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Dry figs help clear mucus from bronchial tubes and are therefore a valuable food remedy for asthma

Medical Abbreviations Lookup

Type few starting characters to view the expansion for the abbreviations:

Medical Procedures Description

Place the mouse over a procedure name to view the description for that procedure

  • Cardiac
    • Carotid Angiography
      This is an imaging procedure, which involves inserting a catheter into a blood vessel in the arm or leg and guiding it to the carotid arteries with the aid of a special X-ray machine. Contrast dye is injected through the catheter so that X-ray movies of your carotid arteries (the arteries that supply your brain with oxygen-rich blood) can be taken.
    • Coronary Angiography
      Coronary angiography is an X-ray examination of the blood vessels or chambers of the heart. A very small tube (catheter) is inserted into a blood vessel in your groin or arm. The tip of the tube is positioned either in the heart or at the beginning of the arteries supplying the heart, and a special fluid (called a contrast medium or dye) is injected. This fluid is visible by X-ray, and the pictures that are obtained are called angiograms.
      Another name for this test is coronary arteriography.

      More Info
    • Coronary Angioplasty (PTCA or PCI)
      Coronary angioplasty (AN-jee-oh-plas-tee) is a medical procedure used to restore blood flow through a narrowed or blocked artery in the heart. The arteries of the heart (the coronary arteries) can become narrowed and blocked due to buildup of a material called plaque on their inner walls. This narrowing reduces the flow of blood through the artery and can lead, over time, to coronary artery disease and heart attack. In angioplasty, a thin tube with a balloon or other device on the end is first threaded through a blood vessel in the arm or groin (upper thigh) up to the site of a narrowing or blockage in a coronary artery. Once in place, the balloon is then inflated to push the plaque outward against the wall of the artery, widening the artery and restoring the flow of blood through it.

      Other Names for Coronary angioplasty are 1. Percutaneous coronary intervention, 2. Percutaneous transluminal angioplasty 3. Balloon angioplasty,4. Coronary artery angioplasty
      More Info
    • Coronary Artery Bypass Graft (CABG)
      CABG reroutes, or "bypasses," blood around clogged arteries to improve blood flow and oxygen to the heart.
      Why is this surgery done?
      The arteries that bring blood to the heart muscle (coronary arteries) can become clogged by plaque (a buildup of fat, cholesterol and other substances). This can slow or stop blood flow through the heart's blood vessels, leading to chest pain or a heart attack. Increasing blood flow to the heart muscle can relieve chest pain and reduce the risk of heart attack.
      How is coronary bypass done?
      Surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked part of the coronary artery.
    • Implantable Cardioverter and Defibrillator (ICD)
      An implantable cardioverter defibrillator is used in patients at risk for recurrent, sustained ventricular tachycardia or fibrillation.

      The device is connected to leads positioned inside the heart or on its surface. These leads are used to deliver electrical shocks, sense the cardiac rhythm and sometimes pace the heart, as needed. The various leads are tunnelled to a pulse generator, which is implanted in a pouch beneath the skin of the chest or abdomen. These generators are typically a little larger than a wallet and have electronics that automatically monitor and treat heart rhythms recognized as abnormal. Newer devices are smaller and have simpler lead systems. They can be installed through blood vessels, eliminating the need for open chest surgery.

      When an implantable cardioverter defibrillator detects ventricular tachycardia or fibrillation, it shocks the heart to restore the normal rhythm. New devices also provide overdrive pacing to electrically convert a sustained ventricular tachycardia, and "backup" pacing if bradycardia occurs. They also offer a host of other sophisticated functions (such as storage of detected arrhythmic events and the ability to do "noninvasive" electrophysiologic testing).

      Implantable cardioverter defibrillators have been very useful in preventing sudden death in patients with known, sustained ventricular tachycardia or fibrillation. Studies are now being done to find out how best to use them and whether they may have a role in preventing cardiac arrest in high-risk patients who haven't had, but are at risk for, life-threatening ventricular arrhythmias.

      According to the American Heart Association Heart and Stroke Statistical Update, in 1998 (the most recent statistics available) there were 26,000 ICD procedures.

      Source:American Heart Association
    • Pacemaker
      Pacemakers are battery-powered implantable devices that function to electrically stimulate the heart to contract and thus to pump blood throughout the body. Pacemakers consist of a pager-sized housing device which contains a battery and the electronic circuitry that runs the pacemaker, and one or two long thin wires that travel through a vein in the chest to the heart. Pacemakers are usually implanted in patients in whom the heart's own "spark plug" or electrical system is no longer functioning normally.
    • Paediatric Cardiac Surgery
      Children aren't simply miniature people who suffer the same diseases adults do, but on a smaller scale. Rather, they have their own specific afflictions and abnormalities. Diagnosing and treating children's heart diseases requires specialized knowledge and a dedicated approach to care.

      Source: Standford school of medicine
    • Valve Replacement - single valve
    • Valvuloplasty
      Valvuloplasty is used to widen a stiff or narrowed heart valve (stenotic heart valve). A catheter is guided through the heart and positioned through the diseased heart valve. Balloons on the catheter are inflated, enlarging the opening through the valve and improving blood flow through the heart and to the rest of the body. This allows the heart to pump more effectively, reduces pressures in the heart and lungs, and reduces symptoms.
  • Dental
    • Oncology
      • Opthalmology
        • Orthopaedic
        • Spinal Surgery
          • Artificial Disc Implantation
            Artificial Disc Replacement a New Alternative to Spinal Fusion Surgery
            About 80% of people have back or neck pain at some point in their lives, and it is second only to cold and flu in the number of doctor's visits it prompts. Fortunately, most of the pain takes care of itself, along with a little help from pain killers. But for some, the pain only gets worse - so bad, in fact, that performing even simple household chores becomes almost impossible. An emerging type of spinal surgery, called total disc replacement promises new hope for some of these sufferers.
            More Info
        • Gastroenterology
          • Colonoscopy
            Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy of suspected lesions.
        • General Surgery
          • Obesity
            • Wellness
              • Diagnostics
                • Cosmetic
                  • Blepharoplasty (Eyelid surgery)
                    Blepharoplasty (Eyelid surgery) is a procedure to remove fat along with excess skin and muscle from the upper and lower eyelids. Eyelid surgery can correct drooping upper lids and puffy bags below your eyes.
                  • Breast Augmentation (Mammoplasty - Augmentation)
                    Breast augmentation (augmentation mammoplasty) is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons.
                  • Breast Lift (Mastopexy)
                    Breastlift (mastopexy) is a surgical procedure to raise and reshape sagging breasts. Mastopexy can also reduce the size of the areola, the darker skin surrounding the nipple.
                  • Collagen Injection
                    Collagen is a natural protein found in humans and animals. The most abundant protein in the body, it provides structural support for bones, tendons and ligaments. Plus, it gives texture and shape to our skin. As we get older, the collagen in our bodies that plumps up our skin and keeps us looking youthful begins to break down and we lose it. This leads to the appearance of aging features like fine lines and wrinkles.

                    Collagen injections are a non-surgical procedure that provides a temporary solution to people wanting to achieve a smoother, more youthful look, with a minimal amount of pain. Plus, patients do not lose time from their daily activities because there is no recovery time; collagen injections can be performed during a lunchtime period. By injecting highly purified bovine collagen into various facial areas, natural collagen is replenished and helps improve upon various signs of aging including facial lines and wrinkles.
                  • Face Lift (Rhytidectomy)
                    Facelift cosmetic surgery (rhytidectomy) is a procedure that treats severe wrinkles to restore a more youthful appearance.
                  • Liposuction (Lipoplasty)
                    Liposuction vacuums fatty deposits from under the skin through a long hollow needle called a cannula. It can be applied to many areas of the body, typically the abdomen, thighs, arms, neck, and certain areas of the face. Liposuction is sometimes referred to as lipoplasty, liposculpture, and suction-assisted lipectomy
                  • Nose Surgery (Rhinoplasty)
                    Rhinoplasty is a nose-reshaping surgery that can correct deformities or make subtle aesthetic changes for cosmetic purposes.It can be performed under local anesthesia (you are awake) or under general anesthesia (you are asleep). Cosmetic nose surgery is often performed in a doctor's outpatient surgical suite. Rhinoplasty normally requires an hour or two in surgery, depending on the amount of nose reshaping to be done.
                  • Tummy Tuck (Abdominoplasty)
                    Tummy tuck (abdominoplasty) is a cosmetic plastic surgery that tightens abdominal muscles and gets rid of excess fat and skin.
                • Vascular System
                  • ENT
                    • Urology

                      Health Tips

                      Eat Smart

                      By Ms Melissa Aiyathurai-Johnston
                      Dietitian, Raffles Hospital

                      Food, food, glorious food! Food makes up a big part of our life. Besides providing nutritional benefits, food is also a source of enjoyment, an adventure and it tastes great!

