HospiNews

Hospital Performs 100 TKRs Using CNS Method

Combination of MSVA and ASM navigation has reduced hospital stay to two to three days

Dr Nilen Shah with the navigation equipment

Mumbai's Bombay Hospital has performed 100 Total Knee Replacement (TKR) surgeries using the Stryker's OrthoMap Articular Surface Mounted (ASM) Knee Navigation. The ASM computer navigation perfectly complements, and is best recognised as an advanced surgical technique for the Mini Subvastus Approach (MSVA) to TKR surgery, also known as Tissue Preserving TKR surgery without any blood loss.

TKR techniques, one of modern-day's recommended treatment options for crippling knee arthritis, is a surgical mastery that involves knee replacements through just a single small cut of 8 to 10 cms. The technique has been so simplified by latest computer navigation methods, so that experienced surgeons are putting knee replacements in without instrumenting either the thigh bone or the shin bone.

Orthopaedic and Joint Replacement Consultant Dr Nilen Shah, who is the pioneer in performing Stryker's OrthoMap Articular Surface Mounted (ASM) Knee Navigation through the MSVA, said, "Combination of MSVA and ASM navigation has reduced hospital stay to two to three days.” He further added that the Stryker's ASM Knee Navigation surgery is of immense benefit in the Indian context. "Given that a majority of our population is osteoporotic, this technology which does not require the insertion of additional large pins in the thigh bone and the shin bone is a great advantage because it obviates the risk of any intra-operative fracture. New knee joints that are implanted through this technique allow full flexion and mobility when implanted properly," said the surgeon, who has earned the distinction of having introduced the Subvastus TKR procedure to India.

He debunked the widespread belief that TKR procedures are followed by extremely long and arduous recuperation and recovery periods including intensive physiotherapy. "That was the case with the classical method of TKR surgeries that were performed by a muscle cutting approach. Here the main muscle of the thigh ie the quadriceps is split right in the centre to expose the knee joint. Naturally, the time taken for the torn muscles to heal is long. Moreover, there is scarring of the muscle post operatively which may cause pain or restrict full movement," Dr Shah explained.

In the MSVA method, however, the thigh muscle viz the quadriceps is not violated at all. "When this approach is combined with advanced navigation technique together with the most advanced knee implants such as the hi flex joints and the gender specific implants, marvelous results become reality for a maximum numbers of patients seeking knee replacements."

He informed that the Stryker ASM Knee Navigation technology provides surgeons a simplified solution to make navigated TKR easier procedures that can be incorporated in the everyday OR environment. This intuitive software and hardware combination enables a less invasive, simplified approach to navigating distal femoral resections, proximal tibial resections and femoral rotation. ASM offers a rapid registration process and does not require standard navigation pin fixation. "If the pins were to be inserted, then an extra five mm long cut would have been necessary," he added.

In a recent TKR surgery, 61-year-old Pratima Ben proved the claim. The patient underwent classical method Knee Replacement surgery on one leg and ASM with MSVA in the other knee.

"What's more, these surgeries are virtually bloodless and the surgeon does not find the need to use post-op drains in patients to drain out the knees after the surgery. Generally, there is no transfusion required either. No plaster is used after the operation and the patient is allowed to walk and bend the knee from the second day onwards," he added, referring to the 1,020 successful Subvastus TKR which he has conducted in India, so far.

EH News Bureau