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Home/Large Joints and Extremities/Why Surgeons Do What They Do
Large Joints and Extremities

Why Surgeons Do What They Do

July 31, 2012 1 min read Premium comments

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Why Surgeons Do What They Do
Source: Wikimedia Commons and D.T. Fletcher, W.C. Warner, M.D. Neel, T.E. Merchant
Secondary

Why orthopedic surgeons do what they do? Yashodamma, age 37, of Bangalore had suffered from rheumatoid arthritis for 18 years and had been bed ridden, in pain, for the last four years. When she went for consultation at Fortis Hospital in Nagarbhavi, joint replacement surgeon Alwin Almeida, M.D., suggested she undergo total knee replacement surgery, according to the July 19 press release.

When he examined Yashodamma, Almeida found that she had a badly deformed right knee with 45 degrees of knee bending, 30 degree inward bowing of the leg and extensive bone loss. He explained,

The surgery was technically demanding and needed meticulous planning. The deformity in multiple planes had to be corrected and the loss of bone had to be addressed. The surgery required an extensive release of contracted muscles and soft tissue and clearing up of hardened and deformed bones. The deformities were fully corrected by meticulous surgical correction.

When attendants got Yashodamma on her feet the day after the surgery she was able to put her right foot on the floor for the first time in four years. She said she felt as if God had given her rebirth. “I have not felt this comfortable for over a decade. I feel happy to walk on my own, ” said Yashodamma.

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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