                      Despite huge and beneficial gains in knowledge about nutrition over recent years, healthy eating has become harder because of the way we live and eat today. There is less reliance on home cooked meals and if we are not mindful, our meals may not be necessarily healthy. They may not be complete (e.g. not being served with enough vegetables) or the portion sizes may be too large.

                      In addition, the modern diet is usually overloaded with calories for energy compared to the amount we expend, has too much fat (especially saturated fat), sugar and salt and lacking in fruits, vegetables, fibre and dairy products.

                      This state of "over nutrition" has seen an alarming rise in the incidence of chronic lifestyle diseases. Today 1 out of 3 Singaporeans are overweight or obese which sets the scene for other conditions such as diabetes and heart disease. Excessive fat or salt and the lack of fibre have also been linked with an increase risk of certain cancers (e.g. breast, bowel, stomach), diabetes, stroke, hypertension and osteoporosis to name a few.

                      There is no secret to healthy eating. You just need to "eat smart"!

                      Enjoy a wide variety of foods
                      Add the grains and legumes
                      Trim the fat

                      Shake the habit - reduce your salt intake
                      Munch those fruits and vegetables
                      Alcohol - enjoy in moderation
                      Reduce your sugar intake
                      Track your weight

                      Enjoy a wide variety of foods
                      Variety is the spice of life! Everyday your body needs nutrients and other healthful substances (such as antioxidants) that only a wide variety of foods can provide. Most foods and beverages are made up of more than one nutrient, however no one food or food category has them all.

                      Add grains and legumes
                      These low fat foods should make up a large proportion of your meals. This group including bread, cereals, rice, pasta and other foods made from grains provides you with carbohydrate (your body's fuel), B vitamins, fibre and a number of minerals. Legumes (e.g. peas, beans and lentils) provide you with good amounts of protein (important for vegetarians), B vitamins and fibre.

                      Having more soluble fibre in your diet, such as the type found in legumes will help to lower your cholesterol. The slow digesting carbohydrate they contain will also help those trying to control their weight or diabetics with their blood sugar control.

                      Trim the fat
                      Reducing your fat intake will lower your risk of becoming overweight which reduces your chance of certain conditions such as diabetes, heart disease, hypertension and certain cancers. Reducing your saturated fat intake will also go a long way to help keep your cholesterol in check.

                      Removing the skin from poultry and limit your intake of fatty meat such as pork belly, luncheon meat. When dining away from home choose more soup based dishes which are low in fat and limit those dishes made with coconut milk.

                      Shake the habit - reduce your salt intake
                      Too much salt has been linked to the development of high blood pressure or hypertension. The average diet contains more sodium then actually required.

                      One way to reduce your sodium intake is by tasting your food before adding salt. Also limit or avoid high sodium condiments such as soy sauce, oyster sauce, tomato ketchup. Opt for herbs, spices, chili or lime juice to add flavour instead.

                      Munch those fruit and vegetables
                      Besides being an excellent source of fibre, this low calorie, nutrient dense group provides you with essential vitamins and minerals, antioxidants, and phytochemicals that may not be present in other groups of food. Studies have shown that those people with a high intake of fruits and vegetables have a low rate of heart disease and cancer. Aim for 2 servings of fruit and vegetables daily.

                      Alcohol - enjoy in moderation
                      A moderate to heavy intake of alcohol has been associated with high blood pressure and certain cancers. An excessive intake can also lead to weight gain as gram for gram alcohol has almost twice the calories of carbohydrate or protein.

                      A safe intake would be no more than 2 standard drinks a day for women and no more than 4 for men with 2 alcohol free days per week.

                      Reduce the sugar intake
                      Food high in sugar tend to be "empty calories" as they have no essential fibre, vitamins or minerals and can sometimes displace more nutritious food. Most foods high in sugar also tend to also be high in fat, which if taken in excess can lead to weight gain. It is best to enjoy these foods in moderation.

                      Track your weight
                      A balance between the right food and regular exercise will ensure that your weight is healthy. Choosing low fat meals with ample carbohydrates, vegetables, fruit and protein will help you lose excessive weight, if you need to and help you to stay slim if you do not.

                      Be careful of fad diets or diets that offer fast weight loss as they more often do not change your eating habits and are nutritionally unbalanced. Once you go off them, the weight tends to come back straight away.

                      Gum diseases (Source: Raffles Hospital)

                      Gum disease is caused by the formation of a sticky colourless film of bacteria called plaque. The earliest stage of gum disease, gingivitis causes the swelling of gums when plaque collects above and below the gum-line. Gingivitis subsequently leads to a more severe form/stage called periodontitis if left untreated. Periodontitis damages the bone that supports the teeth. Once periodontitis develops, the damage is irreversible.

                      1. How can I tell if I have gum disease?


                      2. You may have gum disease if you notice the following:

                        • Your gums are tender and swollen
                        • Constant bad breath or bad taste in your mouth
                        • Notice that there is pus from your gumline or between your teeth
                        • Your teeth are loose and separating
                        • Dentures no longer fit together correctly


                      3. What should I do if I think I have gum disease?

                        • Visit a dentist right away for a cleaning and exam.
                        • Cleaning your teeth properly everyday and making regular dental visits.
                        • Cleaning your teeth is a two-step process that involves brushing followed by cleaning in between your teeth-areas here your toothbrush cannot reach.


                      4. Frequently Asked Questions

                        1. Is flossing the only product available for cleaning in between my teeth?


                          • In addition to floss, there are other products designed to perform the same function. For example, Interdental brushes, Interdental woodsticks and irrigation devices.

                        2. My gums tend to bleed when I floss; is this common?


                          • It is quite common for gums to bleed at first. The bleeding should stop after a few days of flossing as you gums become healthier.

                        3. I've never tried flossing-cleaning in between my teeth before; is it too late to start now?


                          • Absolutely no. Regardless of your age, interdental cleaning provides you with major benefits allowing you to take better care of your teeth and gums.

                        4. What else can flossing do for me?


                          • Flossing plays a role in preventing tooth decay from developing in between your teeth apart from keeping your gums healthy.



                      Photoaging (Source: Raffles Hospital)

                      Do You Know About Photoaging?

                      Skin aging becomes a prominent issue as the "baby boomers" and "late baby boomers" enter their 50s and 40s respectively. Everybody desires not only to look younger, but young too. Thus new anti-aging products and devices appear overnight in this multi-billion dollar industry. The barrage of information that comes through the media and Internet often misleads rather than educate the public. It is important therefore to know what works and what does not.

                      What is photoaging?
                      Skin aging has two components: intrinsic aging and photoaging. Intrinsic aging of skin occurs as a natural part of the aging process. However photoaging occurs as a result of ultraviolet light from sun exposure. Signs of photoaging including wrinkling, sagging, roughness, loss of luster, and age spots. Excesive exposure to the sun can also cause precancerous lesions such as solar keratosis, and cancerous lesions such as squamous cell carcinoma and melanoma.

                      Can photoaging be avoided?
                      Firstly, sunscreen should be started right away. Most people deny that they are sun-exposed and think that they are spread. A walk in the park during the day, hanging out the clothes, working by an unshielded window or a long car-ride are examples of activities that are easily overlooked. Some practical advice with regards to sun protection include the following:

                      • Stay out of the sun between 9 am and 4 pm as much as possible.
                      • Adequate covering for the arms and legs when outdoor, and a wide-brimmed hat for the face and scalp.
                      • Daily use of an appropriate sunscreen with a SPF of 20 or more.

                      These are various treatments available for photoaging.

                      1. Sunscreen
                      2. Moisturiser
                      3. Tretinoin Cream
                      4. AHA (Alpha-hydroxy acids) cream
                      5. Antioxidants
                      6. Chemical peel
                      7. Soft tissue augmentation
                      8. Botox injection
                      9. Dermabrasion
                      10. Laser resurfacing
                      11. Non-invasive method

                      Preventing a Heart Attack (Source: Raffles Hospital)

                      Heart attacks come without warning and strike with deadly force. Whilst the spectrum of treatment modalities has improved over the years, they can sometimes be available too late. Prevention is the greatest cure for heart attacks and you should start today.

