DEPARTMENT OF ORTHOPAEDICS











Replacing pain with joy.

One of the most common health problems people face is joint pain and stiffness, which can take the joy out of living. It can be caused by many types of injuries or conditions and can affect a person of any age group.  In recent times, joint pains are afflicting an increasing number of young people, the causes being diverse. Sagar Hospitals specializes in joint replacement and provides lasting relief to its patients, replacing pain with joy. Literally.
What is a joint replacement?
As the words suggest it is replacing the worn out parts of a natural joint by an artificial joint to allow mobility and have pain relief.
Which joint can be replaced?
Hips, Knees, shoulders, elbow, ankle, wrist and fingers
What do we do?
We remove the worn out part of the joint and replace it with anatomically fitting artificial joints – say ball and socket of a hip joint or the three surfaces of a knee joint.
What do we use?
The artificial joints are made up of biocompatible materials, which is either 315-alloy steel or titanium along with high-density cross-linked polyethylene (Plastic) which possesses specific properties. They are generally very well accepted by the body and have no allergic reaction.
When do we do a joint replacement?
Major joints like the hip and knee, which are, weight-bearing joints are worn out because of a variety of reasons. Wear out of a joint is called arthritis in general terms. Arthritis can be of different natures.
Osteoarthritis – General age related wear and tear.
Rheumatoid Arthritis – Due to an autoimmune disorder.
Gouty Arthritis – Secondary to increase uric acid.
Osteo arthritis of a joint is sometimes also a result of previous injury to the cartilage. Cartilage is a glistening white surface covering of the texture of a billiard white ball on all major joints. When cartilage wears out the pain starts because of exposure of nerve endings. Early Osteoarthritis is very painful but very gross degeneration is not very painful. This is a very important fact to understand as public think that because they have no pain, they are cured. On the contrary, problems increase.
Wear and tear of joint also gives a clinical deformity of bowlegs or knock knees. Sometime there are gross deformities. Unfortunately in our country because of myths and fear, people allow the degeneration to progress extensively and before they reach the doctor. Also the Indian dresses of sarees and dhotis add on as they cover up gross deformities unlike the western dresses.
Joint replacements are done only when there is intolerable pain – pain disturbing sleep, making patients take a lot of medications, difficulty in activities of daily living and restricting social and sporting activity.
It is usually considered in physiological elderly people who have tried a full course of conservative treatment like restricted activity, use of painkiller and stick, physiotherapy and occasional intra articular injection.
What are the advantages of joint replacement?
·        Relieves pain
·        Corrects deformities
·        Gives the person a pain free movement of the joint, which is stable
·        Psychological advantage to be a normal social being
·        Independent following surgery
What are the disadvantages?
·        Not able to squat on the floor after a total hip or knee joint replacement.
·        Not able to use Indian toilet
(Almost all patients usually are not able to do the above before the operation and are already adapted to this life style.)

MYTHS ABOUT THE OPERATION
Will not be able to walk again?
1.      Patients are usually made to walk on the 2nd day of the operation after a total hip or knee joint replacement.
2.      They can walk without walking aid in six weeks time and also climb steps or travel in public transport.
3.      We allow swimming in three months time.
4.      Car driving allowed in three months time.

