Joint Revision Surgery: Why Implants might fail
Wednesday, May 27, 2009
Joint Replacement Surgery has greatly improved the quality of life for many patients. Although the surgical procedure has been extremely successful in the majority of the cases ,however chances are that a small percentage may fail necessitating a procedure known as joint revision.
While Hip and knee replacements have been performed in millions of Americans over the last four decades and today joint replacements are a very common surgical procedure which has improved patients' quality of life by easing pain, increasing mobility and activity levels.
Today, over 400,000 hip and knee replacements are performed in the United States annually. However approximately ten percent of implants will fail and require a second procedure, called a Joint revision, to remove the old implants and replace them with new components.
Reasons why Implants May Fail
Post operative Infection :Iinfection may set in after surgery particularly if the surgery was performed in a non sterile environment. Joint replacement surgery requires extremely sterile environment and many leading hospitals have dedicated Operation Theaters only for Joint replacement due to the risk of infection. Extreme caution should be taken during the surgery to avoid infection as it could lead to very disastrous situations. At times the large foreign metal and plastic implants can serve as a surface for bacteria to latch on thereby increasing the risk of getting infected.
Loosening of the implant :During the initial joint replacement the metal or plastic implants are firmly fixed to the bone but sometimes they may come loose due to normal wear and tear or if the patients leads a very active lifestyle
Technical Failure :In rare occasions the prosthesis may fail leading to instability of the joint, dislocation may occur causing the prosthesis to pop out or move from its initial position
Damage caused due to a fall or an accident Ab accident or any damage may loosen the joints, cause a dislocation or damage the prosthesis
Age Related Factors: Young Adults or young people who are more active may have a higher chance of getting a Joint Revision done,compared to someone who is older and less active.Patients whose primary surgery was performed for inflammatory arthritis and patients with a previous hip fracture are at higher risk for joint revision surgery since the chance of the implants loosening for such patients are high.
Joint revision is also done for implants or prosthesis that have reached the end of their life span or if damage occurs due to a fall or an accident or it may be even caused by the abnormal walking pattern in certain patients .
Diagnosis
Together with the symptoms, an X-Ray of the infected part can reveal if there is need for revision. A surgeon may conduct a standard physical examination followed by lab tests and in some cases a CT scant
Generally a joint revision is generally done as a last resort due to its complexity and cost.
Generally a joint revision is generally done as a last resort due to its complexity and cost.
An Orthopedic Doctors View
Patients need to choose the centers for joint replacement with care as there are only a few hospitals that have the required infrastructure to perform primary total joint replacements and to deal with any complications if at all any.
Since these surgeries are performed in elderly individuals and invariably they do suffer from hypertension, diabetes, heart diseases, hypothyroidism and obesity. To control the medical conditions there should be a team of specialist who can handle these medical conditions. There should be ICU facilities in case it is required .Blood bank should be there in the hospital for emergency needs.
courtesy
DR. SRINIVAS J.V.
M.S. (Orthopedics)
Consultant Orthopedic Surgeon
Wockhardt Hospitals, Bangalore
To schedule an appointment with Doctor J.V Srinivas,please email us at enquiries@wockhardthospitals.net
5 Most Common Orthopedic Problems in Women
Tuesday, May 26, 2009
Women have always led physically active lives. Today, their unique musculoskeletal conditions are better understood than ever before, and the need for gender-specific woman's sports medicine and orthopedic programs grows every year. Injuries and other orthopedic conditions often present differently in women than they do in men. In addition, biologic and gender-specific issues account for a higher prevalence of certain orthopedic injuries and conditions in women.
Certain orthopedic conditions are commonly seen in pregnant women. This is a small synopsis of the conditions commonly seen and what you can do for treatment of these conditions.
- Low Back Pain-It makes sense that low back pain is the most common orthopedic complaint during pregnancy. More than half of all pregnant women experience significant back pain during pregnancy. The extra weight of the baby and the awkward distribution of weight cause muscle fatigue and spasm in the back. While treatment can be difficult during pregnancy, problems seldom linger after delivery. Having a strong back before becoming pregnant can help your body prepare for the weight of the baby.
- Carpal Tunnel Syndrome:Carpal tunnel syndrome is a condition that compresses one of the important nerves in the wrist. Typically patients with carpal tunnel syndrome complain of pain, tingling and numbness in the fingers. Treatment can usually be accomplished with simple steps including night splints (it is a wrist band which is worn at night. While sleeping, people often hold their wrists in a position that allows the median nerve to become pinched. The night splint holds the nerve in a relaxed position).