                      1. Be mindful of your diet and your weight

                      2. Watch what you eat. You should cut down on the fatty, cholesterol enriched foods and sugar. Eat balanced meals with lots of fruit and vegetables. Drink water instead of sugared drinks. Start on an exercise routine that is easy to maintain. Control your weight through proper nutrition and exercise. Spare your heart the extra load.

                      3. Don't smoke.

                      4. If you are a non-smoker, don't start. If you are a smoker, try to kick this habit. You will do better without it.

                      5. Be more active

                      6. Put more zest into your life and more spring into your steps. Walk more. Use the stairs instead of taking the lifts. Try going to work on public transport and walking instead of driving once in a while.

                      7. Manage your stress; don't let stress manage you

                      8. There are many ways to cope with stress in your life. Learn to manage your time more efficiently and take control of stress instead of letting stress take control of you.

                      9. Keep blood pressure, blood cholesterol and diabetes under control

                      10. If you are already suffering from hypertension, high cholesterol or diabetes, follow the advice of your doctors and take your medications as prescribed. Go for your regular check-ups and follow your doctor's recommendations faithfully.

                      11. Check Early to Save Your Life


                        • Don't put yourself at unnecessary risks. The following tests are conditions that are risk factors for coronary heart disease. You should consider doing these tests on a regular basis. They are simple to do and may save your life.
                        • Have your blood pressure checked by your doctor at least once a year.
                        • Do a blood cholesterol test at least once in every 5 years, or more frequently if you have a high cholesterol level. Review the results with your doctor and listen to his advice.
                        • Have your blood glucose checked at least once a year for diabetes. Diabetes can also be screened for by doing a simple urine dipstick test.
                        • If you are particularly at risk of coronary heart disease, you should follow-up with your doctor regularly. Your doctor may advise you to do an ECG (electro-cardiogram) to assess the status of your heart. In some instances, you may need to do an exercise treadmill test to determine the fitness of your cardio-respiratory system.

                      Remember, early detection of heart disease allows for early treatment, and early treatment could well prolong your life.

                      Camera in a capsule (Capsule Endoscopy)

                      Painless and easy screening of the small intestine now at Raffles Hospital.
                      Although small intestinal diseases are uncommon, 10% of patients who often have diarrhoea, abdominal pain, obscure gastrointestinal tract blood loss with anaemia, persistent fever of unknown origin and weight loss, have small intestinal problems.

                      Now a small capsule sized camera can help the doctor to examine the small intestine for possible small intestinal diseases.

                      The vitamin-pill size video capsule comes with its own camera lens and light source. it is used a an endoscope to capture images of the entire small intestine. After the patient has ingested the video capsule, it will obtain images as it travels through the gastrointestinal tract (GIT). Images are sent to a data recorder that the patient wears on a waist-belt. After 8 hours, the image will be downloaded and viewed on a video monitor by the doctor to detect small intestinal lesions.
                      Capsule Endoscopy is a recent medical breakthrough that enables accurate diagnosis of small intestinal diseases in a non-invasive way. The availability of this cutting edge technology has improved the diagnosis and management of the patients with small intestinal diseases.

                      Looking for FREE cost estimate? Register here.

                      Cataract



                      What is a Cataract?
                      We must understand that "we see with our brain not with our eye". Light focused by the cornea, it passes throught the pupil throught a lens. Focusing onto the retina (light sensitive film) When normally clear lens become cloudy. It is called "Cataract". A cloudy lens inhibits light rays from reaching the Retina, Results in hazy or blurred vision.

                      What caused Cataracts?
                      Most common type of Cataract is related to aging of the eye in older adults. Cataract may develop from birth, may be inherited, viral infection (German Measles), eye injury or inflammation, long term steroid in take:
                      • Long-term, unprotected exposure to sunlight
                      • Previous eye surgery

                      • How is a cataract detected?

                        A thorough eye examination by your ophthalmologist ( medical eye doctor) can detect the presence and extent of a cataract, as well as any other consitions that may be causing blurred vision or discomfort. There may be other reasons for visual loss in addition to the cataract, particularly problems involving the retina or optic nerve. If these problems are present, perfect vision may not return after cataract removal.

                        If such conditions are severe, removal of the cataract may not result in any improvement in vision. Your ophthalmologist can tell you how much visual improvement is likely.


                        Common Symptoms of Cataract
                        • A painless blurring of vision
                        • Poor vision in bright light
                        • Better vision in dim light
                        • Fading or yellowing of colors

                        How is cataract treated?
                        Surgery is the only way your ophthalmologist can remove the cataract. However, it symptoms from a cataract are mild, a change of glasses may be all that is needed for you to function confortably. Children or adult Cataracts those only partially clouded lens may not require treatment but should observe periodically.

                        When Cataract surgery should be considered? It is not true that Cataract need to be "Ripe" before they can be removed.

                        When should surgery be done?
                        Cataract surgery should be considered when cataract cause enough loss of vision to interfere with daily activities. When a cataract forms, the lens of the eye become thick and cloudy. Light cannot pass through it easily, and vision is blurred. Cataract surgery can be performed when your visual needs require it. You must decide whether you can do your job and drive safely, can you read and watch TV in comfort? Can you perform daily tasks, such as cooking, shopping, yard work, taking medications without difficulty? Based on your symptoms, you and your ophthalmologist should decide together when surgery is appropriate.


                        What can I expect from cataract surgery?
                        Over 1.4 million people have cataract surgery each year in the United States, 95% without complications. Cataracts surgery is a highly successful procedure. Improved vision is the result in over 90% of cases, unless there is a problem with the cornea, retina or optic nerve.
                        Cataract are a common cause of poor vision, particularly for the elderly, but they are treatable. Your ophthalmologist can tell you whether cataract or some other problem is the cause for vision loss or discomfort, and help you decide if cataract surgery is appropriate for you.
                        Click here to get quote for Cataract surgery

                        Source: Bangkok Hospital Medical Center

                      Stages of Prostate Cancer

                      Stage 1 Stage 2
                         
                      • Tumor not detectable by imaging or clinical exam
                      • Low grade tumor
                      • Less than 5% of tissue specimen
                      • Tumor not detectable by imaging or clinical exam. May be found in one or more lobes by needle biopsy.
                      • Moderate to High grade tumor
                      • Over 5% of tissue specimen
                         
                      Stage 3 Stage 4
                         
                      • Tumor extends beyond prostate capsule. Can invade seminal vesicles.
                      • Any grade tumor
                      • Tumor is fixed or invades adjacent structures other than seminal vesicles, such as sphincter, bladder neck, wall of pelvis, and rectum
                      • Tumor spread to lymph nodes or metasteses
                      • Any grade tumor

                      da Vinci Surgical System

                      The da Vinci Surgical System (da Vinci Robotic Surgery System) consists of an ergonomically designed surgeon's console, a patient-side cart with four interactive robotic arms, the high-performance InSite Vision System and proprietary EndoWrist Instruments. Powered by state-of-the-art robotic technology, the surgeon's hand movements are scaled, filtered and seamlessly translated into precise movements of the EndoWrist Instruments.

                      da Vinci Surgical System Video


                      The da Vinci Surgical System is powered by state-of-the-art robotic technology. The System allows your surgeon's hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative site. The magnified, three-dimensional view the surgeon experiences enables him to perform precise surgery in complex procedures through small surgical incisions.
                      The da Vinci System enhances surgical capabilities by enabling the performance of complex surgeries through tiny surgical openings. The System cannot be programmed nor can it make decisions on its own. The da Vinci System requires that every surgical maneuver be performed with direct input from your surgeon.
                      The da Vinci Surgical System has been successfully used in thousands of prostate cancer procedures world-wide.

                      Click here to get quote for robotic prostatectomy

                      da Vinci Robotic Prostatectomy Video

                      For many patients approaching surgery, it is often difficult to visualize what is entailed in a specific surgical procedure. To give prospective da Vinci Prostatectomy patients a better understanding of the advances made by robotically-assisted minimally invasive surgery, we have produced the following video presentation. This video offers a three-dimensional simulation of the male reproductive anatomy, the enabling technologythe da Vinci Surgical System and the procedure itself.

                      Video about davinciProstatectomy


                      Source: BMC, Bangkok

                      About Birmingham Hip Resurfacing

                      What is Hip Resurfacing
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                      What is Hip Resurfacing?



