60-year-old Kenyan male patient undergoes one hour revolutionary minimally invasive technique
Joseph Maina Githemba from Kenya recently underwent Total Knee Replacement (TKR) surgery by Dr Vikram Mhaskar, Consultant – Knee & Shoulder Surgery, Max Smart Super Speciality Hospital, Saket.
Dr Vikram and his team performed first daycare TKR using minimally invasive technique that included no tourniquet, injecting local anaesthesia into the skin before incision as well as into tissues at regular intervals, meticulous dissection, catching all bleeds before closure of the wound and injection of tranexamic acid to reduce bleeding post-operation. General anaesthesia with adductor canal block was used to make sure that the bleeding is minimal. Along with this, a catheter was inserted into the adductor canal so that the pain relief medicine was continuously flowing around the nerve.
Githemba said, “I was under severe dismay when I met with an accident around 15 years ago. I damaged my knee badly and was unable to walk with sharp pain. I decided to go for the TKR procedure as a last resort but had my doubts about the success of the daycare surgery. To my pleasant surprise, I was prepared for the procedure through exercises, several tests and pre-anaesthesia checkup. The surgery was absolutely painless and only took one hour. I was back on my feet the same day and could return to the comfort of my home. The role of healthcare services at home in my speedy recovery has been invaluable with critical care nurses and professional supporting me every step of the way. I am thankful to Dr Vikram and his team for helping me goes through this procedure.”
With prior planning of implant selection, surgical technique, anaesthesia and analgesia, Daycare TKR ensured minimum surgery time, blood loss and mental stress for the patient. The surgery took only 1 hour with a minimal hospital stay of 12 hours. As part of rehabilitation, Joseph was made to walk using a walker within six hours of the operation and was discharged briefly with information about the exercises to be done at home. Showing excellent improvement, Joseph could walk without a support in 48 hours. He reported no constipation that is otherwise a usual observation during normal TKR procedure due to convalescence and changes dietary habits. A normal TKR procedure takes up to three hours of surgery with 96 to 168 hours of hospitalisation. It takes at least 24 hours for the patient to be mobilized and a long period of three weeks before the patient can walk without support.