March 31, 2022
Osteoarthritis of the knee is a global age related problem experienced by a significant portion of the population. There are many people in our immediate social circle who suffer from chronic knee pain and are unable to perform normal life functions without experiencing excruciating pain. Many such patients turn to injudicious use of painkillers, therapeutic massages and other remedies without any significant improvement. For such patients Total Knee Replacement is the best available option to eliminate the problem and lead normal lives. Total Knee Replacement involves surgically removing the damaged and degenerated knee joint and replacing it with a prosthetic knee joint which performs all the functions otherwise done by a natural knee joint. This mode of surgical treatment renders better functional outcome and enables the patient to get back to normal mainstream activities.
Total Knee Replacement surgery is now commonly done across cities and with increased awareness, more and more people are opting for this mode of treatment. The most important aspect of a functional outcome depends on aligning the prosthetic implant to the optimal mechanical axis of the knee. To determine the axis, the surgeon relies on instrumentation which, in many instances, may not be optimally used due to practical limitations, such as excessive deformity of the bones and obesity with knee contractures. In such cases, Navigation Surgery plays a key role by helping the surgeon to derive greater accuracy of prosthetic positioning and limb alignment.
In Navigation Surgery, the surgeon gets advance computer-generated information on the internal structure of the knee and uses this to guide the surgical procedure. This process is similar to the navigation information an aircraft pilot gets from the air traffic controller regarding speed, attitude, direction of wind and direction of approach to make a smooth and safe landing. Likewise, Navigation Surgery gives accurate information to the surgeon about the optimal mechanical alignment in three critical places and the least tissue damage. It eliminates the need to drill a pilot hole into the bones, thus reducing blood loss and the soft tissue dissection, and subsequently, less pain in the post-operative phase.
The majority of the patients undergoing knee replacement by navigation are able to walk on the same day and the total hospital duration is brought down to less than four days. The functional recovery after navigation knee surgery is far better than the conventional. The cost involved is slightly more than in conventional surgery, but the benefit of shorter hospital stay, faster functional recovery and reduced logistics cost is far greater.
With the concept of navigation taking centre stage in every aspect of life, from aircrafts to seafaring vessels, GPS in cars to ball trading on the cricket field, it is definitely an added tool for better surgical outcome. Navigation Knee Surgery is here to stay and in the coming years we should be seeing more such applications in the field of Orthopaedic Surgery.