For Albert Colaco, 84, being able to stand, walk, sleep and cycle again, is nothing short of a ‘miracle’.
Diagnosed with severe osteoarthritis in both knees, he could barely walk 50 metres at a stretch, until he underwent computer-assisted total knee replacement surgery at Mumbai’s Jaslok Hospital eight months ago.
He was able to stand the same day, and was discharged on day four. His surgeon Dr Ameet Pispati attributes this, in part, to the fact that the surgery was computerised-surgery.
“At Colaco’s age, surgeries are usually risky. But since all his vitals — blood pressure, sugar and haemoglobin levels — were normal, we decided to go ahead,” he says. “Because it was a computerised surgery, he was able to recover quickly and resume his routine. ”
Orthopedic surgeons across India are finding that, as the technology improves, computer-assisted surgeries are offering even greater benefits to patients — benefits that have also been outlined in a 2015 study that analysed 57 knee-replacement cases at Delhi’s All India Institute of Medical Sciences.
“Computer-assisted surgeries are not only more accurate but also safer. Additional benefits include shorter hospital stays, less blood loss and a reduced risk of post-surgery complications,” says Dr Rajesh Malhotra of the AIIMS orthopaedics department, who led the research team.
The study, which was published in Journal of Bone and Joint Surgery, explored how computerisation reduced the risk of life-threatening emboli or clot formations that sometimes resulted from the cutting of bone as done in conventional surgery.
“In a computerised surgery, surgeons can cut the bone at accurate angles and balance the soft tissue around the knee area. This helps in achieving better knee alignment too,” adds Dr Tejas Upasni, a Mumbai-based orthopaedic surgeon. “It also quantifies the tension around the ligament to help the surgeon decide how much pressure he should apply during surgery.”
This kind of advancement is also encouraging patients to overcome their fear and go under the knife to improve their quality of life.
Delhi-based artist Manu Parek, 76, for instance, opted for knee replacement after an x-ray revealed that his arthritis had reached an advanced stage.
“Driving had become very painful,” says Parekh. “So had standing for long hours, which I need to do daily to complete my paintings.”
His condition was bad; the only way to improve his quality of life was to have both his knees replaced, says Dr Rajgopal, chairman of Medanta Hospital’s Bone and Joint Institute.
Today, as a result of the surgery, Parekh is up on his feet, walking, painting and travelling again.
“Studies have indicated that more than 90% of patients who have had total knee replacement surgery experience dramatic reductions in knee pain and a significant improvement in quality of life,” adds Dr Rajgopal. “This is even more true for those undergoing computerised knee replacement surgery.”
New Delhi’s Indraprastha Apollo Hospital, for instance, is using the gyroscope technology — where disc-shaped equipment with a free axis of rotation helps surgeons position knee implants at near-perfect angles and orientations.
“The shelf life of an implant in a knee replacement procedure depends on how well the implant is aligned with the bone. The gyroscope technique helps immensely in this,” says Dr Yash Gulati, senior orthopaedic and joint reconstruction surgeon at the hospital.
While this is a case of a new kind of computerised equipment, similar degrees of improvement are coming to knee surgery via software upgrades. “The basic principle usually stays the same,” says Dr Malhotra of AIIMS. “The aim is to ensure that the implant is as well-aligned with the bone as possible. And different machines with their improved software are helping us achieve this alignment to a greater degree than ever before.”
* An average of 55,000 knee replacement surgeries are conducted in India annually
* 1,000 total knee replacement surgeries, using navigation-based technology, are performed at AIIMS every year
* Osteoarthritis, rheumatoid arthritis and damage to the knee in accidents are some of the main causes for knee replacement
* The average cost of surgery on both knees in a private hospital is Rs 4.5 lakh. In government hospitals, this cost can come down to Rs 1.5 lakh