Knee Replacement Surgery in Kolhapur

What is ACL Tear?

An ACL tear is damage to the anterior cruciate ligament (ACL), located at the center of your knee. A tear in a ligament can either be partial, meaning the ligament is only torn slightly, or it can be complete, where the ligament is torn into two separate pieces. It causes leg pain and instability of the knee.

There are various ways in which the ACL can get injured or torn. The most frequent cause is a sudden pivoting or cutting movement that occurs during sports such as football, basketball, and soccer. Additionally, work-related injuries or car accidents can also cause ACL tears.

When an ACL injury occurs, there may be a sensation of a popping or snapping sound. The level of pain experienced during the injury can vary, but it can be intense in some cases.

When a ligament injury occurs, it is common for healthcare providers to classify the injury using a scale of one to three, where three indicates the most severe injury

Grade One

The ligament continues to perform its role of stabilizing the knee joint, despite having undergone stretching.

Grade Two

Grade 2 ACL injuries are rare. The ligament has been stretched and loosened. It’s partially torn. (This grade is rare.)

Grade Three

When an ACL tear is classified as Grade 3, it means that the ligament has been fully torn in half, leaving the knee joint without any support or stability from the ACL.

Causes of ACL Tear

• Changing direction rapidly
• Stopping suddenly
• Sudden Slowing down while running
• Landing from a jump awkwardly
• Receiving a direct blow to the knee or having a collision, such as a football tackle

Symptoms of ACL Tear

• Popping sound at the time of injury
• Pain and swelling that and lasts for two to four weeks
• Loss of full range of motion in your knee
• Tenderness along the joint line
• Trouble standing or walking on the affected knee
• Inability to support your weight on the affected knee

Treatment

Surgery

Individuals with a grade 3 or complete ACL tear are typically recommended surgical treatment. The type of surgery may vary depending on the nature of the ACL injury, the patient's growth plate status, and the specific type of injury. The procedure is minimally invasive, using an arthroscope, a thin wand-like instrument, rather than a large scalpel incision. The surgeon inserts the arthroscope and the working instruments through small incisions in your knee.

There are several surgical options for repairing an ACL tear, including

What is PCL Tear?

A PCL tear is a type of knee injury that affects the posterior cruciate ligament (PCL), which is one of the major ligaments that provides stability to the knee joint. The PCL is located in the back of the knee and connects the femur (thigh bone) to the tibia (shin bone). When the PCL is torn, it can result in a range of functional limitations, such as difficulty with movement and weight-bearing activities. Treatment options for a PCL tear can vary, depending on the extent of the injury and the individual's specific needs. With appropriate treatment and rehabilitation, most people with a PCL tear can recover and return to their usual activities.

Healthcare professionals categorize injuries to the posterior cruciate ligament (PCL) based on their severity, which can range from mild to severe. The PCL can be classified into four grades

Grade One

Grade One indicating a partial tear of the ligament

Grade Two

Grade Two indicating a partial tear accompanied by a feeling of looseness in the ligament

Grade Three

Grade Three indicating a complete tear of the ligament resulting in knee instability

Grade Four

Grade Four indicating an injury to both the PCL and another knee ligament.

Cause of PCL Tear

• A direct blow to the front of the Knee
• Pulling or stretching the ligament
• Twisting or hyperextension injury
• Fall on the knee while in a bent position
• Traumatic event such as accidents

Symptoms of PCL Tear

• Pain which occurs steadily or quickly after the injury
• Swelling that makes the knee stiff and may cause a limp
• Difficulty in walking
• A feeling of instability in the knee
• Pain that worsens over time
• Stiffness

Treatment

• Rest, ice, compression, and elevation (RICE) to reduce pain and swelling
• Physical therapy to improve range of motion, strength, and stability in the knee joint
• Bracing or taping to provide support and reduce stress on the PCL
• Activity modification to avoid activities that exacerbate the injury

Surgery

What is Multi-Ligament Injury?

