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There arc days whcn we come across stories of medical marvels that lift our spirits and restore our faith in modern medicine, Dr. Kaushal Maihan is the author of one such miraculous story. When a 91-year-old gentleman, with severe pain in his knees, visited the doctor, he became amongst the first to undergo a revolutionary surgery called TPTKR technique (Tissue Preserving Total Knee Replacem ent). It allows neaiiy three times faster recovery with minimal blood loss and pain as compared to conventional knee repbcement surgery. In fact, just four hours after having both knees done in a single sitting, the elderly gentleman walked independently – cnlering the Limca Book of World Record in 2011.
Records aside, what this revolut ionary techniquc has done in the lives of individuals is nothing short of a miracle. The 91-ycar.old could play with his great-grandchildren instead of watching them from the wheelchair. He claimed the surgery didn’t just fix his knees but reversed lime and took him decades back. He stopped imagini ng the good old days and spent every moment doing things that he could only wish for. The biggest reward the surgery gave him was his freedom. He no longer relied on family and friends for the little things. His family stopped cancell ing vacation plans because of his immobility – in fact, they were delighted that he was also a part of their family holidays, the dinncr outings, the weddings and the family albums. For him, this wasn’t a surgery but a gift.
So, ‘Total Knee Replacement’ the only way?
No. But it is the best surgical procedure to tackle end-stage arthritis of the knees, It has stood the test of time and technical advances continue to improve results. This surgery is a powerful tool to not only correct damage in the knee but also to correct faulty biomechanics. Another heart-warmi ng story is of a 64-year-old senior citi,en whose knees were bowed inwards since childhood. Over time, it made him suffer significant arthritic pain in the knee. Total knee replacement not only fixed the damaged surfaces but also allowed the surgeon to correct the bowing, the maltracking of the knee cap. the mairotatiots and other such “manuf acturing defects” (as the doctor prefers to call them). In fact, the “Tissue Preserving Technique” of knee replacement which the doctor developed, allows surgery with less pain, better moment . ithout the need for intensive phyalother. apy and less blood loss. This customiscd surgery allows virtual planning and execution even before the actual surges)’. And the customi scd instruments make the surgery more accurate and less invasive.
Is this technique suitable for everyone suffering from arthritis? Again,no.
Knee arthritis can be divided into patients who suffer from end-stage disease and those who do not. Those not affected by end-stage arthritis will benefit from nonsurgical
measures. Such a patient will benefit signiflcantiv with ezercis. es, activity modification, medicat ion and vLsscosupplement.at ion-which Involves putting artlfldal synovial fluid (the oily fluid hi the normal knee) into the joint. This reduces the discomfort, reduces the wear and tear, and increases the life of the joinL The temi end-stage disease would imply that the cushion in the knee has completely worn out and will, obviously, need some form of intervention surgically to correct the situation. End-stage disease will be seen on an x-ray as complete or nearly total loss of joint space. This loss of space may involve one, two or all three compartments of the knee.
Patients need not go for a total knee replacement If the blomec hanics of the joint are preserved and arthritic disease Is severe but localised to one part of the joint. These patienu arc more suitable for limited surgical options like “mlcroplasty knee resurfacing” or UKR.
Take the case of a 58-year–old female patient who was suffering from severe pain with end-stage disease in one part of the knee. She wasn’t satisfied with the results of nonsurgical management. In her case, the joint space was completely lost but did not affect more than one compartment of the knee. His team evaluated and found that the ligaments and blomechanks were still healthy, so they did a mini-Inv asive LKR procedure with gratifying results. Yet another technique that Dr. Maihan pioneered I. India nearh 12 years back. In this case, surgical conect ion is done through limited surgical exposure. It preserves the patient’s own knee joint with a very natural result. Spccialised training is essential to prevent misuse of this powerful tool.
Since Total Knee Replacement is a very good surgical option with predictable results it somctimcs tends to be overused. Patients should be assessed correctly to see If they can be benefitted with a lesser procedure.
Accredited To : Dr. Kaushal Malhan
