1. FUNCTIONAL OUTCOME OF TOTAL KNEE REPLACEMENT USING INDUS PROSTHESIS Dr. L.k.lelei Specialist orthopedic surgeon Moi university, school of medicine

2.  Osteoarthritis is a primary source of disability and the knee joint is commonly affected.  Total knee arthroplasty (TKA) is the most frequently performed joint replacement surgery.  Its one of the most successful orthopedic surgeries.  The best results for TKR at 10-15 years compare to or surpass the best result of THR. Introduction

3. I.Increasing age II.Obesity III.Female gender IV.Trauma\infection V.Repetitive occupational trauma The clinical features depends upon stage of involvement: PainStiffness Loss of functionDeformity SwellingCrepitus Risk factors for OA

4.  Non pharmacologic  Pharmacologic  NSAIDs  Glucosamine sulphate  Intra articular corticosteroids  Intra articular hyaluronic acid Surgical interventions: Arthroscopy Osteotomy Total knee replacement Conservative management of knee OA

5.  Regular pain needing constant medication  Deformity of the knee  Flexion contracture > 20 degrees  Severe varus or valgus laxity  Night pain, getting up pain  Altered social or family life due to pain Indications for TKR

6. Technical goals of TKR include:  The restoration of mechanical alignment  Preservation or restoration of the joint line  Ligament balancing  Maintaining or restoring a normal angle. Goals of TKR

7.  Relief pain  Improve joint alignment  Treat joint deformity  Improve knee stability  Regain joint strength  Improve mobility Benefits of total knee replacement

8.  Successful results depends upon: i.Precise surgical technique ii.Sound implant design iii.Appropriate material iv.Patient compliance with rehabilitation The long term survival of total knee replacement equals or surpasses that of THR.

9.  Current knee prosthesis design trends focus on shortening the radii of curvature  The INDUS prosthesis is designed so as to keep the thickness of the posterior condyle equivalent to the thickness of the distal condyle.  INDUS knee also incorporates the bone sparing principle.  Designed to be a high flexion prosthesis. Indus knee implants

10. Indus knee prosthesis

11. Radiological images

14.  Patient-reported measures of functional outcome are used to evaluate outcomes after TKA.  less expensive,  less time intensive and  reduce the number of patients lost at follow-up because they do not require a clinic visit. Functional outcome measures

15.  29 patients were done total knee replacement in the year 2015 using Indus prosthesis.  The main indication for knee replacement was severe osteoarthritis(79%).  There were 19 female and 10 males with a mean age of 58.7 years ( range of 29-81 years)  Follow up of patients done from 3 months to 1 year  Mean knee score was 41 using the oxford knee score. RESULTS

16. Gender distribution

17. Indication for surgery

18. Laterality of surgery

19. Score 0-48 3 months N=29 6 months N=24 12months N=15 0-19000 20-29100 30-391371 40-48151714 Oxford knee scores

20.  Total knee replacement (TKR) surgery is one of the most common and successful surgical interventions.  Provides substantial relief from pain and improvement in functional disability in patients with knee arthritis.  Patient-reported outcome measures provides substantial assessment for the outcome. Discussion

21.  Study demonstrates that the Indus Knee implants enables patients have satisfactory functional outcome after surgery.  Average oxford score at 1 year was 41 which is satisfactory.  Two patients still had some stiffness and 5 other patients reported pain that is relieved by analgesics.  Long term follow up to determine longevity of the implant is recommended. Cont’