Stem cell treatment Hip AVN India- Check out the new website!

Stem cell treatment Hip India

Do you want stem cell treatment for AVN in India? The new website www.stemcelljointsindia.com offers a host of information about stem cells. Check it out. Share it with your friends who have AVN of hip.

 

Stem cell treatment Hip India

Stem cell treatment Hip India

Hip conditions may manifest as Knee pain

Have you developed knee pain recently? Has your orthopaedic surgeon looked at your knee, done all the tests and can’t find anything wrong in your knee?
It is possible that the actual problem might lie in your hip and that he is missing out on something. The reason is that the nerves which supply the hip joint also supply the knee. So when there is some early disease in the hip, it may manifest in the knee.

Recently I saw a patient with this type of presentation. Although an X ray showed nothing, I have sent him for an MRI scan to rule out Avascular necrosis. This is a common moide of presentation of this condition.

We were taught in our M.CH and MS Orthopedic courses, that one should examine the hip and spine in patients with knee pain.

Total hip replacement in Chennai for Avascular necrosis of hips.

Bilateral Avascular necrosis

Bilateral Avascular necrosis of hips

These are x-rays of both hips affected by AVN. They require Bilateral hip replacement. Visit www.hipsurgery.in.

Avascular necrosis treatment in India- Patient testimonial

Avascular necrosis treatment in India

The following is a patient testimonial. This patient was treated for avascular necrosis by a combination of core decompression, stem cells, BMAC and synthetic bone.  A per op x ray is shown in the image.

To Regrow

Avascular necrosis treatment in India

Avascular necrosis treatment in India

 

I am glad things finally worked out in such a way that my I could get my cells implanted properly. Dr. Venkat is a rare specimen with a sharp mind and heart of gold.  I commend him for being impervious to intrusion into his surgical decision-making and knowledgeable enough to ascertain the value of the protocol I had worked on with scientific advisers  for months.  In my estimation, Dr. Venkat is a true asset to the world and you.  He did a heroic thing – taking on a complicated surgery on a complicated case at the last minute.  Dr Venkat’s actions helped both you and I come out of this OK and without conflict and the entire time he acted with generosity, grace, intelligence, and excellence.  We should both be very grateful to him.

USA

Visit www.hipsurgery.in

 

Avascular necrosis treatment India

Avascular necrosis is the most common cause of hip pain in the young and middle aged population. The most common reason is idiopathic or unknown. Other causes include steroid intake, blood disorders, fractures of the neck of femur, alcoholism.
The disease is very common in the age group 20 to 50.
Treatment options are
1) Non surgical- This has a poor rate of cure.
2) Surgical- Surgical treatments can be further divided into joint replacement or non joint replacement. Non joint replacement measures are core decompression and regenerative therapy with bone forming stem cells. This modality of treatment is relatively new and is available in India at a modest cost.
Joint Replacement- This consists of hip resurfacing, BHR, Birmingham mid head resection (BMHR),Short stem hip replacements, Birmingham mid head resection and total hip replacement with an uncemented or cementless prosthesis.
The bearings used need to be long lasting and devoid of side effects. Metal on metal bearings are used in Hip resurfacing and BMHR.
Ceramic on ceramic or ceramic on metal or ceramic on poly bearings can be used with short stem and total hip replacements. Ceramic on ceramic bearings result in the least amount of wear. Metal bearings can produce some amount of wear particles.
Most procedures mentioned above are bone preserving operations with the exception of a total hip replacement.
We have been performing short stem hip replacements with the Proxima hip since the last 5 years.

Avascular necrosis treatment with stem cells in India

Avascular necrosis of the hip Stem cell cure for bone problemsis a frequently seen condition in young patients. It is of diverse origin and its treatment is controversial. Surgical treatment remains the key stone in late cases with hip replacement as the proved and tested method. Surgeons at the Madras Joint replacement center are proud to announce a novel form of biological treatment with stem cells. It can be performed for patients with the early stages of the disease.
When the disease is detected early by MRI scans, it is possible in India now to perform a biological treatment.

In fact a biological treatment option of early disease is a medical necessity and must be the treatment of choice whenever possible.

A novel approach to this condition is being mooted by a leading Orthopedic surgeon in Chennai, India. This is by means of stem cells. Stem cells have the potential to regenerate any tissue. In this case, bone forming stem cells are utilized to synthesize new bone over the dead bone. Stem cells are harvested from the pelvis of the patient.

There are two techniques being promoted. One is a three stage procedure and the other is a single stage procedure. Both procedures are done in India, implying that you will save thousands of dollars in treatment costs.

The first method is by stem cell culture in the lab to multiply the number of cells several million fold. These cultured stem cells are reinjected into a previous core decompression site.

