, Mexico, and USA.

    Healthbase serves the American, Canadian, European, African, Asian, Middle-Eastern and Asia Pacific markets, and offers more than 200 procedures.

    About Healthbase Online Inc.:
    Healthbase, an award-winning US-based medical tourism and dental tourism facilitator, is a one-stop source for global medical and dental choices, connecting patients to leading internationally accredited healthcare providers in 18 countries including India, Thailand, Singapore, South Korea, Turkey, Germany, Panama, Costa Rica, Mexico and USA. Healthbase caters to individual consumers, self-funded businesses, insurers, benefits plan consultants, third party administrators and those using Consumer Directed Healthcare Plans (CDHPs) or voluntary benefit plans. Healthbase coordinates over 200 procedures in various categories like orthopedic, spinal, cardiac, bariatric, urology, oncology, dental, cosmetic and general surgery. Some of the common procedures offered are Birmingham hip resurfacing, total hip replacement, knee replacement, ACL repair, rotator cuff surgery, spinal fusion, spinal disk replacement, heart bypass surgery, lap band, gastric bypass, cancer treatment, liposuction, dental implants, crowns, bridges, etc. for a fraction of the cost in the US with equal or superior outcomes. To ensure that patients receive the best care possible, Healthbase works mainly with hospitals that have international accreditations like JCI. To learn more, call 1-888-691-4584, email info.hb @ healthbase.com or visit http://www.healthbase.com.

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