Dr Ankur Jain

Kindly Join in tomorrow 30th June friday at 5pm for an informational session on Knee joint ACL (Anterior cruciate ligament) injury.
In this session I will discuss the common points to know about this injury which should be known to you as a patient, like ACL anatomy, causes, problems & symptoms, investigations and treatment choices available such as arthroscopic reconstruction, so that everyone can make an informed decision at the right time.
Thank you.
Here is the joining link

घुटने के एसीएल (ACL - एंटीरियर क्रूसिएट लिगामेंट) चोट पर सूचनात्मक सत्र के लिए कल शाम 5 बजे शामिल हों।
इस सत्र में, मैं इस चोट के बारे में कुछ सामान्य बिंदुओं पर चर्चा करूंगा जो एक मरीज या उनके रिश्तेदार के रूप में आपको पता होना चाहिए, जैसे एसीएल की शरीर रचना, चोट लगने का कारण, चोट लगने के बाद होने वाली परेशानी, जांच और उपलब्ध उपचार विकल्प जैसे की दूरबीन से की जाने वाली सर्जरी (Arthroscopic surgery)।
कृपया इस सेशन की जानकारी को सभी तक पहुंचाने की कृपा करें, ताकि हर कोई सही समय पर अपनी बीमारी के बारे में सही समय पर एक सही निर्णय ले सके।
धन्यवाद।
यह इस सेशन में शामिल होने का लिंक है

https://bit.ly/44mTpEn

Hello everyone.

Summary - Case of Unilateral Severe KNEE OA
Primary TKR with tibial stem done.
Pt is walking now just after a few days, without any pain instability or any support.
His smile is back and ours increased.

सारांश - एकतरफा गंभीर घुटना घिस जाने (KNEE OA) का मामला
टिबियल स्टेम के साथ प्राथमिक टीकेआर (TKR) किया गया।
यह सज्जन अब कुछ ही दिनों के बाद बिना किसी दर्द अस्थिरता या किसी सहारे के चल रहे हैं।
उनकी मुस्कुराहट लौट आई और हमारी मुस्कुराहट बढ़ गई !!

Detailed discussion
I am presenting a case of Kellgren Lawrence grade 4 left Knee Osteoarthritis with severe varus deformity in a 62 year old male gentleman. He had severe pain while walking from first step for many years, which vastly reduced his social lifestyle and made him dependent even for activities of daily living. He was pretty depressed at the time of presentation and was hoping to get better, even the slightest.

Clinical examination

a. Medial joint line tenderness.

b. Knee range of motion - 20 degree fixed flexion deformity with further flexion upto 110 degree.

c. Severe varus deformity of 30 degree in coronal plane.

d. Tight medial compartment and laxity over lateral aspect of knee joint

e. X-ray suggestive Grade 4 OA with multiple big osteophytes.

After thorough examination, he was counselled to undergo Primary total knee arthroplasty as that was the only option left to eliminate the pain and improve the gait. From the surgeon's point of view it was a tough case for primary TKA because of severe varus, poor quality of bone and huge defect in the medial tibial condyle. Primary tibial base plate would be insufficient for this much of deformity, hence intramedullary tibial STEM was also planned along with base plate.

Meticulous planning was must for the success of surgery. CT scannogram of of left knee was done to calculate the exact varus angle(28 degree). during surgery both superficial and deep medial collateral ligaments were release beforehand to ensure adequate ligament balancing in medial plane. Tibial cut was increased by 2 degree than usual. proper ligament balancing was done after each cut to maintain the flexion and extension gap. Finally the femoral stem and tibial base plate with stem was fixed with bone cement.

As it was an adequate implant choice with good ligament balancing, we started weight bearing from 3rd day onward with long knee brace. It is evident from the before/after clinical photographs and video that varus deformity was corrected quite nicely, and the patient has resumed normal gait and walking quite comfortably with no lurch or pain while walking.

A happy patient is the reward worth trying for and it inspires you to challenge yourself as a surgeon to take up complicated cases and plan for satisfactory outcomes.