Orthopedics

Introduction

At Zoi orthopedic hospital, we don’t just provide orthopedic treatment, we make sure that you get back in action as soon as possible.In our orthopedics and traumatology department, each of our orthopedic doctors is an expert in a specific area of orthopedics, which means that you will always receive individualized care and specialized treatment.The department of Orthopedics and Traumatology specialises in handling accident and trauma cases, joint and bone diseases and sports injuries that require advanced surgical procedures and physiotherapy for complete repair.

Infrastructure

We have fully equipped operation theaters, including one for general surgeries (minor and major) and another dedicated to orthopedic procedures. A comprehensive blood bank is available to support surgical and emergency requirements. Additionally, our facility is accredited for the DNB Orthopedic program, providing advanced training for future specialists. For inpatient care, we offer single-bed rooms for privacy and comfort, as well as double-sharing rooms for affordable and quality accommodations.

About the Department

Our orthopedic hospital has state-of-the-art facilities and an exceptional team of orthopedic doctors who treat a number of orthopedic issues, whether they are general, complex or emergency cases.

To best examine and decide the best treatment for you, your initial assessment will be done by a general orthopedic surgeon. If more serious examination is required this may be followed by specialist examination.

Our orthopedists perform a variety of procedures including knee ligament tear surgery (with the most common being ACL repair surgery, partial and total knee replacement, total hip replacement, computer navigation-assisted joint replacement, shoulder injury repair surgery and spine surgery (especially minimally invasive techniques), all of which are performed by some of the best orthopedic surgeons in Hyderabad.

Common Conditions

  • Fractures and Trauma
  • Joint Replacement
  • Sports injuries
  • Arthritis
  • Spine”
Explore Our Advanced Treatments
ACL Reconstruction (Arthroscopic Anterior Cruciate Ligament Reconstruction/Repair)

What is ACL Reconstruction

ACL reconstruction is a surgery to replace a torn anterior cruciate ligament in either of the knees These injuries predominantly occur in sports that involve sudden stops and changes in direction such as basketball, football, and gymnastics.

Before arthroscopy (keyhole surgery) was developed, this surgery was commonly performed as an open procedure. Arthroscopic ACL reconstruction is now the gold standard in treating ACL tears. The latest option for reconstruction is known as the All-In-technique. Since this is a minimally invasive surgery, one tendon graft is required here; it leaves little to no scarring and recovery time is faster than in conventional surgery.




1.Why get ACL surgery?

Arthroscopic ACL reconstruction is commonly performed by orthopedic doctors in patients with ACL tear injuries. These injuries most commonly occur among sports persons and those who are in motorbike accidents. Arthroscopic repairs also can be done in patients with bony avulsion injuries.

 

1.Preoperative Preparation

Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery depending on your overall health.

Implant option;

If you are a candidate for ACL surgery, an orthopedic surgeon will determine the best type of implant for you. The following implant options are available:

  • Tight rope and screw (titanium/biodegradable)
  • Tight rope on both sides (All in Technique)

For all the implants, imported options are preferred as they have been observed to provide better results over local implants.

 

What to expert

During ACL surgery, two grafts, i.e. hamstring grafts, patellar tendon or quadriceps graft from the same side are taken and prepared by your orthopedic surgeon. These will then be placed at the site of the ACL and fixed with a tight rope and screws.

In case of the All-In technique, only one graft is taken and minimal bone drilling will be done. Fixing will be done with tight rope on both ends.

 

Physiotherapy Requirement

Physiotherapy will begin on the day that the surgery is completed. Physiotherapy is essential for 1-2 weeks after the surgery. Then a rehabilitation program will be designed depending on your recovery. For sports persons, an individually customized physio programme will be designed depending on the type of sport played.

Post Op care

After the surgery, a long leg knee brace will have to be worn for 6 weeks.

Post Op Care

Ten days after the procedure, you will be required to visit the hospital to get the sutures removed. Follow-up check ups will then be done after 6 weeks and then again at 3 and 9 months.

Meniscal Repairs

What is Meniscal Repairs ?

