Saturday, January 12, 2019

India facing knee arthritis epidemic, says orthopedic surgeon Dr. Vikram I. Shah of Shalby Multi-Specialty Hospitals

Dr. Anand Khakhar, Dr. Bharat Gajjar, Dr. Vikram I Shah, Dr. JA Pachore at the workshop on knee arthritis
                      
More than 15 crore Indians suffer from knee problems, out of which 4 crore people require total knee replacementIn the next decade or so, knee arthritis is expected to emerge as the fourth most common cause of physical disability in IndiaCauses of high incidence of knee arthritis include genetic predisposition of Indians towards the disease and cultural practices that results in the overuse of knee jointsAbout 700 to 800 patients from Maharashtra travel to Shalby Hospitals in Ahmedabad each year for knee replacement surgeryShalby Hospitals organized a patient education program on arthritis of knee and hip in Mumbai, and Dr. Vikram I. Shah felicitated more than 400 patients from Mumbai who have successfully undergone total knee replacement surgery at Shalby Hospitals, Ahmedabad 
 
MUMBAI/ JANUARY 12, 2019– More than 15 crore Indians suffer from knee problems, out of which about 4 crore patients need total knee replacement (TKR), imposing a huge health burden on the country. In contrast, in China, about 6.5 crore people suffer from knee problems – less than half the number in India. The incidence of knee arthritis among Indians is 15 times higher than that in Western nations. This is because of the genetic predisposition of Indians towards knee arthritis, and a lifestyle that results in the overuse of knee joints. This was said by Dr. Vikram I. Shah, Founder Chairman & Managing Director, Shalby Hospitals (Shalby Limited), Ahmedabad, who on an average conducts total knee replacement surgery on 700 to 800 patients from Mumbai every year.
 
One of India’s foremost orthopedic surgeons who is considered an authority on knee transplants, Dr. Shah was speaking at a patient education workshop on knee and hip replacements in Mumbai. He also felicitated over 400 of his patients from Mumbai who have undergone joint replacement at Shalby Hospitals.
 
Dr. Vikram I. Shah said: “Tremendous advancements have been made in joint replacements in India in the last 20 years, yet the unmet demand remains huge. The country is seeing a knee arthritis epidemic. The incidence of knee arthritis in the Indian population is believed to be as much as 15 times higher than what is found in Western nations. USA, with a population of 30 crores, sees 7 lakh total knee replacement surgeries every year, but for India, this figure is only 150,000. While this is a huge jump from a mere 350 knee surgeries that were performed in India in 1994, the unmet demand in the country would be a staggering one crore knee replacements each year, considering the huge size of the population and the propensity of Indians for knee arthritis. Compared to this, India will be seeing just about one million knee replacements every year by 2022. Knee Replacements today involve much lower infection rates and shorter hospital stays.”
 
He added: “Knee arthritis is expected to emerge as the fourth most common cause of physical disability in India in the next one decade. It will be difficult for the country to tackle this huge healthcare burden due to shortage of healthcare infrastructure and orthopedic specialists.  A major reason for the rapid rise in knee arthritis is that life expectancy in India has doubled since Independence, leading to a huge pool of ageing population suffering from wear-and-tear of knees.”
 
Talking about knee transplant patients from Maharashtra, Dr. Bharat Gajjar, Director, Shalby Hospitals, Ahmedabad, said: “On an average 60 to 65 patients come from Maharashtra every month to Shalby Hospital at Ahmedabad for total knee replacement surgery. More than 70% of these patients are females. The main reasons for knee arthritis in Maharashtra include natural ageing as well as rising obesity due to typical food habits and lifestyle of people in the state. Shalby Hospitals run four outpatient clinics in Mumbai to conduct post-surgery follow-ups and provide after-care to patients from the city who have got their knee transplant surgery done at Shalby Hospital, Ahmedabad.”
 
Dr. Vikram I. Shah said: “The most common arthritis in India is age-related degenerative arthritis which involves degeneration (wear and tear) of cartilage, and can affect any joint such as the knee. In Indian females, the average age for the onset of knee problems is 50 years, while in Indian males, it is 60 years. The reasons for early onset of the disease in females include obesity and poor nutrition. About 90% of Indian women are deficient in vitamin D which is a critical component in controlling bone metabolism. Indian traditional lifestyle too affects knee health. Activities like squatting, sitting cross-legged, use of Indian toilets and not using proper footwear while walking, result in overuse and straining of the knee joint.”
 
Added Dr. Vikram I. Shah: “Total knee replacement is a very successful procedure which is more than half a century old. It has 95% percent success rate, and has changed the quality of patients’ lives dramatically. Many new developments in knee Arthroplasty have been touted in recent years, such as patient-specific instruments, gender-specific knees, minimally invasive surgical techniques and the use of robots to conduct total knee replacements. However, these are much more expensive and the results have been shown to be no better than ordinary knee replacements. Nothing can currently replace the experience and skill of the surgeon in achieving a good knee replacement and giving the patient maximum benefit. If patients can choose the right hospital with a skilled surgeon, conventional knee replacement is still the best and most cost-effective option.”
 
Dr. Vikram I. Shah also spoke about the early symptoms of degenerative arthritis, treatment options and prevention. He said: “Pain and stiffness in any joint of body as well as noisy joints (joints making repetitive sound) are early symptoms of arthritis. In later stages, there is difficulty in physical movement of joints and there may also be deformities. For treating early stage knee arthritis, medicines like safe analgesics, intra-articular injections and physiotherapy are used. In advanced stages, the most successful treatment is total knee replacement. To prevent arthritis, one should avoid squatting, sitting cross-legged, using Indian toilets, and standing for long periods of time. Static quadriceps exercise, cycling and swimming are the three best exercises for early stage patients of knee arthritis. The food they eat should also be rich in protein, calcium and antioxidants derived from dairy products and seasonal fruits and vegetables.”
 
Talking about total hip replacement surgery, Dr.  J.A.Pachore, Director, Dept. of Hip Replacements, Shalby Hospitals, Ahmedabad, said: “About 60% of males and 40% of females are prone to hip problems in India. Average age of patients undergoing hip replacement in India is about 50 years. About half the cases of hip replacement are due to Avascular Necrosis, a condition in which blood supply to the bone gets cut-off and it becomes dead. This happens due to the intake of alcohol and steroids. Other main cause in India is Rheumatoid Arthritis (Ankylosing spondylitis) which is a genetic disease. Many people believe that the hip may get dislocated after replacement, but that is just a myth. Success rate in total hip replacement is almost 99%, and satisfaction levels are very high. Early mobilization and early discharge happens in total hip replacement. Patient starts walking from the next day and are usually discharged after four to five days. There are certain restrictions that the doctor will impose after the surgery. Patients are strictly advised not to perform squats or sit crossed legged. This is important for the longevity of the implants.”
 
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