The knee joint is a complex structure comprising bones, cartilages, tendons, and ligaments that work together to provide support and stability. Ligaments are strong connective tissues that play a crucial role in maintaining the knee's stability. A multiple ligament knee injury is a condition that occurs when at least two of the four primary ligaments of the knee are damaged. These ligaments include the ACL, PCL, MCL, and the posterolateral corner of the knee, which encompasses several vital structures on the outside of the knee, such as the FCL/LCL, popliteus tendon, and popliteofibular ligament. Multi ligament knee injuries can cause intense pain and severe symptoms, and it is essential to seek immediate medical attention.

Some multi-ligament knee injuries include

• 2 or more knee ligament injuries including injuries to the ACL, PCL, MCL, LCL, menisci.
• Isolated injuries to the PCL, LCL or Posterolateral corner.
• Knee dislocation.

Causes of Multi Ligament Knee Injury

• Car Accidents.
• Sports Injury.
• Fall from heights.
• Direct trauma to the knee.
• Work accidents.

Symptoms of Multi Ligament Knee Injury

• Severe Pain in the knee.
• Sudden swelling.
• Tenderness to the touch.
• Inability to walk.
• Loose and wobbly feeling of the knee.

Treatment

The treatment options for this type of injury are tailored to the specific circumstances of each case and may include

• Rest, ice, compression, and elevation (RICE protocol) to reduce pain and swelling.
• Physical therapy to help strengthen the knee and improve range of motion.
• Bracing or splinting to provide support to the injured knee and limit movement.
• Medications for pain management, such as over-the-counter pain relievers or prescription medication if necessary.
• In some cases, injection therapy may be used to reduce inflammation and pain.

In the case of severe knee ligament injuries, surgery is typically necessary for treatment. However, in patients with low physical demands who lead a sedentary lifestyle, bracing and rehabilitation may be sufficient to alleviate instability issues. For the majority of patients, a complex surgical reconstruction is required to address the injury.

Surgery

Multi-ligament knee injuries involve damage to two or more of the major ligaments in the knee joint, such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Surgery is often required to reconstruct and repair these ligaments to restore stability and function to the knee.

The type of surgery performed will depend on the specific ligaments that are torn and the severity of the injury. In some cases, open surgery may be necessary to access and repair the damaged ligaments. This involves making a larger incision in the knee to access the joint and repair the ligaments using grafts or stitching.

In other cases, minimally invasive arthroscopic surgery may be used. This involves making small incisions in the knee and inserting a tiny camera and instruments to access the joint and repair the ligaments. Arthroscopic surgery may be used for less severe injuries or for specific ligaments, such as the ACL or PCL.

During the surgery, the orthopedic surgeon will typically use grafts to reconstruct the torn ligaments. These grafts may be taken from the patient's own body or from a donor. Multiple grafts may be required, depending on the extent of the damage and the specific ligaments that need to be repaired.

What is Cartilage Defect?

Cartilage, which is a flexible and durable connective tissue and provides a smooth surface for movement, can be easily damaged and result in what is known as a cartilage defect. This type of damage can occur due to various reasons such as trauma, osteonecrosis, osteochondritis, and other underlying conditions. Cartilage defects are most commonly seen in the knee joint, where it is often caused by trauma and seen in association with ligament injuries, such as ACL tears. This can cause pain, swelling, and reduced mobility in the affected joint.

Causes of Cartilage Defect

• Direct blow on the joint.
• Lack of movement.
• Wear and tear due to aging, obesity, or overuse.
• Trauma or injury to the joint, such as a sports injury or accident.
• Genetic factors that can make cartilage more prone to damage.
• Inflammatory conditions such as rheumatoid arthritis or gout.

Symptoms of Cartilage Defect

• Pain, swelling, and stiffness in the joint.
• Clicking or popping sounds in the joint during movement.
• Reduced range of motion in the affected joint.
• Instability or a feeling of the joint giving way.
• Difficulty walking or performing activities that require joint movement.

