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Past events at MIOT

The greatest Orthopaedic innovation of the 20th century was joint replacement surgery. Sir John Charnley’s Low Friction Arthroplasty revolutionized the treatment of hip disorders and paved the way for future developments in arthoplasty.

Present day joint replacement sees the usage of various materials via varying surgical approaches. The accent today is not on merely pain relief and some restoration of function. The aim of modern day joint replacement surgery is to return the patient to completely normal activity and to implant an artificial joint of maximum longevity, with minimum damage to tissue.

It is fitting that the cradle of Indian Orthopaedics – Chennai, under the banner of the Indo-German Orthopaedic Foundation, hosted this seminar on February 06th & 07th 2010 on the advances in joint replacement of the hip, knee, shoulder and elbow. The event witnessed eminent specialists from U.K, Germany, South Africa and Australia showcasing their expertise by performing surgeries that were telecasted live to the participating surgeons.

Being a special master’s course on Joint Replacements, MIOT Hospitals also performed the first ‘Silent Hip’ procedure on an Indian patient.

Dr. Prithvi Mohandas, consultant hip surgeon, is one among the 12 surgeons who were trained in implanting ‘silent hips’ in Kiel, Germany. Along with Nicola Pace, Divisione di Ortopedia, Jesi, Italy, he performed the new technique in total hip replacement on the young patient, in about an hour.

Dr. Prithvi said “Today replacement surgeries is not on merely pain relief and some restoration of function but to make sure the patient returns completely to their normal activity”. This is true especially in the more active young patients, who will require the implant to last longer and offer greater mobility, unlike in older ones. The idea then is to implant an artificial joint with maximum longevity and minimum damage to the human bone and tissue, he explained.

The ‘silent hip,’ a refinement of the pre-existing thrust plate, currently costs Rs.1 lakh and is made of titanium coupled with a delta ceramic bearing that seems to have worked well on the patients on whom it has been used so far, globally. “Usually in joint replacements, the implant produces a reaction in the natural bone and this is called stress shielding. It likely occurs in the first 18 months,” Dr. Prithvi said. It causes discomfort to the patient, stiffness and affects the elasticity of the natural structure.

In the ‘silent hip’ procedure, effort is taken to conserve as much bone as possible. Also scientific studies, which measure this reaction, have shown that no stress shielding occurs in the first 18 months when it is most likely. The patient can begin to walk an hour after surgery, climb stairs in 48 hours and, in three to five days, go home. Complete normal activity will be restored in four weeks.