MIKRS (Minimally Invasive Knee Resurfacing Surgery) – An alternative to TKR (Total Knee Replacement)

Doctors have invented a new minimally invasive knee resurfacing surgery (MIKRS) using OrthoGlide Medical Knee System that has made knee management easy for the doctors & cost effective for patients.

A team of orthopedic surgeons led by Dr Prabhat Lakkireddi, who is a consultant Keyhole and Minimally Invasive Orthopedic Surgeon, successfully performed this new surgery procedure on a 45 year old patient.

When the conservative treatments like medications, injections & physiotherapy fails to manage knee pain; orthopedic surgeons recommend total knee replacement (TKR) surgery. It is one of the most successful procedures used for relief of pain, gaining range of motion & improving the functioning of activities of daily living.

TKR is a long procedure that involves lot of bone cutting, use of bone cement, blood loss, a long (10cm to 15cm) scar & a significant post operative recovery time. But patients preparing to undergo TKR due to osteoarthritis now have the option to postpone the surgery at least for a decade.

This has become possible due to relatively new procedure, MIKRS which promises better management of failed knees. MIKRS involves inserting OrthoGlide, a metallic, wedge-shaped chromium-cobalt implant that replaces worn cartilage inside the knee. It offers patients a less invasive alternative to total knee replacement. This device is inserted into the knee through a 5 to 7 cm incision, which relieves pressure, restores proper joint alignment, redistributes the load more evenly and increases stability. It does not involve too much bone cutting, use of bone cement, blood loss & offers significant recovery time.

Due to wear & tear, the cartilage breaks down, causing bones to rub against each other. The rubbing leads to severe pain & swelling, making it impossible for patients to walk. At this stage doctors usually recommend TKR. But this new implant effectively replaces the worn out cartilage, which is the tissue that cushions the two bones in the knee joint.

The surgery was performed on a 45 year old lady suffering from severe pain in both her knees since past three years. The surgery took under an hour for each knee leaving all the joint bones naturally & virtually untouched with almost no blood loss, no bone loss & no cement. After the surgery the patient experienced minimal pain & started walking the following day.

This surgery promises a less expensive and easy path for regaining normal life style functions, it definitely offers a new ray of hope to active and young patients who are worried about major surgery and prolonged post–op rehabilitation to deal with Knee Arthritis, says Dr Prabhat Lakkireddi, who was trained in London for 10 years and recently joined Apollo Health City.

The major advantages of this surgery over standard total knee replacement include its affordable cost (Rs. 1 to 1.2 lakh) and early rehabilitation which helps patients to return to their normal routine and life style expeditiously. It allows patient to squat and seat cross – legged, an important part of our daily lives in our Indian Culture and which is not possible with the conventional knee replacement surgery. Above all OrthoGlide allows delay of total knee replacement until patients are older and less likely to require a second knee replacement.

Advantages of Minimally Invasive knee replacement surgery

Minimally invasive knee replacement surgery (MIKRS) has gained currency in recent years due to the advances in surgical methods and computer-assisted medical technology. Doctors, implant companies, and hospitals use the term to refer to several different strategies and procedures. Many of these strategies and procedures are aimed at performing knee replacement through smaller incisions. By reducing the size of the incision, the surgeon is able to reduce the damage to the underlying structure of the knee, which in turn, does less injury to the patient. However, always remember that the size of the incision will be dictated by the size of the implants and the need to be able to manipulate them inside the joint to get the optimal positioning. Getting accurate positioning is key to the success of the entire procedure.

Some of these strategies and procedures closely resemble the existing techniques in knee replacement surgery that have been used for years. Therefore the term can be misleading. An article put out by the University of Missouri-Columbia School of Medicine reads:

“Many of the so-called minimally invasive procedures are simply variations of existing techniques to implant total knees, except that they are done through smaller incisions. Other techniques are genuine advances that go much beyond just making a smaller skin cut. The ultimate goal is not only to make a shorter skin cut, but also to reduce deep muscle trauma associated with surgery, such that pain is lessened, discharge is expedited, and the need for prolonged physical therapy is reduced.”

If your orthopedic surgeon has training and experience in MIS, there can be several advantages to going with this new surgical technique. However, it is important to note that not every patient’s situation will allow for the procedure. In the case where the surgeon is experienced and the patient’s situation allows for MIS, then this may be an option to consider.

