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

3. Cruciate Ligaments

4. Anatomy of knee joint

5. Anatomy of knee joint

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

7. 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

9. OA AND RA CULPRIT STRUCTURES

10. PAINFUL KNEES FACTS & MYTHS

11. DOES EVERYBODY GET ARTHRITIS OF KNEES?

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

15. WHAT ARE THE TREATMENT OPTIONS?
PAINKILLERS
PYSIOTHERAPY
SURGERY

16. MOST PATIENTS ARE SCARED OF HOSPITALS AND DOCTORS

17. SUPERSTITIOUS - SEMI INFORMED SUSPICIOUS

18. 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,
Source: , 2003 18

19. Arthroscopic view

21. p)

25. 25

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

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

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

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

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

36. MYTH 1 .

38. MYTH 2 .

40. MYTH 3 .

41. I am too old !!
Who said that ??

42. MYTH 4 .

44. May be better than nothing

45. MYTH 5 .

47. Am I slim enough to get TKR

48. 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”

49. MYTH 6 .

51. -> WHY ??

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

53. . 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 …...

54. 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?

55. What is CAS?

58. 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

67. THANK YOU