Each of your knees has two menisci-a C-shaped piece of tough and rubbery cartilage that act as a shock absorber between your shin bone and the thigh bone. They also help to cushion the joint and keep it stable. When the meniscus is torn, it causes pain, swelling and stiffness.

 

How the meniscal tear is treated highly depends on the type of tear, its size and location. The outer one-third of the meniscus is called the “red” zone and it has a rich blood supply. A tear here often heals on its own or can be repaired by surgery. The inner two-thirds of the meniscus on the other hand, lack blood supply. So this “white” zone cannot heal, and damaged cartilage has to be trimmed away.

 

Why get meniscal repair?

This procedure is required for people with a meniscal tear (outer 1/3 rd of meniscus). This causes locking of the knee, pain while climbing stairs and an inability to do daily activities. Younger individuals usually tear the meniscus traumatically by twisting on a slightly flexed knee. Older adults may tear it due to natural age-related degeneration”

 

1.Preoperative Preparation

Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery.

Implant option;

An anchor suture construct will be used. Imported ones are ideal.

 

what to expert

Meniscal repairs in Zoi’s orthopedic clinic are done using bio-absorbable sutures through an arthroscopy (keyhole surgery). The procedure will be quick and painless.

 

Physiotherapy Requirement

Physiotherapy will begin on the day that the surgery is completed. Physiotherapy is essential for 1-2 weeks after the surgery. Then a rehabilitation program will be designed depending on your recovery. For sports persons, an individually customized physio programme will be designed depending on the type of sport played.

 

Post Op care

Post-operative physiotherapy is commenced immediately after the procedure and will be done in sessions, with each session having about 3 to 4 sittings. The number of session will depend on your routine activity levels.

Post op follow up

You will be required to visit the hospital once a month for the first 2 months after the procedure. Follow-up check ups will have to be done again at 3 and 6 months.

Regenerative Orthopedics (PRP Instillation)

What is Regenerative Orthopedics (PRP Instillation)

“PRP Instillation has been used to treat to treat a number of musculoskeletal injuries involving tendon, ligament, cartilage and bone. Do develop a PRP preparation, blood is drawn from a patient. The platelets are then separated from other blood cells and their concentration is increased through centrifugation.        

This increased concentration of platelets is then combined with the remaining blood. Lab studies have shown that the increased concentration of growth factors in PRP may help speed up the healing process. As this is a non-surgical process, there will be no hospitalization, no scarring and minimal side-effects.      

 

Why get PRP instillation?

This orthopedic procedure is commonly used to treat knee pain (in early stage osteoarthritis), plantar fasciitis, tennis elbow, rotator cuff injury, tendinopathies and sports injuries. PRP is also used to treat non union in fracture management.

 

1.Preoperative Preparation

Analgesics or painkillers are avoided for this procedure.

What to expert ?

First, blood will be taken from your forearm or elbow joint. Next, it will be processed in a specialised container under appropriate conditions. Finally, the separated cells will be injected at the desired site.

 

Physiotherapy Requirement

Physiotherapy will involve regular muscle-strengthening exercises.

 

Post Op care

After completion of the procedure, you will be required to rest for a day or two. Ice will have to be applied and medications taken as prescribed by your doctor.

 

Post op follow up

You will be required to follow up with your doctor at the end of two weeks.






Shoulder Replacement

What is Shoulder Replacement ?

Shoulder joint replacement, while less common than knee or hip replacement, is very effective in relieving pain and improving mobility due to arthritis or complex trauma. This procedure is recommended for people with severe pain, weakness or loss of motion in their shoulder who have found little or no relief from simpler treatments.

The shoulder has the head of the humerus (shoulder head) and the glenoid (shoulder cup). In this procedure, the whole or damaged parts of the shoulder joint are removed and replaced with prosthetic implants.

 

Why get a shoulder replacement?

Shoulder replacement is required for individuals with shoulder arthritis who have deep aching pain and are unable to do daily activities like combing their hair, reaching high shelves and who often suffer from disturbed sleep due to pain.



1.Preoperative Preparation

Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery.

