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Orthopedics is Right Now the Most Rapidly Evolving Specialty

Believes, Dr Anuj Malhotra, Consultant, BLK Centre of Excellence for Orthopedics and Joint Replacement. Having specialization in joint reconstruction and arthroscopic surgeries, Dr Malhotra is MS ORTHO, IOAWOC SICOT fellow and fellow joint replacement EXETER (UK),

Tell us about your journey so far in joint replacement specialty?

Initially I was introduced to joint replacement surgeries they were considered to be major surgeries with patient incurring large amount of blood losses and intolerable post operative pain with slow recovery. As our experience in joint replacement surgeries has increased with time the surgeries have become progressively less invasive, the amount of preoperative blood loss has become minimal and the duration of rehabilitation has become progressively shorter and pain free.

Although if replacement surgeries all alleviate pain on restore function, they are known for associated risks, what is your take on it?

We consider that the two broad categories of risks associated with joint replacements are those of anesthesia and that of surgical complications like infection. The risks related to anesthesia depend on the general functional status of the patient along with the presence/ absence of co morbidities. With the advancements   in current techniques of intensive care and regional anesthesia, the risks associated with anesthesia have become considerably lower. Correspondingly the use of newer advanced theatre protocols and accurate instrumentation have brought down the risk of surgical complications to less than .5 to 1 percent in recent years.

What are your main focus areas?

My main focus areas are basically joint reconstruction minimal invasive Unicondylar knee replacements (which involve replacements of only one compartment of knee), computer navigation and arthroscopic management of sports injuries.

Tell us about your team and what are you able to achieve what was not possible elsewhere?

We are an experienced team of joint replacements surgeons at BLK Super specialty hospital. We have been able to achieve near hundred percent surgical accuracy utilizing the excellent theatre facilities here with newer advanced instrumentation and computer navigation. Now with patient specific knee implants and instrumentation, the surgical time has been reduced drastically and more complex deformities can be handled easily. Apart from this we have been able to offer excellent pain free post operative management which is tailored to patient requirement with the introduction of patient control epidural analgesia.

How wide spread is arthritis in India? What reasons you attribute to this alarming trend?

Knee arthritis in India has always been wide spread but because of the issues of changing lifestyle like- sedentary work and increasing obesity, the incidence has been on upswing. Moreover more and more people are seeking medical attention as they wish to continue at their previous level of activities.

When is knee replacement recommended is it associated with old age?

Knee replacement is usually recommended for those patients who have moderate to severe pain and deformity in the knees which hinders their day to day activities. Old age definitely contributes to the developments of arthritis as in most of the patients the wear and tear is age related if not contributed by injury or trauma.

What are the benefits of such a surgery?

The most important benefit is pain free mobility and more productive meaning full life. Correction of deformities in joint is also important. Due to improvement in patient walking and standing posture there is reduction in back pain and secondary benefits like-better blood sugar and blood pressure control.

What new technologies are being introduced in the field of ortho care?

Orthopedics is right now the most rapidly evolving specialty as the time is advancing computer navigation has become an integral part of surgery. Now with advances in technology Robotic Arthroplasty is picking up fast. Now we have newer implants with which we can replace only one compartment if arthritis is confined just only to medial, lateral or patella femoral part. Latest anesthetic drugs and regional anesthesia techniques are now making it possible to think of knee replacement as day care surgery.


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