Arthritis of the knee is the inflammation of the knee joint causing pain, swelling and stiffness and it affect everyday activities. The most common types of knee arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis (OA) is a degenerative, “wear-and-tear” type of arthritis that occurs most often in people 50 years of age and older. Rheumatoid arthritis is an autoimmune disease in which the immune system damages normal tissue and softens the bone and even younger people develop end-stage arthritis. OA is more common in women than men, but the prevalence increases dramatically with age. The number of people affected with symptomatic osteoarthritis is likely to increase due to the ageing of the population.
According to a recent study on the global burden of diseases, osteoarthritis is the second most common musculoskeletal disorder globally in the 50 to 74 years age group and it leads to activity limitation, work absence and years lived with disability (Lancet, 2020). Among adults 60 years of age or older, the prevalence of symptomatic knee OA is approximately 10% in men and 13% in women. OA is the most frequent joint disease with a prevalence of 22% to 39% in India. In a community-based cross-sectional study, the overall prevalence of knee osteoarthritis is 28.7% (Pal et al, 2016). Knee pain is the most common joint problem among rural adults in Tamilnadu with a prevalence of 18.6% (Muthunarayanan et al, 2015).
Treatment of Arthritis
The initial treatment of osteoarthritis is physiotherapy, lifestyle modification, weight reduction and analgesics. If the arthritis is advanced with severe pain and disability, total knee replacement is the solution. Joint replacement surgery is a safe and effective procedure to relieve pain, correct leg deformity, and help to resume normal activities. From the interpretation of studies by Pal, Azad et al and ISHKS (Indian Society for Hip and Knee Surgeons) registry, about 15 to 20 million patients in India might benefit from total knee replacement. Only 1,00,00 to 1,50,000 people undergo total knee replacement in India. There is a huge lag between the people in need of joint replacement and who gets operated on. Our patients often delay the surgery due to various factors such as inadequate information, fear of the procedure and economic constraints.
Joint Replacement Unit in Ganga Hospital
Ganga hospital is one of the largest orthopaedic hospitals in South Asia with a bed capacity of 650 beds and 36 Operating theatres. The Joint Replacement (Arthroplasty) unit of Ganga hospital helps in alleviating the pain and disability due to advanced arthritis through joint replacement surgeries. We perform more than 2500 joint replacements annually including more than 150 revision surgeries. Our extensive experience enables us to treat complex arthritic conditions with safety and low infection rates. Having performed more than 30,000 joint replacements so far, and being one of the leading arthroplasty units in the country, we are embracing advanced technology to deliver better results and improved functional outcomes to patients suffering from arthritis.
Why Robotic Surgery
The benefits of Robotic Total Knee replacement are increased accuracy of implant alignment, shorter recovery time, early mobilisation, decreased pain post-surgery, decreased post-operative complications and improved functional outcomes. The surgeon does the planning for the patient and the robot executes the cuts perfectly. The planning can be made to suit each patient individually and can be done to accommodate the anatomy of each patient. This greatly increases the congruity of the joint to the entire range of motion and the patients have quicker rehabilitation, more movement and also better function.
We have chosen VELYS amongst many available robots. We are also happy to have the First VELYS in the whole of Asia. The advantages of VELYS Robotic technology are the combination of the best computer navigation and surgical expertise to achieve optimal patient outcomes. It does not need a preoperative CT scan and hence avoids unnecessary radiation and cost. It allows patient-specific intraoperative planning to give excellent results. The PROADJUST software allows patient-specific personalised alignment and soft tissue balancing. The ACCUBALANCE software allows real-time visualisation of joint balance through an entire range of knee motion.
The modern buzzword for health is ‘Mobility is Life and Life is Mobility’. When you have severe arthritis, a patient gets severe pain in the joints which restricts his mobility considerably. This has many implications for the patient. First of all, there can be incapacitating pain making activities of daily life very difficult and sometimes disturbing the night sleep also. Secondly, it also makes them dependent on someone else robbing the individual of their independence. Thirdly and most importantly, it also results in a lack of confidence and loss of self-esteem for the patient. Joint replacement can be a very effective solution for this problem and it can give them a second lease on life.
Although total knee replacement has been a very successful procedure, Robotic-assisted technology can be the next biggest innovation in this field. It allows precise planning of the sizing and placement of the prosthesis according to the specific anatomy of the patient. There is sophisticated software which allows perfect balancing so that the knee has got a smooth movement through the entire range of motion. All these will not only improve the pain outcomes but also will result in early mobilization, shorter hospital stays and longer implant survival.