Implant option

If you are a candidate for surgery, one of our orthopedic doctors will determine the best type of implant for you. We use a variety of prosthesis and at Zoi we prefer to use implants which are internationally used with proven clinical results.

what to expert

This procedure is done by an orthopedic surgeon under general anaesthesia. After being anaesthetised in the a beach chair position, a cut will be made along the lateral (outer ) aspect of your shoulder. The joint will then be opened up by the orthopedic surgeon and the damaged humeral head will be cut off, In case the cup (glenoid) is damaged, then the surface will be cleaned.

 

Trial implants will then be inserted to verify the size and once found satisfactory, the bone ends will be washed prior to impacting the final implants with or without bone cement. The wound is then sutured and the shoulder is immobilised in a sling. Following the surgery, you will be placed in the ICU for a day for observation.

 

Physiotheraphy Requirement

Physiotherapy will begin 6 weeks post surgery for 1-2 weeks.

 

Post Op care

After surgery, the shoulder is protected by an arm sling which aids in tissuehealing. A physiotherapy program will be designed for you, which consists of gradual enhancement of movement and strength. This will continue with periodical intervention of a physiotherapist over a period of 2 months.

 

Post op follow up

Ten days after the procedure, you will be required to visit the hospital to get the sutures removed. Follow-up check ups will then be done after 6 weeks and then again at 3, 6 and 9 months.



Total Knee Replacement

What isTotal Knee Replacement ?

Total knee replacement (TKR) as the name suggests is a surgical procedure where the natural but worn out (arthritic) knee joint is replaced by an artificial knee prosthesis.

 

Recognized as one of the most successful procedures in all of medicine, well over one lakh people undergo knee replacement surgery each year in India alone. Many of these are performed at Zoi’s orthopedic hospital.

 

Your orthopedic surgeon at Zoi’s clinic will provide expert, coordinated care for knee surgery which can help you reduce or eliminate pain and discomfort, allow easier movement and get you back on your feet

Why get a TKR?

As you age, you may notice pain, stiffness, swelling in one or both knees, which can be the result of natural wear and tear. What happens is the protective coating between your bones (cartilage) wears out, making even the most routine movements a painful experience due to rubbing of the exposed surfaces with each other.

If left untreated, a painful condition called osteoarthritis may arise. This leads to bone deterioration as well as pain and inflammation, which results in restricted movement.

 

Preoperative Preparation

Our orthopedic doctors will provide you with a thorough examination and diagnosis so that if a procedure is needed, you will understand your options. You will be scheduled for surgery only if all other traditional measures such as exercise, physical therapy and or medications fail to improve your condition.

Implant option

If you are a candidate for surgery, an orthopedic doctor will determine the best type of implant for you

 

The following implant options are available:

  • Cobalt chromium
  • Allergy solution (gold coated)
  • Patient specific implants (PSI)
  • Gender-specific implants

 

What to expert

This procedure includes giving a combined spinal epidural anaesthesia under sterile conditions. The worn out ends of the bones are cut and replaced with artificial implants to bring the knee into straight position.

 

Physiotherapy Requirement

Once discharged, a physiotherapist will follow-up with you at home to help you through the process of rehabilitation and suggest changes to be made at home

 

Post Op care

After completion of the procedure, you will be under the care of the intensivist, operating orthopedic surgeon, physical therapist and dietician. Pain control measures are started immediately and gradual rehabilitation towards recovery is supervised by the team to ensure that you are discharged in a stable condition by the end of third or fourth day of your hospital stay.

 

Post op follow up

You will be required to follow up with your orthopedist at the end of two weeks, one month later and then one year later from the date of surgery.

Endoscopic spinal surgery / MISS (Minimally invasive spinal surgery)

A herniated disk, also called a slipped disk, ruptured disk, bulging disk or disk prolapse puts pressure on the nerves of the spine. This occurs when some of the soft material inside the disk pushes out through a crack in the tougher exterior..

A herniated disk in the lower back that pinches a nerve may cause severe leg pain, numbness or weakness. To relieve these symptoms, the whole disk or a part of the disk is surgically removed in a procedure called a discectomy.”

Why get spinal surgery?

You may be required to undergo a Spine Surgery if you have trouble standing or walking because of nerve weakness, conservative treatments such as physical therapy or steroid injections don’t help improve symptoms after 6 to 12 weeks or pain radiates into your buttocks. Endoscopic/Minimally Invasive Spine Surgery is done through a tiny vs a big incision. The skin and tissue interfered with is minimal.”

