Strength - Mobility - Function

360° Diagnostics

Dedicated to providing multidisciplinary medical care and backed by state-of-the-art facilities

Orthopaedics & Joint Replacements

SCOTS is the specialized Centre of Orthopaedics and Trauma Services of STAR Hospitals, providing end-to-end service and management of all kinds of bone and joint problems. The Centre provides expert and personalized surgical approach to the bone and joint problems that threaten the comfort and function of many patients on a daily basis. The surgeons of the Centre combine decades of experience, and their own cutting-edge research to optimize the approach to the vast range of conditions that can be effectively managed by arthroscopic surgery, foot and ankle surgery, hand and wrist surgery, hip and knee reconstruction, Paediatric orthopaedic surgery, shoulder and elbow surgery, orthopaedic trauma surgery, as well as tumour surgery and post-surgical reconstruction. With this sole goal in mind, to be the best in individual care, our Centre has incorporated the latest technology with highly qualified professionals. We have come a long way from general Orthopaedics, and are now in the era of super-speciality services. Consistently recognized as one of the leaders in providing orthopaedic services in the region, STAR Hospitals offer a wide range of speciality services, uses state-of-the-art surgical techniques, and conducts vital research in the areas of bone, muscle, and joint disorders. Our services include:

  • Arthritis
  • Foot and ankle
  • General orthopaedics
  • Hand and upper extremity
  • Joint replacement of Hip & knee
  • Limb lengthening and reconstruction
  • Musculoskeletal oncology
  • Orthopaedic trauma
  • Paediatric orthopaedics
  • Sports medicine

Our nationally recognized orthopaedic surgery department focuses on the prevention, diagnosis, and treatment of musculoskeletal injuries for both adults and children. Thousands of patients turn to us each year for high-quality, comprehensive care and innovative services.

Alternative materials to metal and plastic, namely ceramic-on-ceramic, and ceramic-on-cross linked polyethylene; they come with their own unique advantages. This will be explained by your orthopedic surgeon.

The procedure

The total hip replacement is performed in a highly sterile operating room with a special laminar airflow system, which helps reduce the chance of infection. The surgery is performed post administration of an epidural anesthesia. The incision measuring 4-10 inches for a total hip replacement surgery is made along the side of your hip. The incision will measure anywhere from 4 to 10 inches, depending upon your anatomy.

The arthritic ball and socket are then exposed and the bone is prepared to receive the artificial hip joint, and then the prosthesis is inserted. During closure two drains may be inserted around the operated area to assist for blood evacuation. Combinations of staples and/or sutures are used to close up. The entire operation will take from 1 to 2 hours; post which there is recovery and follow treatment given.

Risks of having a prosthetic hip-

There may be loss of blood, formation of a clot in your leg, and some chances of infection. The overall incidences of these risks are extremely small. They should be discussed with your Hip replacement surgeon prior to proceeding with the surgery. Some others are- 1. Ball dislocation (come out of the socket) 2. Wear and tear of parts used. 3. Infection of prosthesis. Again, these issues will be discussed with you by your orthopedic surgeon.

Longevity A total hip replacement depends upon a variety of factors, including: 1. Patient weight 2. Patient activity 3. The mechanical properties of the prosthesis used.

Pre-Operative Orientation

Some patients will be asked to donate a pint of their own blood in the weeks preceding their hip replacement surgery. This addresses the need of blood transfusion during the surgery. Almost all of the patients will receive this donated blood as a transfusion post surgery. A thorough medical examination is conducted as a precaution to make certain that you are healthy enough to undergo hip replacement surgery.Additional testing to examine your heart and lung function is carried out.

Post-Operative Course

After spending time in the recovery room; most patients are able to go to a regular room after a few hours, till when the sensation returns in your legs. A pain pump is connected to the epidural catheter which will allow you to control pain medicine. Most people are quite comfortable with the pain pump in place. The first day after surgery will be active and designed to help you get more mobile. Physiotherapists instruct you in more exercises to perform while in bed and then proceed to help you stand and take a few steps with a walker. Depending upon your age and other factors a short-term placement in a rehabilitation facility may be suggested. Otherwise, you will be discharged home with rigorous physio-therapy in place.