If the damage to cartilage is severe, it may cause a piece of cartilage to break off, resulting in a joint that becomes locked. This can further lead to hemarthrosis, which is bleeding within the joint, causing the affected area to appear blotchy and bruised.

Treatment

Nonsurgical interventions can alleviate pain, enhance mobility, and improve the overall quality of life. However, they are unable to mend the damaged articular cartilage. These treatments are typically administered during the initial phase of an injury or when there is widespread damage to the cartilage.

• Resting.
• Icing.
• Elevating the joint to reduce swelling.
• Anti-inflammatory medications to reduce pain and swelling.
• Using an unloader brace to "unload" (or lessen the weight on) the cartilage injury.
• Corticosteroid injections, to reduce inflammation and pain.

Surgery

Since damaged articular cartilage has limited capacity to heal on its own, surgery is often considered the most effective treatment option. Some surgical procedures are designed to alleviate the symptoms, while others focus on repairing and restoring the damaged articular cartilage. The type of surgery performed will depend on the location and severity of the damage.

Some common surgical options include

What is Patellar Instability?

The patella bone, commonly known as the kneecap, is connected to both the femur and tibia bones by tendons. It is positioned within the trochlear groove located at the end of the femur and slides up and down as the knee bends and straightens. Patellar instability occurs when the kneecap moves outside of this groove. If left untreated, individuals affected by patellar instability may experience severe pain, functional limitations, and develop arthritis in the long run, which can greatly impair their ability to carry out basic tasks. Fortunately, there are several treatment options available for individuals with patellar instability, ranging from physical therapy, to more invasive interventions like surgery.

Causes of Patellar Instability

• Shallow or uneven trochlear groove.
• A direct blow to the knee or a sudden twisting motion can cause the patella to dislocate.
• Loose ligaments can allow the patella to move out of position more easily.
• Repeated stress on the knee joint from activities such as running or jumping can lead to patellar instability over time.

Risk factors for Patellar Instability:

Patellar instability can develop in anyone, but females may have a higher risk due to LAX ligaments. Activities that involve a lot of quick pivoting, such as basketball, cheer, soccer, or high-impact sports like football, can also increase the likelihood of patellar instability.

Medical conditions that result in laxity of connective tissue can lead to patellar instability. Some examples of such conditions are:

• Cerebral palsy.
• Down syndrome.
• Ehlers-Danlos syndrome.

Symptoms of Patellar Instability

• Pain around the kneecap, especially when bending or straightening the knee.
• A feeling of instability or giving way in the knee.
• Swelling around the knee joint.
• Stiffness or difficulty moving the knee joint.
• A popping or clicking sensation when moving the knee.
• Weakness in the thigh muscles or difficulty bearing weight on the affected leg.
• Abnormal alignment or position of the kneecap.

Treatments for Patellar Instability

• A knee brace may be needed to immobilize the knee and keep the kneecap in place. The brace should be worn for several weeks and crutches may be necessary during this time.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), rest, elevation, and ice packs can be used to alleviate pain and reduce swelling.
• Physical therapy for strengthening the muscles that support the kneecap and improving the range of motion in the knee.

Surgery

If you have chronic patellar instability or a complete kneecap dislocation, your healthcare provider may recommend surgery. Most knee surgeries take place arthroscopically. The procedure uses small incisions and a tiny camera (arthroscope). Recovery can take six to 12 months.

What is Meniscus Tear?

The knee joint contains two C-shaped cartilage structures, known as menisci, that are located in the knee joint over tibia, providing cushioning and stability. The medial meniscus is located on the medial side of the knee, while the lateral meniscus is located on the lateral side.

Meniscus tears often occur when an athlete twists their upper leg while their foot is planted and the knee is bent. This type of injury is common in sports, but it can also affect older individuals. Meniscus tears cause pain and swelling, typically felt at the front or sides of the knee. At first, the injured leg may be weight-bearing, but pain and swelling can worsen over time, sometimes leading to a feeling that the knee is giving out.

