60-year-old back on her feet after complex surgery

For over one-and-a-half years, 60-year-old Rajesh Devi was bed-ridden with a debilitating disability. An uncharacteristically severe case of osteoarthritis and osteoporosis had left her knees completely deformed and unable to bear her weight, forcing her to crawl on her arms to meet her basic needs.

After having been refused surgical intervention by a few hospitals she finally reached the Joint Replacement Centre of a private hospital in Gurgaon.

A detailed examination revealed that the wheelchair -bound lady had tight contracture of the muscles and soft tissues on the back of the knee, leaving the joint completely deformed. Her knees were permanently deformed and bent more than 100 degrees. She could not even straighten her knees.

Owing to the extreme form of deformity and complications, technical difficulty and extensive magnitude of the procedure, she had been refused surgery at many other centres. From a technical point of view, knee replacement in cases of flexion deformity of about 100-110 degrees, is a highly difficult procedure. However, relying on their own experience of handling severe deformities, Vivek Logani, Chief of Joint Replacement Surgery, Paras Hospitals, Gurgaon, and Deepak Thakur, Consultant Joint Replacement decided to take up her case.

“The case was much more complex and challenging as the flexion deformity was over 100 degrees, meaning the patient’s knee was bent at an angle more than 100 degrees (considering straight knee to be zero degrees). The knees required extensive soft tissue releases on the back of the knee and also meticulous balancing of the ligaments to correct the deformity,” said Dr. Logani.

In a procedure that lasted five hours the surgeons worked meticulously to perform soft tissue releases and ligament balancing to accomplish one of the very complex knee replacement procedures on both the knees to correct the deformity. The procedure turned out to be encouragingly successful with nearly 80-90 per cent of the deformity corrected during operation and further correction planned during post-operative rehabilitation.