Your return to activity will be accordingly be guided by your surgeon and therapists subsequently.

Your knee joint is simply the hinge between two bones, the thigh bone (femur) and the shin bone (tibia) whose ends are covered with a thick cushion of soft, white cartilage. Due to wear and tear age or other factors this cartilage begins to wear away and thus the underlying bones rub together causing extreme pain and inflammation. While most arthritic knees are due to degenerative arthritis or osteoarthritis, there are other conditions such as rheumatoid arthritis, trauma, prior surgeries or complications, tumours etc.The pain progresses causing swelling instable stride and also deformity at a later stage.

In total knee replacement surgery, the surface of the joint is replaced with that of a metal or a plastic surface which can function similar to a normal joint. Most of the supporting ligaments, tendons and muscles around the knee joint are retained. Thus the new joint’s surface mimics that of the natural knee replaced.

Total knee replacement is recommended for patients with arthritis who have severe pain and limited function which significantly affects quality of life. The most common reason to have a total knee replacement is to relieve arthritic pain. The pain may not be excruciating at any particular time, but it is often chronic and disabling. Everyone’s pain is different, and the degree of pain sufficient to justify surgery should be decided by the patient and the doctor together.

Painful and arthritic knees can become unstable, causing falls and other injuries. Climbing stairs, getting up from chairs and extended walking can also be difficult. While most arthritic knees are the result of degenerative arthritis or osteoarthritis, other conditions such as rheumatoid arthritis, trauma, prior surgeries, instability and tumours can also be relieved by total knee replacement.

Long-Term Prognosis of this type of a surgery- Most usually it depends on one individual to another; however with newer materials and techniques, the lifespan of knee replacements continue to rise.

Minimally invasive total knee Arthroplasty (MIS) simply uses a smaller incision (3 to 4 inches) as against the former which requires a large incision (8 to 12 inches) and also causes significant disruption of the muscles and tendons. Through that same small incision, the diseased surfaces of the knee joint checked and replaced, one at a time, with the required artificial joint components. This new technique is also called quadriceps-sparing knee replacement.

MIS Knee Joint Replacement is considered a giant step forward because it requires shorter hospital stay, ensures faster recovery, less pain and much less scarring.

Potential benefits-

  • More rapid return of knee function because the quadriceps muscle and tendon are not divided in the course of the surgical exposure like in traditional knee replacement, and the kneecap is not averted (flipped out of the way) with the other form of surgery.
  • Smaller incision or opening during the procedure.
  • Decreased post-operative pain and faster rehabilitation as the incision stays out of the important quadriceps muscle/tendon group.
  • Reliable implants used as those in the traditional knee replacement surgery.

High flexion knee replacement surgery-

Flexion is the action of bending a joint, such as your knee or elbow and extension is straightening of a joint. Generally, traditional knee replacements accommodate flexion up to 110 degrees but not allow the patients to squat or kneeling down which require higher flexion.

High flexion knee replacement surgery is a breakthrough where in complete flexion up to almost 155 degrees can be achieved. While fixed bearing conventional knee provides 110 degrees of flexion; rotating platform knee is specially designed to safely accommodate up to 155 degrees of flexion for those who have a good pre-operative range of motion. With proper rehabilitation a patient can resume a completely active life style after total knee replacement including prolonged kneeling, squatting as well as cross legged sitting.

Arthritis of knee is the world’s leading cause of disability. Arthritis causes pain, swelling, inability to walk, reduced bending of knee, inability to sit cross legged, deformity and so on.

Conventional total knee replacement is a well-known treatment for advanced knee arthritis. Knee replacement surgery provides excellent results to the patient, relieving him from pain. The surgery also improves walking ability and allows pain-free knee bending. Most importantly, it improves the quality of life of the patients.