Meniscus Tear Causes

A sudden twisting or bending motion of the knee joint during physical activities like sports, dancing, or lifting heavy objects, can cause meniscus tears. Additionally, the natural degeneration and wear and tear of the cartilage over time make meniscus tears more common in older adults.

Symptoms of Meniscus Tear

• Swelling or stiffness.
• Catching or locking of the knee joint.
• Inability to fully extend or bend the knee joint.
• Pain in the knee joint: usually on the inside (medial), outside (lateral) or back of the knee.

Treatment

Many meniscus tears do not require immediate surgery and can be treated non-surgically.

• Resting and avoiding movement.
• Applying cold packs to the affected area for 20 minutes at a time, several times a day, can help reduce pain and swelling. It is important not to apply ice directly to the skin.
• Using an elastic compression bandage can help prevent additional swelling and blood loss.
• Elevating the leg above heart level while resting can help reduce swelling.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, can help reduce pain and swelling.
• A corticosteroid medication injection into the knee joint can help eliminate pain and swelling.
• Biologics injections, such as platelet-rich plasma (PRP), are being studied as potential future treatment options for meniscus tears.

Surgery

At our hospital, we specialize in employing advanced techniques for meniscus repair, particularly when it comes to bucket handle tears. Our approach involves utilizing a combination of inside-out needles and all-inside devices.

There are three types of surgery used to treat a meniscus tear

What are Loose Bodies?

Loose bodies are small pieces of cartilage or bone that move freely in the synovial fluid of the knee joint, causing obstruction to joint movement during flexion and extension. These fragments can range in size from a small pill to the size of a quarter, and their presence can lead to articular cartilage damage and the development of osteoarthritis. Loose bodies may occur due to injury or gradual wear and tear, and their number can vary from one to many, with some being stable and others unstable, resulting in pain or limited range of motion.

Causes of Lose Body

• Injury to cartilage during trauma or sports can lead to the formation of a loose body.
• Disorders such as Osteoarthritis and Arthritis
• Synovial Chondromatosis, a rare condition where cartilage grows abnormally in the joint lining, causing loose bodies to form.

Symptoms of Lose Body

• Limited range of motion.
• Intermittent joint locking.
• Grinding or popping sensation in the joint.
• Knee pain and Swelling.

Treatment

The treatment options for loose bodies in the joint are determined by the underlying cause and the severity of the condition. Some of the commonly used treatment options include

Surgery

Various surgical procedures are available for removing loose bodies in the joint. The specific type of surgery selected depends on factors such as the size and location of the loose bodies, as well as the underlying cause of the condition. Here are some examples of commonly used surgical procedures:

What is Knee Synovitis?

Knee synovitis is a chronic knee pain condition that involves inflammation or irritation within the synovium. The synovial membrane lining the knee joint becomes inflamed and swollen due to overproduction of synovial fluid. This can be caused by various factors such as injury, infection, and autoimmune disorders. The inflammation can cause the knee to swell, resulting in joint pain, decreased range of motion, stiffness, warmth, and a reddish or pink hue. It's important to note that synovitis can affect other joints in the body as well.

Causes of Knee Synovitis

Synovitis is usually a secondary condition. This means it is caused by another ailment or injury. Possible causes include

• Rheumatoid Arthritis.
• Knee injuries.
• Infection in the joint.
• Overactive immune system.
• Gout, a painful condition affecting joints.

Symptoms of Knee Synovities

• Pain, swelling, and stiffness in the knee joint.
• A warm sensation in the area of the joint.
• Swollen joints for hours or days.
• Joints that turn red or pink.
• A feeling of instability in the knee joint.

Treatment

Surgery

If conservative treatments are not effective, surgery may be necessary to remove the inflamed synovial tissue or repair any damage to the knee joint. There are two main types of surgery that can be used to treat knee synovitis: arthroscopy and open surgery.