- Plantar fasciitis This is a condition that causes pain under the heel of the foot. Often referred to as a heel spur. Plantar fasciitis is often associated with rapid weight gain. During the later stages of pregnancy when women gain more weight, symptoms of plantar fasciitis may become bothersome.
- Meralgia Paraesthetica:Meralgia paresthetica is an unusual condition in most people, but it is quite common during pregnancy. When the baby grows, he may press against a nerve that provides sensation over the outside of the thigh. Some people develop numbness over a patch of skin over the thigh as a result of this nerve compression.
- Osteitis Pubis:Osteitis pubis is an inflammatory condition of the pelvis. The pelvic bones are joined in the front at the pubic symphysis. This joint can become inflamed in certain conditions, including pregnancy. Osteitis pubis usually improves with rest.
- Transient Osteoporosis of the Hip-Another hip condition associated with late-term pregnancy is transient osteoporosis. This condition causes abnormal bone weakening of the ball of the ball-and-socket hip joint. Treatment may involve the use of crutches or a walker to relieve weight on the affected bone.
About Doctor Ashis Anand:Dr Ashis Anand is a highly qualified Orthopedic Surgeon at Wockhardt Hospitals Bangalore and is consultant, sports medicine and an orthopedic surgeon at Wockhardt Hospitals,Bangalore who has worked in India and US. His areas of interest include Arthroscopy and Joint Replacement (Hip, Knee and Shoulder). With more than 450 replacements (Primary and Revision). He has also excelled in Unicompartmental Knee Replacement which is done by very few centers in India.
Mitral Valve Replacement: Diagnosis and Treatements
Monday, May 25, 2009
Dr. Ganeshakrishnan Iyer, Consultant Cardio Vascular Surgeon, Wockhardt Hospitals shares his thoughts on " Mitral Valve Replacements"
The Mitral Valve is located between the left Atrium and the left ventricle of the heart. It acts as a one way door that allows blood flow from the left Atrium to the left ventricle and prevents it from flowing back into the chamber as the heart pumps blood through the Aorta to the rest of the body.
Damage to the Mitral valve affects the normal flow of blood from the lungs to the left Atrium and to the left ventricle. The blood may flow in a reverse direction back into the lungs which could lead to various respiratory problems and several other complications or there could be obstruction to the flow of blood from Left Atrium to Left Ventricle.
Causes of Mitral Valve Replacement
The causes for Mitral Valve Prolapse are classified into congenital and acquired. The acquired causes are categorized as: 1) rheumatic heart disease and 2) degenerative heart disease.
Rheumatic heart disease is a condition in which permanent damage to heart valves is caused by rheumatic fever. The heart valve is damaged by a disease process that generally begins with a strep throat caused by streptococcus a bacteria that may eventually cause rheumatic fever. Symptoms of rheumatic fever are fever, swollen, tender, red and extremely painful joints - particularly the knees, ankles, elbows, or wrists, nodules over swollen joints, red, raised, lattice-like rash, usually on the chest, back, and abdomen, uncontrolled movements of arms, legs, or facial muscles weakness and shortness of breath. The symptoms of rheumatic fever may resemble other bone disorders or medical problems. You need to consult your physician for a diagnosis.
Degenerative heart disease is the disease that has progressed gradually and that there is no specific event that has caused it.
Symptoms
The symptoms related to mitral valve failure progresses slowly, however in certain cases the patients don’t experience most symptoms until the disease is in an advanced stage, and there are also cases where the patient does not experience any symptoms at all.
The general symptoms include chest pains, shortness of breadth, difficulty in breathing, unusual heart heartbeat and fatigue.
Diagnosis
Diagnosis is often based firstly on the symptoms of the patient. A skilled doctor may detect a murmur in the heart beat during a regular health checkup. There are a number of tests that can help diagnose the disease.
Electrocardiograms (ECG) – gives a complete record of the electrical activities of the heart, any abnormalities of the electrical impulses of the heart shows up in this test
Echocardiograms – gives the doctor graphic representation of sound waves that are bounced of the heart to detect any abnormalities in the valves of he muscles of the heart.
Electrocardiograms (ECG) – gives a complete record of the electrical activities of the heart, any abnormalities of the electrical impulses of the heart shows up in this test
Echocardiograms – gives the doctor graphic representation of sound waves that are bounced of the heart to detect any abnormalities in the valves of he muscles of the heart.