                      Provided by Wockhardt Hospital
                      Brought to you by Healthbase



                      Hip ResurfacingHip Resurfacing or Surface Replacement Arthroplasty is a bone-conserving alternative to conventional Total Hip Replacement (THR). Unlike THR, hip Resurfacing does not involve the removal of the femoral head and neck nor removal of bone from the femur. Rather, the head, neck and femur bone is preserved in an effort to facilitate future surgery should it be necessary and to enable the patient to take advantage of newer technology or treatments in the future. The current generation of hip Resurfacing devices utilize a metal bearings have demonstrated a much higher level of wear resistance as well as reduced bone loss and inflammatory tissue reaction about the hip joint as compared to metal-polyethylene bearings.

                      Hip Resurfacing is anatomically and biomechanically more similar to the natural hip joint resulting in increased stability, flexibility and range of motion. Further, dislocation risk is virtually eliminated. Higher activity levels are typically achieved with less risk. These benefits are realized because the head diameter that results from Resurfacing is very similar to the patient's normal head diameter and these larger head sizes are typically much larger than the femoral balls utilized in conventional THR.

                      Advantages of Hip Resurfacing:

                      1. Allows the patient to squat and sit on the floor safely

                      2. Allows a normal range of movement and sporting activities after operation

                      3. Sacrifices only the diseased bone and preserves normal bone

                      4. Restores the normal structures of the hip

                      5. More natural feel after surgery

                      6. Early rehabilitation

                      7. Easy to revise if needed

                      8. Less risk of dislocation

                      9. No leg length alteration


                      Know the physiology of Human Hip

                      The normal hip joint consists of a ball rotating inside a socket. The ball is called the head of the femur and the socket in the pelvis is called the Acetabulum. The surface of the femoral head and the acetabulum (i.e. the ball and the socket) is covered by a protective layer of cartilage ( the white lining seen in the pic). This makes the joint smooth and reduces friction during movements. It covers and protects the bone like the rubber of a car tyre.

                      Any condition that damages the Cartilage will lead to pain, dysfunction and eventually arthritis. Cartilage can get damaged due to a number of reasons including Injury, Infection, Ankylosing Spondylitis, Avascular Necrosis ( loss of blood supply to bone), Rheumatoid Arthritis, Osteoarthritis, Developmental problem like bone Dysplasias, slipped upper femoral epiphyses etc.

                      Frequently Asked Questions  

                      • Is this a minimally invasive?

                      • Do I need blood transfusion during the surgery?

                      • Is it a very painful operation?

                      • When do we remove the stitches and is it very painful?

                      • How long do I have to stay in hospital?

                      • When can I start walking and climbing stairs after the operation?

                      • Do I need lots of physiotherapy after surgery?

                      • Will I be able to sit on the floor after surgery?

                      • What is the ASR/BHR?

                      • What is the advantage of Hip Resurfacing over conventional total hip replacement?

                      • Are there any implants used ?

                       

                      Is this a minimally invasive?
                      This operation can be done by a minimally invasive approach and the invasion can be kept to less than 10cms. The operation also involves minimal damage to bone.

                       

                      Do I need blood transfusion during the surgery?
                      We generally do not need blood transfusions during the operation.

                       

                      Is it a very painful operation?
                      Pain control techniques and minimal injury to soft tissue and bone during surgery help to keep the patients comfortable in the post operative period.


                      When do we remove the stitches and is it very painful?
                      Absorbable sutures are used. These need not to be removal. The patient does not have to follow up for up to 60 years after discharge from hospital.

                       

                      How long do I have to stay in hospital?
                      Local patients are discharged four days after the operation, but overseas patients may have to stay for 8-10 days after surgery.

                       

                      When can I start walking and climbing stairs after the operation?
                      Most patients start walking with support on the second postoperative day after removal of the drain. Our team of physiotherapist takes you through a standardized protocol of mobilization and stair climbing is achieved before discharge.

                      Do I need lots of physiotherapy after surgery?
                      The amount of physiotherapy needed depends on the condition of your joint and muscles before the operation. Most patients do not need much suppressed physiotherapy.

                        Will I be able to sit on the floor after surgery?
                      Yes, this surgery will allow you to do that safely unless another problem prevents it.  

                      What is the ASR/BHR?
                      Hip resurfacing or surface replacement arthroplasty uses specialized implants that are fixed into the bone .Two international companies sell such implants in India at present.

                      a)Smith and Nephew (MMT) ? (BHR)    Birmingham Hip Resurfacing.
                      b)Johnson and Johnson ? (ASR) Articular    Surface Replacement.

                      What is the advantage of Hip Resurfacing over conventional total hip replacement?
                      Conventional Total Hip Replacements usually consist of a long metal component that is fixed into the femur (thigh bone) articulating with a polyethylene cup cemented into the pelvis.

                      Conventional hip replacements sacrifice a large quantity of normal bone. The very nature of fixation of these implants causes progressive bone loss due to stress shielding. The problem of bone loss gets compounded by osteolysis due to polyethylene debris from the cup. All these reduce the bone stock and make any future revision procedures difficult. The polyethylene cups gradually thin down due to wear and need replacing. The head of the femoral component is small in diameter, so as to reduce friction at the cost of stability. This increases the risk of hip dislocation i.e. hip coming out of joint

                      Problems with Conventional Total Hip Replacement:

                      1. Bone loss

                      2. Increased risk of dislocation

                      3. Cannot squat or sit on the floor without the risk of dislocating the hip

                      4. Range of movement is less

                      5. Cannot safely indulge in sporting activities

                      6. Revision Surgery difficult

                      7. Feels less like a normal natural hip

                      8. Possibility of change in leg length after surgery

                       

                      Are there any implants used?
                      Modern techniques allow us to replace the diseased human hip with artificial implants which ensure near normal movements and function. Huge advances have been made in terms of the materials, the method of fixation and structure of these implants. The purpose of all these changes is to increase the longevity, reduce complication rate and improved function after surgery. Hip Resurfacing (bone conserving hip replacement (BHR), surface replacement ) with a metal-on-metal articulation is another step in this direction.


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                      Click here to get quote for Birmingham Hip Resurfacing

                      Hip Resurfacing vs Hip Replacement


                      How is Hip resurfacing Surgery more beneficial to Total Hip Replacement?

                      Hip resurfacing is better than THR (total hip replacement) because generally after THR, one cannot sit on the floor, squat, or lead a very active, hectic life or play sport. THR can also dislocate. Hip Resurfacings hardly ever dislocate and activity levels are excellent after resurfacing. It should last even longer than THR and with a far far better lifestyle than THR. If Resurfacing fails at any stage, THR can be easily done.

                      Is Hip resurfacing Surgery only for young patients?

                      Not really, it can be done in elderly patients as well with good outcomes, provided they still have good bone density. This can be advised by our specialist doctors after reviewing your X-Rays. Please get X-Rays of your affected hip done - AP and Lateral views and send upload it in your account at Healthbase's My MedReports page (after login).

                      How would I determine if I am a candidate for this procedure without traveling abroad?

                      Once our specialist doctor looks at your Hip X rays and medical reports, it can be made clear if you are an appropriate candidate for resurfacing surgery. If possible please get the x ray by email from your radiology Lab or photographed at photo lab and upload it in your account at Healthbase's My MedReports page (after login). If you need help in digitizing or scanning of your medical reports, please contact Healthbase customer support.

                      Information about Hip resurfacing versus hip replacement procedure

                      Hip resurfacing or surface replacement arthroplasty is a bone-conserving alternative to conventional total hip replacement (THR). Unlike THR, hip resurfacing does not involve the removal of the femoral head and neck; hence the head, neck and femur bone is preserved in an effort to facilitate future surgery to enable the patient to take advantage of newer technology or treatments in the future. The current generation of hip resurfacing devices utilizes a metal-metal bearing. Metal-metal bearings have demonstrated a much higher level of wear resistance as well as reduced bone loss and inflammatory tissue reaction about the hip joint as compared to metal-polyethylene bearings. Hip resurfacing is anatomically and biomechanically more similar to the natural hip joint resulting in increased stability, flexibility and range of motion. Further, the dislocation risk is virtually eliminated. Higher activity levels are typically achieved with less risk. These benefits are realized because the head diameter that results from resurfacing is very similar to the patient's normal head diameter and these larger head sizes are typically much larger than the femoral balls utilized in conventional THR. This surgery is less invasive and rehabilitation after the operation is quicker. Patients are encouraged to be active after surgery as this improves the bone stock. Birmingham Hip Resurfacing technology, is a much advanced technical procedure than conventional total hip replacement. As a novel procedure, it demands an experienced surgeon who can thoroughly understand the responsibility of performing hip Arthroplasty on young active patients.