First time in india successfully performed Minimally Invasive Knee Replacement Surgery (MIKRS) in Apollo Hospitals by Dr Prabhat Lakkireddi and his team

Apollo Hospitals, Hyderabad, has performed a new minimally invasive knee replacement surgery, that boasts of being the first of its kind to be done in Andhra Pradesh, and some of the few performed in India. Dr Prabhat Lakkireddi, who led the orthopaedic surgeon’s team, said that this new method eliminates the need for cutting the bone, which helps in a quicker recovery. It is also 50% cheaper than conventional surgery.

Arthritis is the most common cause for knee pain; it is a condition where the lining between the bones (cartilage) gets damaged causing inflammation and pain. In India 50% of the population develops arthritis in their lifetime. It is the most common disorder after diabetes.

This new technique involves replacing worn out cartilage with OrthoGlide, a metallic, wedge shaped device that is implanted in place of the cartilage inside the knee. The device can be places inside the knee with just a 5-7cm incision, which relieves pressure, restores joint alignment, distributes the load evenly and increases stability.

This breakthrough in knee replacement surgery was performed on a 45-year-old woman, in a 45 minute surgery. ,” Dr Prabhat says that OrthoGlide allows doctors to delay total knee replacement until the patient becomes older and requires the surgery.

Original Article: http://health.india.com/news/knee-resurfacing-minimally-invasive-knee-replacement-performed-in-apollo/

Apollo Hospitals Perform Minimally Invasive Knee ReplacementResurfacement Surgery Using OrthoGlide Medial Knee System

Apollo Health City performed a revolutionary Minimally Invasive Knee Replacement (Resurface) Surgery (MIKRS) using OrthoGlide Medial Knee system. This surgery was successfully performed for the first time in Andhra Pradesh by a team of orthopedic surgeons led by Dr Prabhat Lakkireddi, consultant keyhole and minimally invasive orthopedic surgeon. The team performed a bilateral (on both the knees) OrthoGlide knee surgery for the first time in India. 

OrthoGlide, a metallic, wedge-shaped device is a novel implant that replaces worn cartilage inside the knee. It offers patients a less invasive alternative to total knee replacement. This device is inserted into the knee through a 5 to 7cm incision, which relieves pressure, restores proper joint alignment, redistribute the load more evenly and increases stability.

The surgery using OrthoGlide knee implant was performed on a 45-year-old lady with severe pain in both the knees for the past three years. The path breaking surgery took under an hour for each knee leaving all the joint bones naturally and virtually untouched with almost no blood loss, no bone loss and no cement. After the surgery, the patient had minimal pain and started walking the following day.

Dr Prabhat Lakkireddi, who was trained in London for 10 years and recently joined Apollo Health City, said, "This surgery promises a less expensive and easy path of regaining normal life style functions, it definitely offers a new ray of hope to active and young patients who are worried about major surgery and prolonged post-op rehabilitation to deal with Knee Arthritis." 

The major advantages of this surgery over standard total knee replacement includes its affordable cost and early rehabilitation which helps patients to return to their normal routine and life style expeditiously. It allows patients to squat and sit cross-legged, an important part of our daily lives in our Indian Culture, which is not possible with the conventional knee replacement surgery. Above all, OrthoGlide allows delay of total knee replacement until patients are older and less likely to require a second knee replacement, Apollo Health City said.

As against a total knee replacement, MIKRS involves two inches incision, no cutting of the natural bone, the joint is left intact, no cutting of the muscle therefore no bleeding, less painful, low infection, less complications, fast recovery, can walk the same day, the surgery can be performed as a day care surgery, therefore doesn't require hospitalization and cost would range between INR1.1 - 1.2 lakhs, which would come down further with mass utilization of the device. This surgery has the approval of the FDA. The total knee replacement is a major surgery involving an incision of 6–8 inches, around half a liter blood loss, bone cutting which means usage of bone cement, high risk of infection, hospitalization of five to 10 days and long period of rehabilitation, Apollo Health City added.

According to Apollo Health City, this surgery can be opted after conservative oral medical treatments fail. 'MIKRS' offers a cost effective treatment for early and moderate arthritis of the knee joint at virtually half the cost of total knee replacements - which is considered to be the last option for the disease in advance stages with badly degenerated joints.

Original Source: http://www.researchviews.com/healthcare/medical/orthopedicdevices/NewsReport.aspx?Type=4&sector=Orthopedic%20Devices&ArticleID=24974