According to Dr. Ashwani Maichand of Fortis Hospitals, when your knee does not respond to medication and treatment, it is worthwhile considering knee replacement surgery as an option. NRI Achievers brings you this article in the form of Q&As, as part of the series we have initiated to bring our readers up-to-date on techniques and technologies that have taken root in Indian medical science and healthcare.

Advancements in medical technology have led to precise and highly functional artificial knee implants that can duplicate the way in which the natural human knee moves – and these implants are custom-fit for your body. It is now among the safest and most effective of all standard orthopedic surgeries. There are two types of replacement surgeries – total knee replacement, and partial knee replacement. Total knee replacement is what comprises more than 90 percent of today’s procedures.

Benefits of Computer-assisted Surgery
Employing computers in surgeries have the laudable benefit of taking the “guesswork” out of surgery. It allows and facilitates the surgery to be done with much greater precision and accuracy.

Why is it important in knee replacement?
Numerous studies have shown that knee replacements performed well in the first place (for example, well-aligned and balanced) are likely to last longer and feel better. In addition, it can shorten the hospital stay of the patient and decrease recovery time. Computer-assisted surgery helps the surgeon align the patient’s bone and implants with a degree of accuracy hitherto not possible with just the judgement of the naked eye. It can also help in balancing the ligaments to ensure a better range of motion and a knee replacement that is more natural in it’s functioning.

What are other benefits and potential complications of computer-assisted surgery?
Computer-assisted surgery increases the precision and accuracy of the entire procedure, giving the surgeon real-time feedback during the surgery itself. This procedure also decreases errors by alerting the surgeon to potential pitfalls before they arise. It also gives the surgeon the confidence to perform the surgery with more precision and control.
Potential Complications: Right here at the outset, let us affirm that computer-assisted total knee replacement is extremely safe. This is because surgeons who use computer-assisted surgery utilize instruments that do not disturb the marrow. It is believed to be safer than traditional surgery. Moreover, it leads to less blood loss and may lead to decrease in blood transfusion requirement after the surgery.

Are all surgeons trained in computer-assisted surgery?
Like all other complex technology, not all individuals are trained in computer-assisted surgery. Proper training and hands-on experience to needed before a surgeon may attempt using this technology.

Does it take additional time to perform?
Like any technology, there is a learning curve for both the surgeon and the OR staff. In hospitals where surgeons and OR staff embrace computer-assisted surgery, it adds an average of some 10-15 minutes to the procedure. But some surgeons do succeed in performing computer-assisted surgery in less time than via conventional procedures.

Is it necessary for all total knee replacement?
Many surgeons fall-back upon computer-aided surgery while operating upon patients with severe deformities or mal-alignments. Others believe that computer-assisted surgery is helpful for all patients, not just the difficult ones. That said, precision and accuracy is of course beneficial for all patients, though it might be a bit more time-consuming than standard surgeries and may require better-trained OR personnel. Moreover, many hospitals are also reluctant to spend money on purchase of expensive computer technology, not to mention the added OR time, personnel training and technology costs. Therefore it might be difficult for many hospitals to offer this procedure.

Can computer-assisted surgery be performed through smaller incisions?
Computer-assisted surgery allows the surgeon to “see” more with the aid of the computer. Since the surgery is performed with greater accuracy, the patient can reap the benefit of less invasive procedures without sacrificing the precision of the procedure.
Health & Wellness

Does it mean additional cost for the patient?
Though hospitals deploying computer-assisted surgery incur higher costs, the additional cost is typically not passed on to the patients, but is instead absorbed by the hospital. Moreover, since potential complications can be prevented and recovery is accelerated, cost-containment can be streamlined overall.

Is computer- assisted total knee replacement available at the Minomax knee and shoulder clinic?
Yes, our surgeons, teams and OR staff are all well-trained in computer-assisted knee replacement surgery.

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