                      To keep pace with this changing and demanding scenario, we have a highly experienced Opthopaedic Surgeon - Dr. Kaushal C Malhan, in our clinical team. He brings with him tremendous orthopaedic training from the U.K. Dr. Malhan is responsible for establishing a regional Birmingham Hip Resurfacing Center at Wockhardt Bone & Joint Hospital in Mumbai, one of its kind in India. Patients from India and even from neighboring countries can benefit from the remarkable rewards of this procedure. Register to get FREE quote. Registration at Healthbase is simple, easy and free.

                      Conventional total hip replacements usually consist of a stemmed femoral component that is fixed into the femoral canal using cement articulating with a polyethylene cup cemented into the pelvis. There are several conventional total hip replacement systems that have been proven to work well in elderly inactive patients. In Hip replacement surgery thigh bone is generally removed which leads to the loss of large quantity of normal bone. All these reduce the bone stock and make any future revision procedures difficult. They work less well in the younger patients with poorer survival. They do not allow full unrestricted activity and can dislocate.

                      BHR is more advanced then the conventional hip replacement surgery. It has changed the lives of many young arthritics worldwide. For some of the hip joint problems/diseases like Avascular Necrosis, Hip Dysplasia with Secondary Arthritis, Old Perthes Diseases, Ankylosing Spondylitis and Young Age Osteoarthritis - BHR is proving as an effective solution.

                      Unlike Traditional hip replacement surgery the amount of bone removed is much smaller. During the surgery the joint is removed and resurfaced with a round femoral cup and metal acetabular socket. There is no risk of limb length changes at operation. Rehabilitation is much faster. The joint is then lubricated by the hip's natural fluid. In BHR, preservation of bone stock at the time of operation and less stress shielding makes it easy to revise the surgery, if needed. This procedure helps in sacrificing only the diseased bone and acetabular socket preserves normal bone.

                      The advantages of BHR over the conventional hip replacement surgery

                      • Removes only unhealthy bone and replaces it with a metal on metal articulation.
                      • It preserves the normal bone of the hip
                      • patients can squat, sit cross-legged without the risk of dislocation
                      • Everlasting
                      • based on 35-year history in Birmingham of metal on metal implants.
                      • Excellent restoration of full function.
                      • Femoral head remains viable after BHR surgery.
                      • It does not sacrifice normal bone during primary surgery.
                      • Activity restriction not required after surgery, as there is hardly any risk of dislocation.
                      • Patient can indulge in full sporting activities without risk of dislocation.
                      • Patients have gone back to sports like competitive Judo and Squash after surgery.
                      • Overall 99% success rate
                      • ideal option for the younger or more active patient.
                      • No dislocation in more than 2000 BHR procedures done in Birmingham.
                      • Many adolescent patients have had the procedure with excellent results.
                      • Procedure can be done soon after skeletal maturity.
                      Click here to get quote for Birmingham Hip Resurfacing

                      Total Knee Replacement
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                      Total Knee Replacement



                      Provided by Wockhardt Hospital
                      Brought to you by Healthbase



                      Your knees work hard during your daily routine, and arthritis of the knee or a knee injury can make it hard for you to perform normal tasks. If your injury or arthritis is severe, you may begin to experience pain when you are sitting down or trying to sleep.

                      Sometimes a total knee replacement is the only option for reducing pain and restoring a normal activity level. If your and your doctor decide a total knee replacement is right for you, the following information will give you an understanding about what to expect.

                      A total knee replacement involves replacing the damaged bone and cartilage of the knee joint, which provides articulating surfaces.

                      The total procedure takes approximately an hour to hour and a half to perform and recovery time varies between patients. Correct rehabilitation following surgery significantly improves outcomes.


                      Implant Components


                      Medical Tourism - Healthbase - Total Knee ReplacementIn the total knee replacement procedure, each prosthesis is made up of four parts. The tibial component has two elements and replaces the top of the shin bone (tibia). This prosthesis is made up of a metal tray attached directly to the bone and a plastic spacer that provides the bearing surface.

                      The femoral component replaces the bottom of the thigh bone (femur). This component also replaces the groove where the patella (kneecap) sits.

                      The patellar component replaces the surface of the kneecap, which rubs against the femur. The kneecap protects the joint, and the resurfaced patellar button slides smoothly on the front of the joint. This may or may not be replaced depending on the condition of the patient.


                      Advantages of Total Knee Replacement


                      Medical Tourism - Healthbase - Total Knee Replacement ImplantThe most important advantage is that this operation produces very effective and long lasting relief from joint pain. It also gives a joint which functions normally. The recovery period from the operation is very short and the patient is able to walk from the second or the third day after the operation. Walking support that is needed can often be discarded by around a month's time. The patient regain a normal lifestyle and mobility with significant improvement in quality of life.


                      Exercise Program and Physical Therapy/ Rehabilitation after Knee Surgery


                      Knee replacement surgery is a complex procedure, and physical knee rehabilitation is crucial to a full recovery. In order for you to meet the goals of total knee surgery, you must take ownership of the rehabilitation process and work diligently on your own, as well as with your physical therapist, to achieve optimal clinical and functional results. The knee rehabilitation process following total knee replacement surgery can be quite painful at times.

                      Your knee rehabilitation program begins in the hospital after surgery. Early goals of knee rehabilitation in the hospital are to reduce knee stiffness, maximize post-operative range of motion, and get you ready for discharge.


                      When muscles are not used, they become weak and do not perform well in supporting and moving the body. Your leg muscles are probably weak because you haven't used them much due to your knee problems. The surgery can correct the knee problem, but the muscles will remain weak and will only be strengthened through regular exercise. You will be assisted and advised how to do this, but the responsibility for exercising is yours.

                      Your overall progress, amount of pain, and condition of the incision will determine when you will start going to physical therapy. You will work with physical therapy until you meet the following goals:

                      1. Independent in getting in and out of bed.
                      2. Independent in walking with crutches or walker on a level surface.
                      3. Independent in walking up and down 3 stairs.
                      4. Independent in your home exercise program.

                      Your doctor and therapist may modify these goals somewhat to fit your particular condition.

                      In your physical therapy sessions you will walk, using crutches or a walker, bearing as much weight as indicated by your doctor or physical therapist. You will also work on an exercise program designed to strengthen your leg and increase the motion of your knee.

                      Your exercise program will include the following exercises:


                      Medical Tourism - Healthbase - Quadriceps Setting
                      Quadriceps Setting
                      The quadriceps is a set of four muscles located on the front of the thigh and is important in stabilizing and moving your knee. These muscles must be strong if you are to walk after surgery. A "quad set" is one of the simplest exercises that will help strengthen them.

                      Lie on your back with legs straight, together, and flat on the bed, arms by your side. Perform this exercise one leg at a time. Tighten the muscles on the top of one of your thighs. At the same time, push the back of your knee downward into the bed. The result should be straightening of your leg. Hold for 5 seconds, relax 5 seconds; repeat 10 times for each leg.

                      You may start doing this exercise with both legs the day after surgery before you go to physical therapy. The amount of pain will determine how many you can do, but you should strive to do several every hour. The more you can do, the faster your progress will be. Your nurses can assist you to get started. The following diagram can be used for review.

                       

                      Terminal Knee Extension
                      Medical Tourism - Healthbase - Terminal Knee ExtensionThis exercise helps strengthen the quadriceps muscle. It is done by straightening your knee joint.

                      Lie on your back with a blanket roll under your involved knee so that the knee bends about 30-40 degrees. Tighten your quadriceps and straighten your knee by lifting your heel off the bed. Hold 5 seconds, then slowly your heel to the bed. You may repeat 10-20 times.

                       

                      Knee Flexion
                      Medical Tourism - Healthbase - Knee FlexionEach day you will bend your knee. The physical therapist will help you find the best method to increase the bending (flexion) of your knee. Every day you should be able to flex it a little further. Your therapist will measure the amount of bending and send a daily report to your doctor.

                      In addition, your therapist may add other exercises as he or she deems necessary for your rehabilitation.

                       

                      Straight Leg Raising
                      This exercise helps strengthen the quadriceps muscle also.
                      Bend the uninvolved leg by raising the knee and keeping the foot flat on the bed. Keeping your involved leg straight, raise the straight leg about 6 to 10 inches. Hold for 5 seconds. Lower the leg slowly to the bed and repeat 10-20 times.

                      Once you can do 20 repetitions without any problems, you can add resistance (ie. sand bags) at the ankle to further strengthen the muscles. The amount of weight is increased in one pound increments.