Will have a stiff leg all the life?
Patients are allowed to or made to move the placed joints on the day of the operation.
Will have to use a stick all life?
Stick to be used for about 6 to 12 weeks only
Diabetic and Hypertensive patient are not suitable for joint replacement?
We have successfully operated on patients with diabetes, blood pressure, old heart attack, thyroid problem, but with adequate preoperative assessment and treatment.
Myths about stay in hospital?
Patients are usually discharged within a week of one joint replacement.
Is it very very painful?
First two three days after the operation the pain is totally controlled by special techniques like epidural analgesia or controlled pumps. Pain usually disappears in three to 6 weeks.
Cannot do replacement surgery in patient with excess weight?
It is possible to operate on obese people but we explain the possible risks. Obese patient cannot walk before operation because of pain and hence cannot exercise. To enable them to exercise and lose weight, replacement of the painful affected joints is necessary.
Age is a bar?
Joint replacements are done usually in patients above the age of 55-60 years in our country. We have operated on patients at 85 years who are fit physiologically. In patients with Rheumatoid Arthritis who have multiple joint disease involvement we may have to replace the joints even at an earlier age.
What are the materials used?
·        315 Medical set
·        High-density polyethylene
·        Titanium
·        Ceramic
·        Highly cross-linked polyethylene.
How long does it take for the operation?
About 1 to 1 1/2 hours for total knee and total hip joint replacement. About 2 hours of total shoulder replacement.
POST OPERATIVE REGIME
·        Passive / Active Knee movements on a continuous passive motion machine on the afternoon of the operation day
·        Stand up with full weight on the legs on the 1st day
·        Walk with support on 2nd day
·        Full bath / shower on 2nd or third day with a waterproof dressing on the wound.
·        To the toilet (commode) on 3rd day – 4th day
·        Climb steps on 5th day
·        Home within a week
·        Self-physiotherapy or exercises with the help of family members at home
·        Suture remove on 15-20th day
·        No plaster or knee braces after the operation
·        Drive / Swim in 3 months
·        Give up stick in 6-8 weeks

What cant we do after operation?
·        Can’t use Indian toilets
·        Can’t sit with legs crossed on the floor

Sagar Hospitals, with over a decade’s track record of excellence, has brought new-generation healthcare to Bengaluru through its two multispecialty, tertiary care hospitals, four clinics and chain of pharmacies..
Infrastructure highlights
·        665 beds
·        15 Operation Theatres, Robotic-enabled core OT with LED lights
·        128 Slice Cardiac CT
·        1.5 Tesla MRI with Total Imaging Matrix
·        Video Conferencing and Remote Access to Patients

Centers of Excellence
·        Sagar Center for Cardiac Care
·        Sagar Center for Diabetes & Endocrinology
·        Sagar Center for Pediatrics
·        Sagar Center of Neuroscience
·        Sagar Center of Nephrology & Urology
·        Sagar Center of Orthopedics

As part of its massive expansion blueprint, Sagar Hospitals’ brand of excellence will soon be made available overseas - in Dubai & Muscat and other parts of Karnataka.


Centre of Excellence - Orthopaedics

In this busy world and this fast moving life and various pressures we undergo, our body definitely undergoes lot of stress resulting in a very early pains & unhealthiness. Here, in Sagar Hospitals, we understand this & we have roped in the best Orthopedics specialists from across the world to give you faster relief from pains.

 At Sagar Hospitals, the department of Orthopaedics is fully equipped and functioning unit with a team of highly trained specialists. It offers Trauma Care, Joint replacement Surgery for Hip, Knee, Shoulder and Elbow, Arthroscopy, Sports injuries, Spine surgeries, Reconstruction surgeries, Deformity Correction and Paediatric Surgeries and many others.


STAR PERFORMER:
Dr. H P C Khincha, MBBS, FRCS (Edinburgh, UK), M.Ch (Liverpool, UK), FASIF
Orthopedic Surgeon









Being awarded with Gold Medal for Pathology & Microbiology, he has  experience of more than three decades.  He also has the fellowship of Geneva, Switzerland & Tubigen, Germany. He is the most sought after surgeons for Total Knee Replacement.


He had been a faculty member for teaching on Advanced Fracture Management in AO team Switzerland and plenty of AO courses across India. He is a founder member of the Indian Society of Hip & Knee surgery, whose sole function is to teach & propagate Joint Replacement surgeries in the nation.
He is associated with lot of sport bodies for treatment of sport injuries such as National Cricket Academy, State Cricket Board.. He has treated patients in all age groups up to 90years.He is a specialist  in Joint Replacement Surgery, Arthroscopic Surgery (Key Hole surgery),Fracture management(poly trauma) .Contact:+919591991852
                                                                         
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