Femoral Anatomy The largest and most complicated joint in the body Consists of three joints medial & lateral tibio-femoral joints patello-femoral joint

Cruciate Ligaments

Anatomy of knee joint

Anatomy of knee joint

Knee Pain – Common Causes Young Sports injuries Meniscal injuries Cruciate lig injuries Chondromalacia After Accidents Old Osteoarthritis Rheumatoid arthritis infection

Risk Factors for OA Systemic Risk Factors Age Joint trauma Joint Biomechanical Risk Factors Age 10-fold increase from 3065 Genetics (generalized) Gender Men <50: higher risk Women >50: higher risk Nutritional Low vitamin C and D intake Joint trauma Obesity (knee, hip, hand) Occupation Abnormal joint biomechanics Dysplasia, malalignment, instability, abnormal innervation Knee extensor weakness Sports injury risk

OA AND RA CULPRIT STRUCTURES

PAINFUL KNEES FACTS & MYTHS

DOES EVERYBODY GET ARTHRITIS OF KNEES?

WHAT ARE THE SYMPTOMS? PAIN MORNING STIFFNESS SWELLING CREAKING SOUNDS DIFFICULTY IN SQUATTING DIFFICULTY IN STAIRS

WHAT ARE THE TREATMENT OPTIONS? PAINKILLERS PYSIOTHERAPY SURGERY

MOST PATIENTS ARE SCARED OF HOSPITALS AND DOCTORS

SUPERSTITIOUS - SEMI INFORMED SUSPICIOUS

Knee Surgical Treatment Options Arthroscopy Synovectomy Tibial osteotomy Total knee replacement Uni-compartmental replacement Source “Arthritis and Your Joints: Knee ”. DePuy Orthopaedics, Inc. 2 April, 2003. http://www.allaboutarthritis.com Source: www.AllAboutArthritis.com , 2003 18

Arthroscopic view

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ONCE OPERATED HE IS NO MORE A PATIENT “ HE IS NOW IMPATIENT”

NO, BUT WE CAN DELAY OR SLOW DOWN THE PROCESS CAN WE PREVENT OA? NO, BUT WE CAN DELAY OR SLOW DOWN THE PROCESS

WHAT SHOULD I DO? KEEP FIT KEEP YOUR WEIGHT DOWN NO SQUATTING MINIMIZE STAIRS

WHAT EXERCISE IS GOOD? IS CYCLING / TREADMILL GOOD? ANY DIET RESTRICTIONS?

WHAT ABOUT INJECTIONS INTO THE JOINTS? WHAT IS THIS KEY HOLE SURGERY? IS THERE ANY BENEFIT WITH OTHER FORMS LIKE HOMEOPATHY, AYURVEDA ETC.

MYTH 1 .

MYTH 2 .

MYTH 3 .

I am too old !! Who said that ??

MYTH 4 .

May be better than nothing

MYTH 5 .

Am I slim enough to get TKR

PHYSIOTHERAPIST SHOULD BE PHYSIO -TERRORIST I ALWAYS TELL THE PATIENT, “I HAVE GIVEN YOU A NEW MOTOR -YOU SHOULD GET THE PETROL FROM YOUR MUSCLES”

MYTH 6 .

-> WHY ??

GROSS DEFORMITY Rehabilitation is not possible unless both knees are operated simultaneously. Bilateral TKR …...

. Rehabilitation quick since equal weight is placed on both knees. Cost reduction by 30% as compared to staged procedure. No evidence of statistically significant increased complications as compared to staged procedure. Bilateral TKR …...

HOW MANY DAYS I SHOULD STAY IN HOSPITAL? HOW MANY DAYS THE OPERATION HOLDS GOOD? WHAT ABOUT MR. RAO WHO NEVER WALKED AFTER THE OPERATION?

What is CAS?

Addressing the Need The benefits of a properly positioned and aligned implant are well known. iASSIST Knee is a personalized guidance system that helps to achieve these goals without any of the shortcoming of previous Navigation Systems Intra-operative Feedback Alignment Validation Simple & Easy to use Repeatable Outcomes No Computer Screen to Look at No line of sight issue No bulky System Surgeon No Capital Investment No pre-operative imaging Draws patient Interest No additional incision No additional Pins

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