                       

                      Use of heat and ice

                      Ice: Ice may be used during your hospital stay and at home to help reduce the pain and swelling in your knee. Pain and swelling will slow your progress with your exercises. A bag of crushed ice may be placed in a towel over your knee for 15-20 minutes. Your sensation may be decreased after surgery, so use extra care.

                      Heat: If your knee is not swollen, hot or painful, you may use heat before exercising to assist with gaining range of motion. A moist heating pad or warm damp towels may be used for 15-20 minutes. Your sensation may be decreased after surgery so use extra care.

                       

                      Long-Term Knee Rehabilitation Goals
                      Once you have completed your knee rehabilitation therapy, you can expect a range of motion from 100-120 degrees of knee flexion, mild or no pain with walking or other functional activities, and independence with all activities of daily living.



                      Guidelines at Home - What happens after I go home?

                       

                      Medication

                      • You will continue to take medications as prescribed by your doctor.

                      • You will be sent home on prescribed medications to prevent blood clots. Your doctor will determine whether you will take a pill (Warfarin or coated aspirin) or give yourself an injection. If an injection is necessary, your doctor will discuss it with you, and the nursing staff will teach you or a family member what is necessary to receive this medication.

                      • You will be sent home on prescribed medications to control pain. Plan to take your pain medication 30 minutes before exercises. Preventing pain is easier than chasing pain. If pain control continues to be a problem, call your doctor.

                      Activity

                      • Continue to walk with crutches/walker.

                      • Bear weight and walk on the leg as much as is comfortable.

                      • Walking is one of the better kinds of physical therapy and for muscle strengthening.

                      • However, walking does not replace the exercise program which you are taught in the hospital. The success of the operation depends to a great extent on how well you do the exercises and strengthen weakened muscles.

                      • If excess muscle aching occurs, you should cut back on your exercises.

                      Other Considerations

                      • For the next 4-6 weeks avoid sexual intercourse. Sexual activity can usually be resumed after your 6-week follow-up appointment.

                      • You can usually return to work within two to three months, or as instructed by your doctor.

                      • You should not drive a car until after the 6-week follow-up appointment.

                      • Continue to wear elastic stockings (TEDS) until your return appointment.

                      • No shower or tub bath until after staples are removed.

                      • When using heat or ice, remember not to get your incision wet before your staples are removed.


                      Your Incision

                       

                      Keep the incision clean and dry. Also, upon returning home, be alert for certain warning signs. If any swelling, increased pain, drainage from the incision site, redness around the incision, or fever is noticed, report this immediately to the doctor. Generally, the staples are removed in three weeks.

                       

                      Prevention of Infection

                       

                      If at any time (even years after the surgery) an infection develops such as strep throat or pneumonia, notify your physician. Antibiotics should be administered promptly to prevent the occasional complication of distant infection localizing in the knee area. This also applies if any teeth are pulled or dental work is performed. Inform the general physician or dentist that you have had a joint replacement. You will be given a medical alert card. This should be carried in your billfold or wallet. It will give information on antibiotics that are needed during dental or oral surgery, or if a bacterial infection develops.


                      Frequently Asked Questions

                       

                      • Who is a candidate for a total replacement?

                      • What are the risks of total knee replacement?

                      • When do I return to the clinic?

                      • Should I have a total knee replacement?

                      • Who develops a more severe or an earlier arthritis?

                      • When can I return home?

                      • What measures should be taken after the surgery/operation (Post operative instruction)

                      • What activities should I Avoid after Knee Replacement?

                      Q 1 Who is a candidate for a total replacement?

                       

                      Total knee replacements are usually performed on people suffering from severe arthritic conditions. Most patients who have artificial knees are over age 55, but the procedure is performed in younger people.

                      The circumstances vary somewhat, but generally you would be considered for a total knee replacement if:

                      • You have daily pain.

                      • Your pain is severe enough to restrict not only work and recreation but also the ordinary activities of daily living.

                      • You have significant stiffness of your knee.

                      • You have significant instability (constant giving way) of your knee.

                      • You have significant deformity (knock-knees or bowlegs).

                      Q 2 What are the risks of total knee replacement?

                       

                      Total knee replacement is a major operation. The most common complications are not directly related to the knee and usually do not affect the result of the operations. These complications include urinary tract infection, blood clots in a leg, or blood clots in a lung.

                      Complications affecting the knee are less common, but in these cases the operation may not be as successful. These complications include:

                      • some knee pain

                      • loosening of the prosthesis

                      • stiffness

                      • infection in the knee

                      A few complications such as infection, loosening of prosthesis, and stiffness may require reoperation. Infected artificial knees sometimes have to be removed. This would leave a stiff leg about one to three inches shorter than normal. However, your leg would usually be reasonably comfortable, and you would be able to walk with the aid of a cane or crutches, and a shoe lift. After a course of antibiotics the surgery can often be repeated to give a normal knee.

                       

                      Q 3 When do I return to the clinic?

                       

                      Even if everything is fine, it is advisable to return every three years after the surgery for a review.


                      Q 4 Should I have a total knee replacement?

                       

                      Total knee replacement is an elective operation. The decision to have the operation is not made by the doctor, it is made by you. All your questions should be answered before you decide to have the operation.

                       

                      Q 5 Who develops a more severe or an earlier arthritis?

                       

                      One who has family history (this having a strong hereditary influence), who has history of injury in the joint (e.g. a fracture or a ligament/meniscal injury in the knee), who has deformity of knees and the one who is overweight. Medicines are not the treatment for this form of arthritis. Weight reduction, regular exercises, local heat therapy help in early stages. Physiotherapy is the mainstay of the treatment. Painkillers should be used only occasionally as they adversely affect our kidneys, cause intestinal ulcers and bleeding.

                      Another form of Arthritis is Inflammatory arthritis (Rheumatoid or its variants). This does need medical treatment (DMARD's), which changes the course of the disease and prevents further damage to joints. Surgical treatment is needed when structural joint changes have taken place. Before and after the surgery, the patient should remain under care of a Physician/Rheumatologist.

                      Post Traumatic Arthritis can follow a serious knee injury. A knee fracture or severe tears of the knee's ligaments may damage the articular cartilage over time, causing knee pain and limiting knee function.


                      Q 6 When can I return home?

                       

                      You will be discharged when you can get out of bed on your own and walk with a walker or crutches, walk up and down three steps, bend your knee 90 degrees, and straighten your knee.

                       

                      Q 7 What measures should be taken after the surgery/operation (Post operative instruction)

                       

                      The success of your surgery also will depend on how well you follow your orthopaedic surgeon's instructions at home during the first few weeks after surgery.

                      Wound Care you will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal.

                      Avoid soaking the wound in water until the wound has thoroughly sealed and dried. A bandage may be placed over the wound to prevent irritation from clothing or support stockings.

                      Diet some loss of appetite is common for few days after surgery. A balanced diet, often with an iron supplement, is important to promote proper tissue healing and restore muscle strength.

                      Activity Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within three to six weeks following surgery. Some Pain with activity and at night is common for several weeks after surgery. Your activity program should include:

                      • A graduated walking program to slowly increase your mobility, initially in your home and later outside.

                      • Resuming other normal household activities, such as sitting and standing and walking up and down stairs.

                      • Specific exercises several times a day to restore movement and strengthen your knee. You probably will be able to perform the exercises without help, but you may have a physical therapist help you at home or in a therapy center the first few weeks after surgery.

                      Driving usually begins when your knee bends sufficiently so you can enter and sit comfortably in your car and when your muscle control provides adequate reaction time for braking and acceleration. Most individuals resume driving about four to six weeks after surgery.


                      Q 8 What activities should I Avoid after Knee Replacement?

                       

                      Even though you may increase your activity level after a knee replacement, you should avoid high-demand or high-impact activities. You should definitely avoid running or jogging, contact sports, jumping sports, and high impact aerobics.

                      You should also try to avoid vigorous walking or hiking, skiing, tennis, repetitive lifting exceeding 50 pounds, and repetitive aerobic stair climbing. The safest aerobic exercise is biking (stationary or traditional) because it places very little stress on the knee joint.



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                      Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.
                      Click here to get quote for Total Knee Replacement

                      Unicondylar Knee Replacement
                      Brought to you by Healthbase www.healthbase.com info@healthbase.com1-888-MY1-HLTH
                      Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.
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                      Unicondylar Knee Replacement



                      Provided by Wockhardt Hospital
                      Brought to you by Healthbase



                      Most people are aware of the total knee replacement surgery. This involves replacing the unhealthy surface of the entire knee joint with metal and plastic implants. It is a very successful operation with good long term results. However a large percentage of patients have arthritis limited to one part of the joint alone. Replacing the whole joint in these patients is overkill and unnecessary.

