Knee Replacement Surgery without cutting muscles

Total knee replacement is the most successful orthopaedic surgical procedure of modern era. When there is a severally damaged osteoarthritic knee, the joint is completely degenerated, the total knee-replacement surgery is the preferred procedure. In this procedure the surgeon shaves the damaged cartilage from the bone ends and replaces it with new surface called prostheses which can be made of alloy-metal, high-grade plastic and polymers. Use of Advanced technology in knee replacement surgery has made this procedure more accurate and long lasting. Total Knee Replacement can be performed as unilateral (single knee) or bilateral (both knee together). The goal of knee replacement surgery is to provide the patients to live pain free life and return to normal daily activities.

There are two approaches for the total knee replacement surgery (TKR):-

  • Traditional Approach

    During the traditional approach to knee replacement the skin is cut 15-20 cms. along with the quedriceps muscles in centre of the knee and thigh. The knee cap is flipped, the thigh and leg bones are separated from each other to perform traditional knee replacement surgery. This approach involves cutting the quedriceps muscles which results in prolonged post-operative pain, recovery and the patient need walking aids for 3-4 weeks.

  • Minimal Invassive Subvastus Approach

    The minimally invassive subvastus approach differs completely from the traditional approach. In minimally invassive subvastus approach the skin is cut only 8-10 cms. The thigh muscles are kept intact by pushing them to the side without cutting them. The knee cap is not flipped to expose the knee joint and the thigh and leg bones are not separated but they are cut in place. This approach
    results in significantly less trauma to the leg, shortens recovery time and more strength and mobility in the newly implanted knee joint. The huge advantage of this procedure is not weakening the thigh muscles at all resulting the patients are able to walk even without help of any walking aids almost immediately after the surgery.

    Advantages of knee subvastas approach:
    • Less or no pain after surgery
    • Less blood loss
    • No muscle cut
    • Quicker recovery
    • Increased strength and mobility of newly implanted knee Joint

Dr. Anoop Jhurani, joint replacement specialist and director at Fortis Escorts Hospital uses minimal subvastus approach along with latest Pin less computer navigation machine for the first time ever in Rajasthan which helps to make the procedure virtually pain less and provides the patients full mobility in the knee and walk freely very early in post-operative period.

Dr Anoop Jhurani who has performed more than 4000 jointreplacements is one of the most experienced joint replacement specialist in the city of Jaipur and state of Rajasthan. He has made a mark at the national level by his enterprising work and presentations.

Cement on Cement Technique

This was a 45-year-old patient with bilateral hip replacements done 15 years back. They were old Charnley style prosthesis which were cemented well and lasted for 15 years. The acetabulum had Paprosky type 2c defect and needed a hemispherical jumbo cup. I reconstructed the acetabulum with bone graft at the base and a 66 mm trabecular metal cup. The femur was reconstructed using cement on cement technique as the previous cement mantle was well preserved. I have revised  both  his hips using the same technique.

Training and Fellowship

‘ Jaipur Arthroplasty Fellowship’ is a one month fellowship program for experienced Orthopedic surgeons wishing to learn the science and art of joint replacement surgery. They will be able to scrub in surgeries, learn the pre op planning and post operative protocols.

Publications

The effect of patellar replacement technique on Patellofemoral complications and anterior knee pain, journal of Arthroplasty Feb 2012.

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Dr Jhurani is an authoritative figure within the Orthopaedic surgery circles in Rajasthan. With several laurels to his name.

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Dr. Anoop Jhurani is using latest pin-less computer navigation machine for the first time in Rajasthan.

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