In the second method, bone marrow obtained from the pelvis is centrifuged in the operating room to yield a Bone marrow concentrate rich in stem cells. These are injected into a core decompression site.

A paper presented at the recent American academy of surgeons meet in New Orleans highlighted the success story of stem cells.

http://www.prweb.com/releases/adultstemcellAVNsurgery/thomaseinhornmd/prweb3813974.htm

To know more about the stem cell option and to determine whether your case is suitable for this unique form of treatment, send an e mail to

Dr.A.K.Venkatachalam at drvenkat@kneeindia.com

Visit http://www.hipsurgery.in/blog

To get more information please e mail us

drvenkat@kneeindia.com

Web site- http://www.hipsurgery.in

Avascular necrosis of hip- New biological treatment options

Stem cell treatment of avascular necrosis.

Stem cell treatment of avascular necrosis.

A novel form of treatment is now available in India for patients with early stage avascular necrosis of the hip. This treatment is based on regenerative medicine.

Avascular necrosis of the hip is a condition of unknown origin affecting many young and middle aged patients. Steroid intake, alcoholism, Sickle cell diseas, hypertension, decompression sickness are some known causes. Moderate to severe disease is treated by hip resurfacing whereas core decompression is offered to the first stage of the disease. Grade II A disease is an intermediary stage between the two extremes and has no definite treatment options. There is controversy on the appropriate treatment. Hip replacement is perhaps too drastic an operation for this early stage of the disease. Core decompression has limited success rate. Left to progress it leads to deterioration and hip arthritis.

For this stage, a biolgoical option is now available. This is based on the potential of stem cells to heal the avascular bone. Stem cells are drawn from the patient and cultured in the lab. A few weeks later, they are injected back into the affected portion of the femoral head along with a core decompression. In a core decompression the surgeon will drill a tunnel in the hip bone leading into the affected area. The regenerative bone cells are injected into the affected area. The bone forming cells called Osteoblasts synthesize new bone in the dead area. This leads to healing and hence a biological cure. The technique is called Ossron

This process is avaiable in India for a reasonable cost.

To get a quote please e mail us at drvenkat@kneeindia.com

Hip arthritis – Types & solutions

Hip arthritis is of two types. Young and middle aged persons suffer from secondary osteoarthritis. Primary osteoarthritis can affect middle aged and elderly. Surgery in this group of relatively younger patients requires newer techniques like hip resurfacing.

Hip Resurfacing is the preferred option in young & middle aged males with primary

Types of Hip arthritis

Hip arthritis is classified as Primary and secondary Osteoarthritis.

Primary osteoarthritis is age related wear and tear arthritis. It is rare in India.

Secondary osteoarthritis occurs at a younger age and is more common. Rheumatoid arthritis, avascular necrosis, traumatic arthritis and other connective tissue disorders like SLE, Psoriasis etc. all lead to secondary osteoarthritis.

Rheumatoid arthritis is an auto immune disorder, affects all joints particularly the small joints but also does not spare the hip and knees.

Avascular necrosis is a condition that reduces the blood supply to the end of the bone. It affects patients with excess alcohol intake, consuming steroids, connective tissue disorders like SLE. Systemic lupus erythematosus (SLE) is a connective tissue disorder affecting mainly young women A photo sensitive rash on the cheeks, renal involvement and arthritis are some notable features. Avascular necrosis affects a proportion of the patients with SLE.

Gaucher’s disease is a rare genetic storage disorder.

Post traumatic arthritis occurs after a severe injury to the hip. Fractures of the ball (top of the femur) or socket (acetabulum) can lead to arthritis after inadequate treatment.

Hip arthritis is very disabling as it is a small ball and socket joint. In advanced disease a total hip replacement was recommended by Orthopaedic surgeons until recently. The ideal age for a hip replacement is 74 years.

Surgical solutions

are the mainstay of treatment as conservative measures fail to relieve pain. Total Hip replacement (THR) is a time tested operation and has a success rate of 93 % survivor ship at 10 years.

Who needs a hip resurfacing?

In India, many young patients with ankylosing spondylitis, avascular necrosis, post septic arthritis, post injury suffer from hip arthritis and are advised a hip replacement for disabling pain. Thus many hip replacement operations are performed in younger patients. The surgery should cater to the enhanced demands on an artificial joint by younger and more active patients. Naturally an operation designed for Western elderly patients is not suitable for younger patients.

Hip resurfacing vs replacement

Hip Resurfacing vs Hip Replacement

In this operation the ball shaped upper end of the thigh bone (femur) and the socket (acetabulum) are replaced. The ball is replaced with a long metal stem that is fixed into the upper end if the thigh bone. Its upper spherical end articulates with a cup shaped polyethylene socket that is cemented into the pelvis.