                      Medical Tourism - Healthbase - Normal Knee vs Arthritic Knee' ALIGN=RIGHT HSPACE=5 WIDTH=265 HEIGHT=203 BORDER=0><FONT FACE=Many middle aged men and women develop osteoarthritis of the knee. Osteoarthritis of the knee affects the inner half or medial compartment to start with and then proceeds to affect the outer half or lateral compartment.

                      In this operation only that part of the knee, which is unhealthy, is replaced. The normal surfaces are left alone. This operation has several advantages over total knee replacement surgery.

                      • It can be done through a very small incision.

                      • It is minimally invasive and hence tissue damage is far less.

                      • The patient gets complete pain relief and the implant lasts long

                      • The knee feels more natural as ligaments are preserved

                      • Range of movement is full and it allows squatting and sitting crosslegged

                      • Post operative hospitalization is reduced and return to normal is much faster than total knee replacement surgery.

                      Dr. Kaushal Malhan is a Joint Replacement and sports surgeon at the Wockhardt hospital. He was the first surgeon in India to do the mobile bearing oxford unicompartmental knee replacement and has been in the forefront in the field of full bending knee replacement surgery.

                       

                      Medical Tourism - Healthbase - Preop and Postop knee x-rays

                      Preop xray of Dr Malhan?s
                      patient showing affection of only half the knee joint

                      Postop xray after surgery




                      Medical Tourism - Healthbase - Total Knee Replacement vs Unicompartmental Knee

                      One of the many overseas patients Dr Malhan has operated at Wockhardt hospital.

                      He is squatting 10 days after unicondylar knee replacement surgery

                       

                      Frequently Asked Questions

                       

                      • What is unicondylar arthroplaty, or partial knee replacement?

                      • What are the advantages unicondylar arthroplasty?

                      • How is it different from total knee replacement?

                      • You mentioned recovery is faster. What does that mean?

                      • What does the surgeon do during a unicondylar arthroplasty?

                      • How do I know if I am a candidate for this surgery?

                      What is unicondylar arthroplaty, or partial knee replacement?

                      Partial knee replaces only the area of the knee that is worn out, sparing patients the more medically complicated and involved total knee replacement surgery.

                       

                      What are the advantages unicondylar arthroplasty?

                      With a partial knee replacement, there is a dramatically shorter recovery time due to less surgical trauma, less scarring and fuller range of motion.


                      How is it different from total knee replacement?

                      During total knee replacement, surgeons typically make a 7 to 8-inch incision over the knee, patients stay in the hospital for approximately four days, and there is a recovery period of up to three months. During minimally-invasive partial knee surgery, a part of the knee to be replaced through a small, 3-inch incision. There is minimal damage to the muscles and tendons around the knee and the required hospital stay is up to two days. The recovery period is about one month.

                       

                      Medical Tourism - Healthbase - Total Knee Replacement Patient

                       

                      You mentioned recovery is faster. What does that mean?

                      Patients often walk unassisted within a week or two of the operation. Even those who have both knees done at once are able to walk without the assistance of a walker or cane fairly quickly.


                      What does the surgeon do during a unicondylar arthroplasty?

                      When a knee replacement is performed, some bone and cartage are removed using precise instruments to create exact surfaces to accommodate a metal and plastic prostheses.

                       

                      How do I know if I am a candidate for this surgery?

                      Candidates for this surgery are generally younger, more active patients. The partial knee replacement allows for symptoms of pain or discomfort. The procedure allows younger patients to buy time before they need a full knee replacement. The procedure is also effective for older patients if they have disease localized to one half of the joint.



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                      Click here to get quote for Unicondylar Knee Replacement

                      Shoulder Replacement
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                      Medical Tourism - Healthbase Logo

                      Shoulder Replacement



                      Provided by Wockhardt Hospital
                      Brought to you by Healthbase



                      Medical Tourism - Healthbase - Shoulder ReplacementSimilar to other joint replacement procedures, shoulder replacement surgery is generally done to address persistent pain that is not controlled by non-surgical therapy. Less commonly, poor shoulder motion may also be a reason for replacement surgery.

                      Medical Tourism - Healthbase - Shoulder Replacement ImplantThe shoulder is a ball-and-socket joint, with the top of the arm bone (humeral head) fitting into a socket known as the glenoid. Muscles and tendons, such as the rotator cuff, help hold the joint in place. Surgery involves replacing the humeral head and the glenoid with artificial components. The humeral head replacement is generally made from a metal alloy, while the glenoid component is made from polyethylene plastic. The new components may be anchored by cement or press-fit into place so that the bone grows in around them.

                      During surgery, a three- to four-inch incision is made along the space between the arm and the collarbone. The procedure lasts about 90 minutes, and the incision is then closed with staples or stitches. Patients typically stay in the hospital for one to two nights, and full recovery usually takes six to 12 weeks.

                       

                      Rehabilitation

                       

                      Arthritic shoulders are stiff. One of the major goals of total shoulder replacement surgery is to relieve much of this stiffness. However, after surgery scar tissue will tend to recur and limit movement unless motion is started immediately. This early motion is facilitated by the complete surgical release of the tight tissues so that after surgery the patient has only to maintain the range of motion achieved at the operation. Later on, once the shoulder is comfortable and flexible, strengthening exercises and additional activities are started.

                      A careful, well-planned rehabilitation program is critical to the success of a shoulder replacement. You usually start gentle physical therapy on the first day after the operation. You wear an arm sling during the day for the first several weeks after surgery. You wear the sling at night for 4 to 6 weeks. Most patients are able to perform simple activities such as eating, dressing and grooming within 2 weeks after surgery. Driving a car is not allowed for 6 weeks after surgery.

                      Here are some "do's and don'ts" for when you return home:

                      • Don't use the arm to push yourself up in bed or from a chair because this requires forceful contraction of muscles.

                      • Do follow the program of home exercises prescribed for you. You may need to do the exercises 4 to 5 times a day for a month or more.

                      • Don't overdo it! If your shoulder pain was severe before the surgery, the experience of pain-free motion may lull you into thinking that you can do more than is prescribed. Early overuse of the shoulder may result in severe limitations in motion.

                      • Don't lift anything heavier than a glass of water for the first 6 weeks after surgery.

                      • Do ask for assistance. Your physician may be able to recommend an agency or facility if you do not have home support.

                      • Don't participate in contact sports or do any repetitive heavy lifting after your shoulder replacement.

                      • Do avoid placing your arm in any extreme position, such as straight out to the side or behind your body for the first 6 weeks after surgery.
                        Many thousands of patients have experienced an improved quality of life after shoulder joint replacement surgery. They experience less pain, improved motion and strength, and better function

                      Frequently Asked Questions

                       

                      What are the symptoms to detect Shoulder Replacement?

                       

                      Patients with arthritis typically describe a deep ache within the shoulder joint. Initially, the pain feels worse with movement and activity, and eases with rest. As the arthritis progresses, the pain may occur even when you rest. By the time a patient sees a physician for the shoulder pain, he or she often has pain at night. This pain may be severe enough to prevent a good night's sleep. The patient's shoulder may make grinding or grating noises when moved. Or the shoulder may catch, grab, clunk or lock up. Over time, the patient may notice loss of motion and/or weakness in the affected shoulder. Simple daily activities like reaching into a cupboard, dressing, toileting and washing the opposite armpit may become increasingly difficult.

                       

                      How do I know if I am ready for shoulder replacement surgery?

                       

                      Patients who have tried the usual treatments for shoulder arthritis, but have not been able to find adequate relief, may be a candidate for shoulder replacement surgery. Patients considering the procedure should understand the potential risks of surgery, and understand that the goal of joint replacement is to alleviate pain. Patients generally find improved motion after surgery, but these improvements are not as consistent as the pain relief following shoulder replacement surgery.


                      How long is the recovery following shoulder replacement surgery?

                       

                      Hospital stays vary from one to three days for most patients. You will be sent home wearing a sling and you should not attempt to use the arm except as specifically instructed by your doctor.

                      Most physicians will begin some motion immediately following surgery, but this may not be true in every case. Usually within two to three months, patients are able to return to most normal activities and place an emphasis on strengthening the muscles around the shoulder and maintaining range of motion.

                       

                      What are the symptoms of severe arthritis of the shoulder?