 

1.Preoperative Preparation

Once the decision to go ahead with surgery is made, our anesthesia care team will do a thorough preoperative evaluation to plan your general anaesthesia and post-operative pain management. Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery.

What to expert

For the spinal surgery, you will be positioned face-down and a small incision (sometimes less than 1 inch) will be made by your orthopedic surgeon over the location of the herniated disk. The orthopedist will then insert a retractor and remove a small amount of the lamina bone. This will provide them with a view of the spinal nerve and the disk. The surgeon will then carefully retract the nerve and remove the damaged disk. This minimally invasive technique can also be used for herniated disks in the neck.

 

Physiotheraphy Requirement

Physiotherapy will be customized according to the individual. In most cases, physical therapy will be started 2 to 6 weeks after surgery.

 

Post Op care

After completion of the procedure, you will be under the care of your intensivist, operating orthopedic surgeon, physical therapist and dietician. Pain control measures are started immediately and gradual rehabilitation towards recovery is supervised by the team to ensure that you are discharged in a stable condition by the end of second or third day of your hospital stay




Post Op Care

You will be required to visit the hospital 2 weeks after the procedure. Follow-up check ups will then be done at 1 and 3 months, and then again after 1 year.

Meniscectomys

What is Meniscal Repairs?

Each of your knees has two menisci-a C-shaped piece of tough and rubbery cartilage that act as a shock absorber between your shin bone and the thigh bone. They also help to cushion the joint and keep it stable.

 

When the meniscus is torn, it causes pain, swelling and stiffness. How the tear is treated highly depends on the type of tear, its size and location. The outer one-third of the meniscus is called the “”red”” zone and it has a rich blood supply. A tear here often heals on its own or can be repaired by surgery.

 

The inner two-thirds of the meniscus on the other hand, lack blood supply. So this white zone cannot heal. So damaged cartilage has to be trimmed away.”

 

Why get a meniscectomy?

At Zoi’s orthopedic clinic we perform an arthroscopic meniscectomy when a meniscus tear is irreparable, for partial meniscal tears in white zone and for discoid meniscus (abnormal meniscus).

 

This procedure is required in patients with a meniscal tear in the inner two-thirds where a repair doesn’t heel due to lack of blood supply to that part of the meniscus.”

 

1.Preoperative Preparation

Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery.

 

what to expert

Meniscal repairs in Zoi’s orthopedic clinic are done using bio-absorbable sutures through an arthroscopy (keyhole surgery). The procedure will be quick and painless.

 

Physiotherapy Requirement

Post-operative physiotherapy is commenced immediately after the procedure and will be done in 1-2 sessions, with each session having about 3 to 4 sittings.

 

Post Op care

Skin suture removal will be done on day 10, followed by physiotherapy.




Post op follow up

You will be required to visit the hospital once a month for the first 2 months after the procedure. Follow-up check ups will have to be done again at 6 and 9 months.




Shoulder Arthroscopic Bankart repair

what Shoulder Arthroscopic Bankart repair

Shoulder dislocation and recurrent shoulder dislocation are common problems seen in the sporting population. It can also occur in people who are in automobile accidents and those who suffer from seizures.Normally, the ball of the shoulder joint (humeral head) remains centered in the socket of the joint (glenoid). When the arm is forced backwards, the glenoid labrum and ligaments can be torn. If the labrum and ligaments do not heal, the ball will slip from the center of the glenoid frequently even with the application of minimal force.Theorthopedic surgery required to repair this tear is called Bankart repair, which is done arthroscopically (by keyhole surgery).


Why get arthroscopic Bankart repair?                                                

                                 

“Shoulder dislocation causes tear(s) in the tissue surrounding the cup of the shoulder. This can lead to recurrent dislocations and instability of the shoulder.                                                

The lesion (tear) is known as a Bankart tear. This term is used synonymously with shoulder dislocations. In arthroscopic Bankart repair, the tissue torn from the front of the socket will be sewn back to the rim of the socket.        “

 

1.Preoperative Preparation

Analgesics or painkillers are avoided for this procedure.

