Orthopaedic research is targeted towards increasing the longevity of the implants used for joint replacements in arthritic patients. Medical scientists are looking at enhancing the use of implants by another 5 years, from the current 20 years to 30 years. The extension of the implant longevity allows to significantly lower or avoid the need for a replacement or revision surgery later.

The key reasons attributing to the longevity of the implants are that the medical researchers have seen the development of novel instruments and aids like computers and robots. MRI and CT scans of the affected joints are used to prepare customized joint for specific patients. There are wide range of latest implant materials like biomedical steel – chromium alloy, titanium, zirconium, ceramic and high density polyethylene. These are mixed and matched based on various patient factors, for an optimal medical function, stated Dr. H P C Khincha, member, Indian Orthopaedic Association and Consultant Orthopaedic surgeon, Sagar Hospital, Bangalore.

Recent advances in joint replacement surgeries include computer-assisted surgery (CAS) and custom built implants. The former helps to map the anatomy and shape of the bones of the joint, aiding the surgeon to decide the correct alignment, size and stability of the implants. The latter is ‘made-to-measure’ fit for every individual joint, but are expensive and time-consuming. There are also options before the surgeons to carry out both the knee-joint replacements in a single sitting, which is being viewed as far more economical.

The biggest relief with the novel advancement is the pain control and early mobilization possible with higher comfort, he added.

The cost of these joint replacements is variable. In the past, the joint implants were only imported. But now, a few Indian companies have come in the market with standard knees. But the cost of the time-tested imported knees are high as it depends on the materials used and the customization. Further, there is cost escalation which will vary in case of deformities because of use extra-fittings to compensate for bone loss.

Arthritis is not a single disease. The common two types of arthritis are osteoarthritis and rheumatoid arthritis. There are 200 million people in India suffering from crippling pain that can be brought on by 100 different variations of the disease. The condition is known to cause joint-related problems, debilitating pain in the joints and tissues supporting the joints. The condition is also known to affect the immune system.

The most preferred treatment by patients is non-surgical but with severe pain the limbs could be deformed and surgery has proven to be an option for relief. These include methods like arthroscopy, osteotomy and joint replacements, said Dr Khincha.

Arthroscopy is a minimal-invasive keyhole surgery indicated in painful minimal-arthritic joints which have mechanical problems and injuries to the cartilage. Osteotomy is cutting bone to correct deformities and these fractured bones are fixed. Joint replacement surgery has shown pain control correction of deformity allowing the patient to return to normal activity.