~ Marks world’s 1st successful Bilateral Total knee replacement (TKR) on a patient suffering from Ankylosing Spondylitis – a condition that primarily impacts the hips and spine ~
~ Surgery conducted by Dr Rajesh Badiyani, Joint Replacement Surgeon and Dr Ramesh Kumar Tikare, Anesthesiologist Fortis Hiranandani Hospital Vashi-A Fortis Network Hospital ~
A 32yr old privately employed young lady from Uran was suffering from bilateral Knee Osteoarthritis secondary to Ankylosing Spondylitis. Dr Badiyani explains, “There are two types of Osteoarthritis one which is due to age, known as Primary Osteoarthritis, which is more common in patients above 50yrs and other is Secondary Osteoarthritis which is more prevalent in younger patients. The reasons could range from Rheumatoid Arthritis, Ankylosing Spondylitis and also Gout, in this particular case, the patient’s knees had developed Osteoarthritis secondary to Ankylosing Spondylitis, which had progressed in the past 3yrs, because of which her knee movements were getting restricted day by day. Highlight of this case, which makes it rare, is that Ankylosing Spondylitis usually affects the spine and hip but in this case, her both knees were affected and eventually she developed Tri-compartmental Osteoarthritis”.
Ankylosing Spondylitis is a form of arthritis that leads to chronic swelling of the spine and the sacroiliac joints(located at the bottom of the spine). In such cases, the hips and spine are severely impacted, knees haven’t been reported to have been impacted, yet. The patient had consulted multiple doctors to seek relief from pain, finally, upon consulting Dr Rajesh Badiyani, Sr. Joint Replacement & Orthopaedic Surgeon, Hiranandani Hospital Vashi – A Fortis Network Hospital, she consented for Bilateral Total Knee Replacement(TKR). Wherein the worn surface of the arthritic knee joint would be replaced with artificial metal and plastic implants. For the procedure, gender specific knee implant, specifically made for Asian females, using bone conserving and tissue preserving technique which helped the patient recover faster. This surgical procedure was conducted successfully on a 32yr old young female for the 1st time in India; so far it’s the world youngest lady to have undergone this surgery.
The patient’s history revealed that she suffered severe restrictions with movements at both the knee joints and had difficulty in going about normal day to day activities. Her range of movement at both knees was 10 – 70 degree, due to intolerable pain while making knee movements. She was unable to walk and stand for more than 10mins at a stretch. The young lady was having symptoms of pain and stiffness, bone fusion (over growth of the bones) and pain in ligaments and tendons. Rarity of the case is that Bilateral TKR is recommended for patients above 50yrs, however in this is case the patient underwent Bilateral TKR at the age of 32yrs!
Speaking about the surgery, Dr. Rajesh Badiyani, said “This is the 1st of its kind surgery probably in the world wherein a young lady of 32yrs underwent Bilateral TKR for Ankylosing Spondylosis. She was suffering from Knee Osteoarthritis secondary to Ankylosing Spondylitis, since years and in future she would have lost movement due to gradual loss of elasticity of the muscles and soft tissue. The only way to save her knees was through this surgery. Our patient is recovering and is able to walk now. She has been advised to undergo physiotherapy and she is back to her routine life and work”.