By Vinod Kumar
Total Knee Replacement surgery has been a boon in alleviating pain and disability in patients suffering from arthritis. Orthopedic surgeons of the city say most of the knee replacement implants so far have been designed according to the anthropologic measurements of the Western people, these implants sometimes tend to mismatch when used in Indian patients. Knee size and body size differ in Asians compared to Western counterparts. As a result, an Asian’s knee might not fit these prostheses.
According to Prof. (Dr.) Raju Vaishya, Sr. Consultant Orthopaedic & Joint Replacement Surgeon, Indraprastha Apollo Hospitals, New Delhi, “Indians require a higher flexion for most of their daily habits and customs. They also have poor bone mass and poor bone quality, due to delayed referrals and osteoporosis. Hence in these patients excessive bone cutting is associated with more post procedural complications.”
In India, over the last few years, the volume of joint replacement procedures has increased dramatically due to increased level of awareness and improvement of technologies. Treatments of joint and knee problems have improved significantly and newer therapies and methodologies including the very exciting biologic disease modifying drugs and procedures like arthroscopy and joint replacements have made a tremendous impact on our ability to treat the various Arthritis. With the help of these therapies, patients are now able to live a fuller, healthier and more active life, no matter what is their age. They can still reach for the stars and realize their dreams.” said Dr.Santosh Kumar, Founder of Poorva International Orthopaedic Foundation. and Head of Department of Computer Assisted Joint Replacement Surgery, Belle Vue Clinic, Kolkata.
Newer instruments and technologies enable the surgeons to consistently achieve results that are far more accurate than via conventional methods. As the accuracy level is very high, it also helps increase the life of the implants, and it also results in less blood loss during the surgery.
Orthopedic experts believe that obesity and changing life style need to be blamed for the rise in joint problems. “More knee replacements are being performed in younger population than before due to obesity, sedentary lifestyles & other forms of arthritis.
Prof. Surya Bhan, who is a Former Head of Orthopedics Department, Chief of Emergency Services and Chief of Trauma Centre, All India Institute of Medical Sciences (AIIMS) said that it is a common misconception that diseases affecting joints, such as rheumatoid arthritis (RA) and degenerative osteoarthritis only affect the elderly. Statistics show that both the young and active can also suffer from these debilitating conditions.
As the number of younger patients with arthritic knees increases, the emphasis should be given to prevention, and improvements in surgical techniques and implants which will lead to better long-term outcomes when joint replacement with Indian Specific Joint is performed, said Prof Surya Bhan.
Now a days arthritis of the knee and other joints is striking at younger ages but shedding a few pounds if you’re overweight may reduce your risk. As people become more aware of the facts leading to joint pain they are more inclined to seek help. Many people believe that only the elderly suffer from arthritis but I treat patients of all ages in my practice. Often they are misdiagnosed because some doctor ruled out the possibility of a patient having some form of arthritis as they are too young, and the elderly don’t seek treatment as they believe there is nothing that can be done now,” explains Dr. Santosh Kumar.
Early diagnosis and aggressive treatment are critical in minimizing the devastating effects of these diseases. Evidence suggests that disease control as soon as possible after onset determines the subsequent disease course and long term outcomes, which suggests there is a therapeutic window of opportunity.
“The treatment for Arthritis varies from patient to patient depending on the type of Arthritis they suffer from as well as their individual profile. We use a combination of symptomatic treatment such as anti-inflammatory drugs and disease modifying drugs to treat these diseases. We also recommend exercises to help improve a patient’s general health, improve mobility and to strengthen muscles. The type of exercise will vary according to the patient and the type of Arthritis they are suffering from. The daily stresses of life may also aggravate, and can trigger a flare of symptoms, so patients are encouraged to reduce stress,” opines Dr. Santosh Kumar.