Cardiac Catheterization – where a dye is injected into the blood stream and an x ray is taken that shows the direction of blood flow.
Treatment
Surgery to replace or repair the mitral valve is often the best option. However if the damage is beyond repair the total replacement is the only other option. Mitral valve replacement surgery is performed to replace the damaged or diseased valve with an artificial one. The artificial valve may be made of metal and pyrolytic carbon (Synthetic) or it may be derived form biological tissue (Biological).
Life Expectancy Figures: The Best and the Worst
Sunday, May 24, 2009
A recent report published by World Health Organization: "World Health Statistics, 2009" shows the life expectancy statics for various countries.
Japan tops the country where people lives the longest,while Sierra Leone occupies the last rank, which is half of what people live in japan. While an average japanese lives for 82 years,citizens of Sierra Lone lives up to an average age of 41 years.
Japan tops the country where people lives the longest,while Sierra Leone occupies the last rank, which is half of what people live in japan. While an average japanese lives for 82 years,citizens of Sierra Lone lives up to an average age of 41 years.
The report shows that children younger than 5 account for nearly 20% of the world's deaths, and that child mortality is a major reason for the wide range in life expectancy among countries.
The World Health Organization's new report is based on data from 2007, the most recent year for which global life expectancy statistics are available.
The report shows that 14 countries had life expectancies of at least 81 years. Here are those countries, along with their life expectancy for babies born in 2007:
* Japan: 83
* Australia, Iceland, Italy, San Marino: 82
* Andorra, France, Israel, Monaco, New Zealand, Norway, Singapore, Spain, Sweden: 81
* Australia, Iceland, Italy, San Marino: 82
* Andorra, France, Israel, Monaco, New Zealand, Norway, Singapore, Spain, Sweden: 81
At the other end of the life expectancy spectrum, 15 countries had life expectancy below age 50. Here are those countries and their life expectancy for babies born in 2007:
* Sierra Leone: 41
* Afghanistan: 42
* Lesotho, Zimbabwe: 45
* Chad, Zambia: 46
* Central African Republic, Guinea-Bissau, Mozambique, Swaziland, Uganda: 48
* Burkina Faso, Burundi, Mali: Nigeria 49
* Afghanistan: 42
* Lesotho, Zimbabwe: 45
* Chad, Zambia: 46
* Central African Republic, Guinea-Bissau, Mozambique, Swaziland, Uganda: 48
* Burkina Faso, Burundi, Mali: Nigeria 49
See the entire report here
Ankylosing Spondylitis: Symptoms and Treatement
Friday, May 22, 2009
Rhematologist Dr Ramesh Jois, Wockhardt Hospitals,Bangalore explains Ankylosing Spondylitis:
Ankylosing Spondylitis is an inflammatory diseases predominantly affecting the spine and causing severe stiffness ,pain and loss of movement.this chronic diseases at a later stage can lead to fusion of the vetebral column resulting in virtual imobilty. Ankylosing Spondylitis can also affect your joints including hips and knees which can cause pain and swelling of the joints leading to permanent damage if treatement is not done at the right time.
Ankylosing Spondylitis is an inflammatory diseases predominantly affecting the spine and causing severe stiffness ,pain and loss of movement.this chronic diseases at a later stage can lead to fusion of the vetebral column resulting in virtual imobilty. Ankylosing Spondylitis can also affect your joints including hips and knees which can cause pain and swelling of the joints leading to permanent damage if treatement is not done at the right time.
Causes : Its believed that Ankylosing Spondylitis is genetically inherited .Those individuals with the gene HLA-B27 are at a higher risk group.However not everyone having the particular strain of gene will develop Ankylosing Spondylitis.
Symptoms : Some of the typical symptoms include Inflammation of spine and joint and pain in lower and mid back and buttocks.The pain is generally worse in the mornings and while resting which leads to disturbed sleep patterns.The pain gradually increases over time before worsening further.
Severely affected patients can develop complete fusion of the spine and the pain almost disappears ,but the spinal mobilty could be lost .This disease could affect the hips and knees resulting in permanent damage.Some patients develop problems other than spine,including eye inflammation ,skin rashes and diarrhoea.
Treatement Options
Physical examination,XRay,MRI findings and blood tests.More recently over the last few years,newer drugs including biological therapy/anti TNF therapy are available.