Flexion is the action of bending a joint, such as your knee or elbow. The opposite motion is extension, which is the straightening of a joint. Generally, traditional knee replacements accommodate flexion up to 110 degrees and have not been designed to allow the patients to squat and kneel which require higher flexion. Many daily activities require a higher range of motion: Gardening, golfing or activities such as kneeling for prayer and sitting cross legged can demand up to 130-150 degrees of bending.

Recent innovation of knee design (High Flexion Rotating Platform Knees) is a breakthrough where complete flexion upto 155 degrees could be achieved. Desire for high flexion may be dictated by patient’s favourite activities or cultural background. Many daily activities require the ability to flex the knee beyond 120 degrees.

Complete knee bending is a pre- requisite for the patients of Asia, Japan and more so in Indian continent. This will raise high level of confidence in patients to get surgery done as they will also get good flexion. So patients today should not hesitate to get knee replacement done due to reduced knee bending after knee replacement.

The knee of a woman is not simply a smaller version of a Man’s knee. There are differences involve the bones, ligaments and tendons in the joints therefore merely a different size for women doesn’t resolve differences. There is proof that the shape of women’s knees typically fall into different ranges than men’s therefore making these differences significant.

Anterior knee pain in some female patients was a matter of concern and a cause of concern before when women specific knees were not prevalent. With the advent of specific knees designed for female bones the comfort factor was remarkable and their ability and ease to sit & climb increased significantly.

I-ASSIST is basically a computer assisted stereotaxic surgical instrument system used to help the surgeon in such gross deformities in positioning the implant system components intra operatively. This improves accuracy reduces complications and allows surgeon to focus in correcting deformities in the patient. It consists of an i-pad like computer which aids in accurate bone cuts and place the implants in desired position.

I-ASSIST is computer assisted stereotaxic surgical instrument system to assist the surgeon in such gross deformities in positioning the implant system components intra operatively.

This computer Aided Surgery I-ASSIST has multiple advantages improves accuracy reduces complications and allows surgeon to focus in correcting deformities and on the patient. It comprises of one i-pad like computer which guides accurate bone cuts and place the implants in desired position.

This innovation in knee replacement surgery is called patient matched instrumentation. Using this approach a CT scan and an X-ray of the patient scheduled to undergo the surgery is first taken. This is then sent it to the knee implant company abroad and an artificial model of the bones is created from this data. Based on this data cutting blocks are cut the required bone to get the alignment right and these blocks are shipped in a sterile container. During the surgery a single customized block is used to cut the patient’s bone which saves the routine 6 blocks usually used. The surgery thus lasts only for a short period, less painful and faster recovery.

The joint replacement services at STAR Hospitals include:

Lower Leg, Ankle, and Foot: Shoulder Arm, Elbow, Wrist, and Hand
Achilles Tendinitis Biceps Rupture Carpal Tunnel
Ankle Fracture Biceps Tendinitis Colles Fracture
Ankle Sprain Dislocated Shoulder Dislocated Elbow
Calf Strain Frozen Shoulder Elbow Bursitis
Femur Fracture Rotator Cuff Tears Elbow Fracture
Foot Fracture Proximal Humerus Fracture Finger Sprain & Metacarpal Fractures
Plantar Fasciitis Shoulder Impingement Forearm Fracture
Shin Splints Shoulder Sprain Fractured Clavicle
Toe Fractures   Golfer’s Elbow
Toe Sprain   Tennis Elbow
Back, Head, and Neck Knee Thumb Sprain
Cervical Lumbar Spondylosis Knee Sprains Wrist Fracture
Concussions Kneecap Bursitis Wrist Sprain
Facial Fracture Meniscus tear  
Fractured Clavicle  Patellar Tendinitis  
Nose Fractures  Posterior Cruciate Ligament(PCL) Injuries  
Anterior Cruciate Ligament (ACL) Injuries  

Dr. Neelam V Ramana Reddy

Consultant Orthopaedician & Joint Replacement Surgeon

Dr. Rajesh Podili

Consultant Trauma & Joint Replacement