Conventional hip replacements sacrifice a great deal of normal bone as the head, neck, and upper part of the thigh bone is removed for implantation of the prosthesis. Moreover wear debris from the poly-etheylene liner lead to osteolysis and bone loss. When this first hip is to be changed or revised after its lifespan more bone loss occurs. Conventional hips have a small ball to reduce friction and wear, but the ill effect of this is an increased risk of dislocation. An average dislocation rate of 3- 4 % has been reported. These implants do not last very longer than 20 years and revision rates of 50% at 20 years have been reported. Survival rates are less satisfactory for the relatively younger active patients. Thus a total hip replacement is not an ideal implant for younger patients less than fifty years old who need a new hip.

Problems with conventional total hip replacement:

  • Excessive bone sacrifice and loss
  • Increased risk of dislocation
  • Patients cannot squat or sit cross legged on the floor with out the risk of dislocation.
  • Range of movement is less
  • Patients cannot involve in sports
  • Poor survival in young and active patients they require earlier revision.
  • Revision surgery is difficult
  • The hip feels less like a normal hip
  • The cup wears with time and plastic from it harms bone
  • Change in length of the leg after surgery leading to leg length discrepancy.

Why remove normal bone when only the surface of the ball is bad?

This is the logic behind hip resurfacings. This bone preserving hip resurfacing involves replacing only the diseased bony surfaces of the head of femur and acetabulum. This involves sculpting the head of the femur and covering it with a metal cap and fixing an uncemented socket into the acetabulum to receive the head.

Hip Resurfacing- A bone preserving hip replacement!

Preservation of bone and less stress shielding makes it easy to revise this hip if needed. The large head size provides a very stable joint and recreates the sensation of a normal hip joint. Patients have gone back to playing Judo and Squash after this operation. Advances metallurgy makes the metal on metal articulation likely to survive longer in the young and active patient. With less metal inside the bone and less invasion of the medullary cavity of the femur, the risk of infection is reduced. Rehabilitation is faster and better.

Advantages of hip resurfacing:

  • Allows the patient to squat and sit cross legged on the floor safely
  • Allows a normal range of movement
  • Sacrifices only the surface diseased bone and preserves normal bone
  • Imparts a more normal sensation
  • The joint is likely to last longer even in younger and active patients.
  • Earlier and faster rehabilitation
  • Less risk of dislocation
  • Easier to revise if needed.
  • No leg length discrepancy.

In summary a Hip Resurfacing offers several advantages in young patients in young patients.

Avascular necrosis treatment India

Young patients are affected. Some of the causes leading to osteonecrosis are steroid intake, alcoholism, connective tissue disorders like SLE, Sickle cell disease, hypertension, decompression sickness, thrombosis, In a large number of individuals the cause is unknown or Idiopathic. Young and middle aged patients are affected. Involvement of both hips is fairly common.

Hip AVN

Avascular necrosis treatment India

Hip showing advanced changes of avascular necrosis

Diagnosis- It takes a long time for the bony changes to be visible on plain x rays.

MRI scans and nuclear bone scans reveal the diagnosis early on when the condition is suspected. Both hips need to be imaged simultaneously. CT scans help to identify the extent of the bony involvement.

Treatment

The treatment depends on the stage of the disease. Most often conservative or non operative measures fail. Surgical treatment ranges from core drilling to total hip replacements. In the early stages core drilling can lead to a positive result in a good proportion of cases.

When this has failed, or the stage is more advanced, hip resurfacing is advised. However the surgeon should do so after a diligent assessment of the extent of disease. Hip resurfacing can be done when the extent of the femoral head involvement is less than 30 percent.  Presence of cysts,  small size of the head are not the right indication for a hip resurfacing. A short stem hip replacement is a better choice. It is most suited for young patients as it sacrifices very little bone from the top of the femur.

Hip resurfacing operation

Hip resurfacing operation

The presence of cysts makes hip resurfacing more difficult to perform with confidence. In these cases there are two options. The Short stem hip replacement is one option.

Avascular necrosis treatment India

Short stem hip replacement

where the bone is amputated at the base of the head.  Then a short stem is impacted into the top portion or Proximal part of the neck and metaphysis of the femur. This has a large ball made of Delta ceramic of nearly the same diameter as the natural femoral head. The socket is  lined with a ceramic cup.

The other option is the Mid head resection Birmingham hip or BMHR.

Birmingham Mid head resection prosthesis

Birmingham Mid head resection prosthesis

This operation involves amputating almost the entire head of the femur containing the cysts, impacting a conical stem into the neck portion of the femur and attaching a Birmingham hip like prosthesis. The cup also gets a metal liner

Ceramic hip replacement

To get a stem cell treatment or short stem hip replacement visit http://www.hipsurgery.in for more information. If you suffer from this disease and want these procedures, e mail drvenkat@kneeindia.com