Ankylosing Spondylitis is approximately three times more common in men than in women.It is generally prevalent in the age group of 20-40 .In very rare cases children are also affected.
Ankylosing Spondylitis is approximately three times more common in men than in women.It is generally prevalent in the age group of 20-40 .In very rare cases children are also affected.
For scheduling an appointment please email us at enquiries@wockhardthospitals.net
Doctor Spotlight : Spine Surgeon Dr Surya Prakash Rao Voleti
Thursday, May 21, 2009
DR. Surya Prakash Rao Voleti
Consultant Spine Surgeon,Kamineni Wockhardt Hospitals,Hyderabad
MS(Ortho). DNB (Ortho)
A.O Fellow (Germany)
GICD Spine Fellow (France)
International Fellow of the SRS (Scoliosis Research Society )
Dr Surya Prakash Rao Voleti is one of the few amongst the orthopedic fraternity in the state of Andhra Pradesh doing dedicated work in the field of spine, particularly in the management of spinal deformity & he has been doing this for over a decade now for wockhardt hospitals
He is also trained in minimally invasive techniques in the management of the degenerative and traumatic affections of spine. He is Equally competent in the management of all Orthopedic conditions, both in children and adults. His work on posterior Hemivertebrectomy in management of neglected congenital scoliosis is well appreciated at the National and International orthopaedic forums.
His areas of expertise are Management of complex trauma, neglected limb deformities using Ilizarov system are the other areas of his expertise. He was a faculty at prestigious Nizam’s Institute of medical sciences for which he has served for a decade.
Professional qualifications
- 1987-1992 MBBS Jawaharalal Institute of postgraduate medical research and education (JIPMER) Pondicherry
- 1993-1996 M.S.Orthopaedics Seth GS Medical college and KEM Hospital, Mumbai,
- 1996 Dip (Orthopaedics) (College of Physicians and Surgeons,Mumbai)
- 1997 DNB (Orthopaedics) (National Board of examinations, New Delhi
Areas of Expertise
- Scoliosis ,Kyphosis and all forms of spinal deformity
- Congenital degenerative,Neoplastic and traumatic conditions of spine
- Pediatric conditions including neglected limb and post traumatic deformites
- Complex adult trauma including the management of acetabular fractures
Honors & Awards
- AO Fellowship at the Department of Orthopaedics and Truamatolgy University of Freiburg, Germany with Prof. N.Sudkamp.
- Recipient of ASSI-Depuy Spine Travelling fellowship for the year 2004 and visited various centers in Delhi and Mumbai in Jan –Feb 2005
- Recipient of GICD – Spine fellowship and visited four centers in France in June –July 2005
- Was awarded ‘ VYAGRESHWARUDU GOLD MEDAL’ for the best paper in the State chapter of IOACON in Guntur in October 2005
- Was awarded Gold Medal For the best paper in the Surgical treatment of Spinal aliments as ISSICON at Delhi in March 2006
- Recipient of Global outreach educational scholarship for the year 2006 and attended the Scoliosis research society (SRS) 41st annual conference at Monterey, California.U.S.
- First orthopaedic surgeon in the state and amongst handful of few spinal surgeons in the country who are awarded the international fellowship of the Scoliosis research society (SRS).
You can also visit Our Center at Hyderabad at the following address for Consultation
Kamineni Wockhardt Hospitals
Abids, Hyderabad- 500 001
Andhra Pradesh - India.
Tel: (040) 6692 4444
Fax: 040-6692 4242
37% of Uninsured Americans Ready To Travel Overseas For Medical Treatement
According to a a latest poll conducted by Gallup, A growing number of U.S. citizens are opening up to Medical Tourism and traveling to different countries for Medical Treatments.
Gallup found that 29 percent of respondents would consider traveling to non-U.S. destinations for a major problem or procedure, 24 percent would seek cancer diagnosis and treatment overseas, 15 percent would travel for orthopedic procedures, 14 percent would go abroad for heart treatment and 10 percent would travel to get plastic surgery.
The poll concludes that the uninsured are the most interested in medical tourism options, with 37 percent of uninsured respondents saying that they would consider cancer care overseas. Only 22 percent of those with health insurance shared this sentiment.
Gallup says the survey results indicate that the increasing cost of medical care in the United States and large numbers of uninsured is making medical tourism a viable option.