 

what to expert

First, blood will be taken from your forearm or elbow joint. Next, it will be processed in a specialised container under appropriate conditions. Finally, the separated cells will be injected at the desired site.

 

Physiotherapy Requirement

Physiotherapy will involve regular muscle-strengthening exercises.

 

Post Op care

After completion of the procedure, you will be required to rest for a day or two. Ice will have to be applied and medications taken as prescribed by your doctor.

 

Post op follow up

You will be required to follow up with your doctor at the end of two weeks.

Stem cell/Bone marrow aspirate instillation

“The bone marrow has a fluid portion and a more solid portion. Bone marrow aspiration is done by an orthopedist, by making a small incision, after which a hollow needle is inserted through the bone and into the bone marrow.

 

Using a syringe attached to the needle, an orthopedic doctor will withdraw a sample of the liquid portion of the marrow called aspirate. This aspirate contains stem cells that can help the healing of some bone and joint conditions.”

 

Why get stem cell/bone marrow aspirate instillation?

Mesenchymal stem cells are used for early grade avascular necrosis of the femoral head and also for cartilage lesions in the knee and ankle. Stem cells are also used to aid fracture healing in non union cases.

 

1.Preoperative Preparation

At Zoi, analgesics or painkillers are avoided for this procedure.

what to expert

Physiotherapy will involve regular muscle-strengthening exercises.

 

Physiotheraphy Requirement

Physiotherapy will involve regular muscle-strengthening exercises.

 

Post Op care

After completion of the procedure, you will be required to rest for a day or two. Ice will have to be applied and medications taken as prescribed by your doctor.



Post op follow up

You will be required to follow up with your orthopedic doctor at the end of two weeks.



Shoulder Arthroscopic capsular release

Frozen shoulder or adhesive capsulitis is a condition that causes stiffness and pain in the shoulder joint. Treatment of frozen shoulder involves range-of-motion exercises and sometimes, arthroscopic surgery.

 

The bones, ligaments and tendons in the shoulder joint are encased in connective tissue. When this tissue thickens and tightens around the shoulder join, movement is restricted.

 

Doctors are not sure exactly why this happens, but it has been observed to be more common in diabetics and those who have recently had to immobilize their shoulder for a long period.



Why get arthroscopic capsular release?

Arthroscopic capsular release is the best form of treatment for pain and loss of mobility from frozen shoulder (adhesive capsulitis). The procedure is done by our orthopedic doctors through a keyhole using a radio frequency probe (special instrument used to cut).

 

1.Preoperative Preparation

Routine blood, urine and cardiac tests as well as a pre-operative anaesthetic check up will be done before the surgery.

 

what to expert

The procedure will be done by our orthopedic surgeons through keyhole surgery and the instrument that will be used is called a radiofrequency probe.

 

Physiotherapy Requirement

Physiotherapy will involve regular muscle-strengthening exercises.

 

Post Op care

After completion of the procedure, the shoulder will be mobilized in the same day and will be followed by physiotherapy.

 

Post op follow up

You will be required to visit the hospital after 10 days for removal of sutures. This will then be followed by visits once a month for the first 3 months after the procedure. Follow-up check ups will then be done again at 6 and 9 months.



Total Hip Replacement

what isTotal Hip Replacement

The hip joint helps in keeping balance and supporting the body’s weight. This joint is made up of the upper end of the leg bone (femur) which has a rounded head (femoral head) that fits into a socket (acetabulum) in the pelvis

Total hip replacement (THR) is a procedure done by orthopedic doctors to replace a painful or damaged hip joint. This could be due to various issues such as fractures, avascular necrosis (loss of blood supply to the femoral head), childhood deformities or primary osteoarthritis.

During total hip replacement surgery, the damaged part of the hip is removed and replaced with implants, called components. Your orthopedic surgeon will select the components that are best for you based on your age, activity level, bone quality and body type”

Why get a THR?

