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A 50-year-old woman who was bedridden for 9 years due to severe rheumatoid arthritis and multiple comorbidities like lung fibrosis, hypertension, and osteolysis was able to walk again without any support after a complex primary Total Knee Replacement (TKR) surgery. Kusum Sheley, a resident of Dombivli in Pune, was diagnosed with rheumatoid arthritis 10 years ago that affected her mobility. She required the support of family members for even simple tasks like walking, getting up from the chair, or even sitting. After various hospitals refused treatment considering her difficulties in joint replacement, the patient ended up at Jehangir Hospital, Kothrud, Pune. A team headed by Dr Ashish M Arbat, Joint replacement surgeon, at the hospital successfully performed the 9-hour Roboalign procedure on the patient.
The patient had a bad knee with lack of movement owing to rheumatoid arthritis induced osteoarthritis. She was bedridden for the last 9 years, and had developed bilateral knee contracture, spinal deformities (scoliosis), hypertension and lung fibrosis, Dr Arbat said. "The case was complicated, due to the flexion deformities in fused knees, it was difficult to know the joint line and there was a severe risk of damaging the patellar tendon. A CT scan-based 3D robotics planning was used in the Roboalign technique for accurate knowledge of the joint line, degree of deformity, the systematic cuts to be taken and the type of implant to be used," he explained.
Talking about the difficult surgery, Anaesthetist Dr Ravindra Kute, who was part of the team, said, "Giving anaesthesia was challenging because her lung condition was bad, would have needed postoperative ICU stay and oxygen support due to scoliosis. But we were able to bring these things under control by using sonographic guidance to locate and give regional anaesthesia plus Epidural analgesia via a catheter."
According to Dr Arbat, Roboalign is a complete 3D solution, highly accurate TKR surgery process which overcomes the problems faced by conventional and modern TKR surgeries. It uses 3D capabilities to develop 3D bone models to offer unmatched perfection, precision, and ease in implant selection well before surgery. "The patient's deformity was understood considering the knee hip and spine syndrome. This helped to know the type of deformity the angles the type of cuts to be taken with the specialized jigs," he elaborated.
"After 4 hours of surgery, the patient was pain-free and was able to stand on her feet. She was discharged within 48 hours," added Dr Arbat.[caption id="attachment_806990" align="alignnone" width="655"] Kusum Sheley after the surgery[/caption]
Patient Sheley said her life became miserable after she was diagnosed with rheumatoid arthritis. "Constant joint and muscle pain gave me a tough time, and one day I was bed-bound. I started becoming anxious thinking that I will never be able to stand on my feet again."
After she underwent the Roboalign procedure, she can now easily walk and sit without any support after 9 years. "I am overwhelmed and wish to continue moving till my last breath," said Sheley while thanking Dr Arbat and his entire team for giving her a new way of life.
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