Exclusive Shoulder to Ankle Arthroscopy & Arthroplasty Centre
 
 
 
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RECENT ADVANCES
Sports medicine deals with complexities of sports science including diet, exercises, injury prevention and treatment, surgical and nonsurgical management, rehabilitation and returning to preinjury level.
a) Arthroscopy is a subspeciality of Orthopaedics dealing with joint related problems through key hole approach using advanced technology and instruments.
b) Joint reconstruction and replacement are two different modalities dealing with restoration of joint to normal.
 

Platelet Rich Plasma Injection (PRP):
For chronic Tendon, Ligament, Muscle and Cartilage Dissorders like;

  • Rotator Cuff Disease
  • Impingement
  • Tennis Elbow
  • Plantar Fascitis
  • Tendo Achilis Problems etc.
 

Cartilage Repair

Normal knee function requires a smooth gliding articular cartilage surface on the ends of the bones. This surface is composed of a thin layer of slippery, tough tissue called hyaline cartilage. This cartilage also acts to distribute force during repetitive pounding-like movements such as jumping or running.

 

Injured Cartilage

A severe knee cartilage injury can radically change an active adult's lifestyle. Symptoms such as locking, catching localized pain and swelling often affect your ability to work, play, even perform normal activities.

A cartilage lesion appears as a hole or divot in the cartilage surface. Since cartilage has minimal ability to repair itself, even what may seem like a small lesion (ranging from the size of a dime to a quarter), if left untreated, can hinder your ability to move free from pain, and cause deterioration to the joint surface.

 
Treatment with Autologous Chondrocyte Implantation (ACI)

Although cartilage in unable to repair itself on its own, advanced FDA-approved technology allows cartilage cells, know as chondrocytes to be harvested from your knee and cultured and multiplied. The fresh chondrocytes are then reimplanted in your knee and cause hyaline cartilage to regenerate. This biological repair is known as ACI. When you successfully complete ACI and rehabilitation, you should be able to resume all normal activities, including sports.

ACI, also known as Carticel treatment, restores the articular surface and regenerates hyaline cartilage without compromising the integrity of healthy tissue or the subchondral bone. Carticel has demonstrated important benefits in patients with a type of lesion called a femoral focal lesion. If your orthopedic surgeon has determined that you have this type of lesion, then Carticel may be an appropriate treatment option. The procedure consists of two steps. The first is the harvesting of some healthy cartilage from your knee through an arthroscope. This sample of cartilage is used to create new chondrocytes, which take 3-4 weeks that are then reimplanted in your knee. The second step is the reimplantation of the cultured chondrocytes, or Carticel. This procedure is done through an arthrotomy, and is depicted below.

 
Implantation of Carticel

Step 1

An arthroscopic biopsy - First, the surgeon examines your knee through an arthroscope - a small device that allows the doctor to see into your knee joint. If a lesion is detected, a tiny biopsy of healthy cartilage tissue will be removed.

Step 2

Cell culture processing - The cartilage sample is then sent to Genyzme Tissue Repair (GTR), where it is cultured. Cell culturing takes about 4-5 weeks, during which time your cells multiply significantly. About 12 million cells will be supplied to your surgeon at the time of your operation.

Step 3

A surgical procedure is performed, and the damaged cartilage is removed.

Step 4

Periosteum, skin that covers the bone, is sutured over the prepared defect.

Step 5

Surgical implantation - The cultured cells are then implanted into the lesion. Here, the cells may continue to multiply and intergrate with surrounding cartilage. With time, the cells will mature and fill-in the lesion with hyaline cartilage.
 
 

Post-Operative Rehabilitation

To derive maximum benefit from ACI, you should adhere strictly to the personalized rehabilitation plan recommended by your physician. This will include progressive weight-bearing, range of motion, and muscle strengthening exercises which may begin as early as the day after surgery.

 
Viscosupplements
Viscosupplements are gel-like substances, hyaluronates, that mimic the properties of naturally occurring joint fluid. Currently, there are five FDA approved hyaluronates which include: Hyalgan, Supartz, Synvisc, Euflexxa, and Orthovisc. These hyaluronates are injected into the joint. The number of injections performed varies with the type of viscosupplement used; however, usually three to five injections are required for the best response. While these
 
medications are only FDA-approved to use in the knee, they can be used "off-label" to treat arthritis in the shoulder, the ankle, and the thumb joints (the "CMC joints"). Your doctors at ARC have extensive experience with both "on-label" (FDA-approved) and "off-label" use of these injectable medications.
 
Computer Navigation and Robotic Surgery
Computer Assisted Orthopaedic Surgery (CAOS) is getting popular and accepted in the various parts of the world. There have been many initiatives that have known brought these technologies from the research room all the way to clinical use and commercial developments. In some parts of Central Europe, Computer Assisted Surgery tools are being used on a routine basis, but there are continuing challenges in the clinical adoption and routine use of these surgical tools. Computer Assisted Orthopaedic Surgery - based technologies are the surgical toolbox of the future and represent a spectrum of devices, including 3 dimensional image guided and non-image based navigation systems, intra operative fluoroscopic navigation, Robotic assistive tools, and new intra operative visualization devices. CAOS tools couple simulations with real time evaluations of surgical performance.
 
 
 
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