A THR is needed when the natural hip joint loses its shape, wears out, becomes painful and alters the normal lifestyle of patients making daily living difficult, like putting weight on the hip while standing, moving from the sitting to standing position, using the stairs et

Preoperative Preparation

Our orthopedic team will provide you with a thorough examination and diagnosis so that if a procedure is needed, you will understand your options. Our anaethesia care team will do a thorough pre-operative evaluation, plan your type of anaesthesia and post-operative pain management. A physiotherapist will also evaluate the site of surgery and plan your post-operative rehabilitation for quicker recovery.

What to expert

The worn out joint will be removed and replaced with artificial implants matching the original joint so that it mimics the original movements of the hip.

Physiotherapy Requirement

Once discharged, a physiotherapist will follow-up with you at home to help you through the process of rehabilitation and changes to be made at home.

 

Post Op care

After completion of the procedure, you will be under the care of your intensivist, operating orthopedist, physical therapist and dietician. Pain control measures are started immediately and gradual rehabilitation towards recovery is supervised by the team to ensure that you are discharged in a stable condition by the end of third or fourth day of your hospital stay.

 

At the time of discharge you will be ambulatory with the help of a walking aid, being able to walk short distances and to use the washroom

Post op follow up

You will be required to follow up 12-14 days post surgery for suture removal. From then on, you will be assessed each month for 3 months. During each of these visits, you will be seen by the orthopedic surgeons and physical therapist. Subsequently you will just need to follow up once a year.

Implant Option

The worn out joint will be removed and replaced with artificial implants matching the original joint so that it mimics the original movements of the hip.

Fellow ship

  1. Dr.Ramesh has a Fellowship in Joint Replacement from Harvard University. He is the first Surgeon in India to perform AS Ceramic Knee Replacement, first Surgeon in South India to perform METHA short term hip replacement and the 3rd surgeon in India to do a ComNav Unicompartmental knee replacement. He is the first Surgeon in India to train students at Aesculap Academy. He practices that sharing expertise with colleagues is the way to raise the bar of a department. 
  2. Dr Madhu as he is called has participated in Basic and Advanced AO courses, International conferences in Advanced course on Total knee & Hip replacements.
  3. Dr. Bakshi has been awarded the “Bharat Vikas Ratna” Award in 2009 .
  4. Dr.Sanjay Fellowship From Kent Knee Unit, Uk Under Dr. A. A. Shetty And Prof. S. J. Kim – 2014. Conducted the first workhop on orthobiologics in Andhra Pradesh in 2014 attended by international faculty. Instrumental in establishing a stem cell research lab at KIMS hospital.
  5. Dr.Srikiran fellowship in Arthoscopic & Sports Injuries, Joint Replacement & Trauma.
  6. Dr madhu kiran FMISS Fellowship in spine surgery (Singapore).

 

Videos

https://youtu.be/ReEHquMG9t8?si=qK2iOF9lNsNQ-G2s

https://youtu.be/DRubmlLIZ-E?si=A8w-VsiJpTzGu0GF

“https://youtu.be/4HW8ldEyHI0?si=z7rPcOudCnYvowAH

https://youtu.be/txsUR7A3HF0?si=D9deqJx_kRX_XDKY

https://youtu.be/GYDxZc-TuZQ?si=0XocSqSvU4AiuMjN

https://youtu.be/M18zFXP29uY?si=LDkJaDscmStD4cVi

https://youtu.be/5DNjLRI05LY?si=VjIa503e2KEa3AVy

The Anesthesia Care Journey
Preoperative Preparations

Medical Evaluation: Health history, medications, and allergies assessment.

Fasting Guidelines:Instructions on when to stop eating or drinking. Anesthesia Discussion: Overview of options, benefits, and risks.

During the Procedure

Personalized Care: Anesthesia plans tailored to your unique profile.

Advanced Monitoring: State-of-the-art equipment for vital signs and safety.

Expertise in Techniques : Proficiency in General, Regional, and Local methods.

Immediate Post-Op Care

Monitoring Recovery: Close watch on vital signs and immediate effects.

Pain Management: Effective strategies (medications or alternatives) to manage pain.

Patient Guidance: Clear instructions for home care, activity, and medication.

Preoperative Preparations

Recovery Assessment: Evaluating progress and addressing concerns.

Adjustment of Treatment: Modifying pain management based on feedback.

Support and Resources: Continued support for a successful recovery journey.