"If strides in insurance reimbursements, overseas hospital quality, and affordability continue, it will be an increasingly attractive option for Americans," Gallup says. "The data suggest the estimated population of 48 million Americans without health insurance are motivated by costs and would be more likely than those with health insurance coverage to consider seeking medical care from alternative sources."
The Gallup Poll throws up some interesting trends
- 29% of respondents would consider traveling outside of the US for alternative medical treatments for a major medical problem
- 24% would seek cancer diagnosis and treatment abroad
- 15% would receive orthopedic procedures
- 14% would consider traveling to another country for heart treatment
- 10% would seek plastic surgery
Americans from Mid Western region are the least willing to consider medical treatment abroad. Westerners are the most open to Medical Tourism,while Southerners are also below average in their enthusiasm for medical tourism, with the exception of hip or knee replacement.
Doctor SpotLight :Cosmetic Surgeon ,Dr Apul Parikh
Sunday, May 17, 2009
Dr. Apul Parikh
Dip Cosmetic Surgery(London)
Ebopras(european boardof plastic reconstructive and aesthetic surgery)
MS, FRCS, Dip. Cosmetics
Wockhardt Hospitals, Bangalore.
Ebopras(european boardof plastic reconstructive and aesthetic surgery)
MS, FRCS, Dip. Cosmetics
Wockhardt Hospitals, Bangalore.
Today in Doctor Spotlight we feature Doctor Apul Parikh, who has recently joined us at Wockhardt Hospitals,Bannerghata Road as a Cosmetic Surgeon
Dr. Apul Parikh is amongst the leading plastic and cosmetic surgeons in India. Dr. Parikh has recently moved back to India from the United Kingdom. Dr. Apul initially graduated from the University Of Leeds School Of Medicine. After completing his basic surgical training he specialised in Plastic Surgery in which he has published a number of papers. He has worked in several prestigious London teaching hospitals, including the Royal Free Hospital, St. Bartholomew’s Hospital, the Royal London Hospital and Wexham Park Hospital. He also completed a fellowship at the Memorial Sloane-Kettering Cancer Hospital in New York. Dr Apul Parikh has recently passed the European Board of Plastic surgery (EBOPRAS).
Academic Training :Dr. Apul Parikh was actively involved in the teaching of plastic surgery to undergraduate and post-graduate trainees in the UK and was a Lecturer at the Royal Free Hospital and the Royal London Hospitals.
Dr. Apul Parikh has also received further super-specialised training in Cosmetic Surgery. He has successfully completed the UK’s maiden Diploma in Cosmetic Surgery and is now one of the lecturers to the students. He has been privileged to have been trained by Dr. Dai Davies, Dr. Nick Percival, Dr. Jan Stanek, and Dr. Simon Myers who are all regarded as the leading UK surgeons in the field of cosmetic surgery. Dr. Parikh is also one of the privileged few surgeons to have been trained in Cosmetic Vaginal Surgery.
More recently Dr. Parikh underwent specific training in Rhinoplasty (Nose jobs) in Dallas (USA) under the supervision of Dr. Rod Rohrich and Professor Jack Gunther. Dr. Apul Parikh is one of the few Cosmetic Surgeons to offer computer assisted consultations.
Cosmetic Surgery Procedures Offered by Dr Apul Parikh at Wockhardt Hospitals,Bangalore
Face:
▪ Hair transplantation, Brow lifts
▪ Facelift and Neck lift procedures
▪ Blepharoplasty (Upper and Lower Eyelid Surgery)
▪ Rhinoplasty (Nose Jobs)
▪ Otoplasty (Prominent ear correction)
▪ Lip Augmentation
▪ Injectible Fillers/Botox Injections
Breast Procedures
▪ Breast Augmentation
▪ Breast Reduction/Mastopexy (Uplift)
▪ Inverted Nipples Correction
▪ Gynaecomastia (Male Breast Reduction Surgery)
Body
▪ Abdominoplasty (Tummy Tucks), Thigh/Body Lift (Post Massive weight loss/Bariatric Surgery)
▪ Arm Reduction Surgery
▪ Liposuction
▪ Cosmetic Vaginal Surgery (Labia Reduction, Vaginal Tightening, G-Spot Augmentation)
Skin:
▪ Laser Surgery (Tattoo removal, Rejuvenation)
▪ Chemical Peels
▪ Spider Veins removal
▪ Scar Revision Surgery
For appointments with Dr Apul Parikh, please write to enquiries@wockhardthospitals.net
Subscribe to:
Posts (Atom)
AddThis
Posts
