CHENNAI: Sixteen years ago, Luxmi Manohar was diagnosed with having giant cell tumour in her knee which was benign and it was treated with curettage and cementation. It essentially meant that after the tumour was removed, the area with defect was filled with cement that emitted enough heat to destroy tumour cells.
After a successful surgery, Manohar went back to her normal life till two years ago, but was diagnosed with severe arthritis in her knee joints. However, unlike other arthritis cases where the solution would have been a regular knee replacement, the doctors were in a fix as to how to do a knee replacement where there was a cement filling. That was when the doctors at Apollo came up with the idea of a conventional prostheses with navigation assistance.
Dr Nandakumar Sundaram, senior orthopaedic surgeon, Apollo Hospitals, who conducted the surgery, said that usually in such situations, the routine for doctors is ‘tumour prothesis’. However the doctors and patient were not keen on this method.
“This procedure is difficult for the patient as the prosthesis is quite large and this method also risks the chances of the cement loosening, fractures, restricted movement, infection and skin necrosis,” he explained.
Therefore, Sundaram and his team tried to come up with a new method where a regular knee replacement could be done and then they discovered that the ‘navigation machine’ could act as their saviour.
“Besides this tumour prosthesis, the other option is pushing a rod through the bone which is also risky. So we decided to use the navigation machine through which we were able to successfully place the regular knee replacement prosthesis,” he said.
Since the patient has normal prosthesis, they risk no infection and can gain full mobility within a few days. Seven weeks since the surgery, Luxmi Manohar is able to walk and hopes to be fully functional in a few more weeks.
Sundaram said this was the first time such a surgery was taking place, where a regular knee replacement prosthesis with navigation assistance was used sucessfully in case of giant cell tumour distal femur with cementation associated with osteoarthritis. He hopes that more doctors will realise this option and utilise it to benefit their patients to the fullest.
The surgery costs Rs 2 lakh to 2.5 lakh, doctors said but the cost could change according to the type of prosthesis that is needed.