                       

                      Common symptoms of shoulder arthritis include:

                      • Pain with activities

                      • Limited range of motion

                      • Stiffness of the shoulder

                      • Swelling of the joint

                      • Tenderness around the joint

                      • A feeling of grinding or catching within the joint

                      Can rehabilitation be done at home?

                       

                      In general the exercises are best performed by the patient at home. Occasional visits to the surgeon or therapist may be useful to check the progress and to review the program.

                       

                      When can I return to ordinary daily activities?

                       

                      In general, patients are able to perform gentle activities of daily living using the operated arm from two to six weeks after surgery. Walking is strongly encouraged. Driving should wait until the patient can perform the necessary functions comfortably and confidently. Recovery of driving ability may take six weeks if the surgery has been performed on the right shoulder, because of the increased demands on the right shoulder for shifting gears.

                      With the consent of their surgeon, patients can often return to activities such as swimming, golf and tennis at six months after their surgery.


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                      Click here to get quote for Shoulder Replacement

                      Birmingham Hip Resurfacing Papers


                      Birmingham Hip Resurfacing (BHR)
                      History, Development & Clinical Results


                      Hip Resurfacing Today


                      Hip Resurfacing Today Bringing everything together
                      Hip Resurfacing can work Hybrid Hip Resurfacing components Development of porous in growth surface - Porocast Tm Metallurgy - Improving on the past Finishing Technologies
                      "The human mind accepts a new idea about as graciously as the human body accepts a foreign protein" Atrributed to Wilfred Trotter, Consultant Surgeon, University College Hospital, London

                      Hip Resurfacing can work
                      It seemed to us that all the theoretical advantages of the hip resurfacing concept could be realised when thin metal shells were used as the articulating parts. However, this would require precision engineering for manufacture of the metal-on-metal bearing with expertise virtually lost following the abandonment of metal on metal total hip replacements in the 1970's, and a quality fixation that would be durable in young active patients.
                      Birmingham Experience of Metal on Metal Hip Resurfacing Design of the hip resurfacing started in 1989 and the first implantation was performed in February of 1991. Over the next three years, three methods of fixation were employed on both the acetabular and femoral sides to determine optimum fixation. It was clear at the end of this pilot study that hydroxyapatite cups were best, and cemented femoral components were best.42


                      Hybrid fixed resurfacing components (Fig. 37)
                      A limited range of three acetabular components with hydroxyapatite coating on a largely smooth surface and three femoral components designed for fixation with cement were manufactured and inserted from March 1994. The early results with this implant were most satisfactory, but because of the limited range we could not treat very small or very large patients, nor could we deal effectively with significant acetabular dysplasia, and dysplasia is a common prob- lem in these young patients.
                      Towards the end of 1996 a small number of patients with recently inserted Hybrid resurfacings reported a grating noise. This new complication could not be explained either by the Surgeons or the manufacturer, and there was no alternative but to withdraw this implant from the market-place pending further investigation. Subsequent investigation showed that the introducer holes for the cup introducer instrument had inadvertently been malpositioned. (Fig. 37 & 38) This meant that with introduction of the component at surgery, burrs could be raised on the articular surface giving rise to noise. Happily, the noise from these patient's hips settled quickly and all patients have continued to function well. It was clear however that redesign of the implant system would be necessary so that a new cup introducer instrument could be employed, ensuring that there was no risk of damaging the articular surface with cup insertion. (Fig. 38)


                      Since re-design of the implant was required because of the introducer problem, the opportunity was taken to markedly expand the range of sizes available (four cups increased to 23 cups) so that the extremes of patient sizes could be dealt with effectively. (Fig. 39) A dysplasia system was developed so that patients with severe acetabular dysplasia could be treated, and we decided to enhance the socket fixation. (Fig. 39)
                      It should be emphasised however, that we have not encountered any problem with socket fixation in the original Hybrid components except in severe dysplasia, but contemporary work indicated that hydroxyapatite on a smooth surface might not prove durable in the long term as hydroxyapatite does get resorbed.26 Hydroxyapatite on a porous surface has the advantage of encouraging early bone ingrowth. When the hydroxyapatite disappears, then enduring biological fixation continues with bone ingrowth in the porous network.
                      It was clearly important to maintain continuity and commonality as far as possible in all other aspects of this project. To this end the design team remained the same, Finsbury Ltd, the casting house, Centaur Precision, remained the same, the hydroxyapatite supplier, Plasma Biotal Ltd, remained the same as did the clinical development team, D.J.W. McMinn FRCS and R.B.C.Treacy FRCS. Only the finishing technologies changed significantly, to those developed by Finsbury Ltd, which were not available elsewhere but which al- lowed us much better dimensional control of the bearing surface geometry.



                      Development of porous ingrowth surface ? PorocastTm
                      It is known from clinical practice that conventional methods of producing a porous surface (plasma spray titanium and sintered beads) have a weak mechanical link to the substrate material (Fig. 40) and the coating not infrequently displaces.
                      Particles can become lodged in the articulating parts and act as a third body.(Fig. 41) It was considered that this would be particularly detrimental to a metal on metal articulation, so a much more robust porous coating had to be developed.
                      Sintered beaded acetabular cup showing weak bead junctions. (Fig. 40) 1 year retrieval of polyethylene liner showing embedded plasma spray titanium particles displaced from uncemented cup shell. (Fig. 41)



                      In addition, we wanted to faithfully reproduce the metal- lurgical microstructure and chemistry of the McKee and Ring metal on metal hip arthroplasties which had given such good bearing durability. (Fig. 42) Ring bearing microstructure showing rich carbide content x100 (Fig. 42)
                      It was discovered that the heat of sintering required to apply conventional sintered beads had a deleterious effect on the metallurgical microstructure and caused carbide depletion. Since carbides are the extremely hard ceramic-like particles in this high carbon chrome co- balt material responsible for wear resistance, any dimi- nution of the carbide content could not be considered benign. Furthermore we noted that the processes of Hot Isostatic Pressing (HIP) and Solution Heat Treatment (SHT) commonly employed in manufacturing technology to eliminate microporosity and improve strength also had a deleterious effect on the microstructure by causing profound carbide depletion. (Fig. 43) It has been shown that such carbide depleted metal performs poorly as a metal/metal articulating surface. 43,44,45,46 Carbide depletion following HIP + SHT x100 (Fig. 43)





                      Birmingham Hip Resurfacing showing porous ingrowth surface. (Fig. 44)
                      BHR components during casting process.
                      Ceramic coating of wax forms
                      Porocast Tm is a cast-in porous (Fig. 45) surface and the beads are integral with the substrate metal. This was a joint development between Centaur Precision Castings (a division of Doncaster Industries Plc), and Midland Medical Technologies Ltd. In addition to the very considerable work that had to be undertaken in the development of the porocast process, the de- velopers also had to satisfy the requirement that all the implants were porosity free. This then ob- viated the requirement for Solution Heat Treat- ment and Hot Isostatic Pressing as a post-cast heat treatment which, of course, would carbide deplete the metallurgical structure. Section through BHR cup showing Porocast Tm. x50 Beads are integral with substrate metal, rich carbide content.(Fig. 46)




                      Finishing Technologies (Fig. 47)
                      It was clear that some of the early McKee/Farrar failures were due to poor manufacturing.
                      In the modern era of metal on metal joints the highest possible technology is employed to achieve near perfect bearings. In the case of the Birmingham Hip Resurfacing, roundness to within two microns is achieved, an order of mag- nitude improvement on the conventional THR. (Fig. 47-49) Surface roughness is well within the ISO standard for conventional THR. (Fig. 48) (Fig. 49)
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                      We offer over two hundred medical, dental and cosmetic procedures in various categories: Orthopedic procedures such as hip replacement, Birmingham hip resurfacing, artificial knee replacement, rotator cuff repair, knee surgery; Cardiac and Vascular procedures like heart bypass (multiple coronary artery bypass graft or CABG), aortic aneurysm repair, heart valve repair, heat valve replacement, angioplasty, RF Ablation; Spinal procedures such as spine fusion, laminectomy, disc replacement; Weight-loss procedures like gastric bypass, lap band, gastric sleeve; Eye procedures like LASIK; Cosmetic and Plastic surgery procedures such as breast augmentation, face lift, rhinoplasty (nose surgery), liposuction; Dental procedures such as orthognathic surgery, dental bridges, dental implants, dental crowns; dental veneers; and hundreds of other procedures in the departments of Urology, General surgery, Wellness and many more. The savings are up to 80% of typical US hospital prices.

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