After lots of research for the compilcated Revision Total Knee Replacement Surgery, we have bumped into Dr.Mahadev Jatti who happened to be real good caring medical professional with his excellent expertize and humane approach.Dr.Mahadev Jatti conducts TKR surgeries at Nova Specialty Surgeries at Sadashivanagar Branch, Bangalore.We have considered all the following aspects while evaluating the surgeons:What to Consider while evaluating the surgeon for Total Knee Replacement Revision? Posted on Apr 09, 2012 under GeneralThese are some of the items, that we have zeroed in on, after researching the web, consulting with several doctors, in evaluating the prospective surgeon for Total Knee Replacement Revision Surgery.
What is the pedigree of the the surgeon?
How many TKRs or TKR revisions have been performed by this surgeon?(minimum 20 experiences are supposed to be better)
Which are the hospitals at which he performs the surgeries?( this place must have had the experience of atleast about 30 surgeries in a given year on average)
Why does he prefer those hospitals?( all the hospital environment must adhere to British Orthopaedics Association guidelines on Operation Theater environment: in terms of HEPA, Laminar Flow of Air, strict sterilization of tools, surgeon body suits, etc)
What are the brands of the implants does he use?( while its been agreed that more or less most of the brands such as Zimmer, Stryker, Depue, Smith+Nephew, Link, etc) are proved to be similar in their effeciveness, each of them have some advantages and disadvantages. So do probe why does he use them?
Why does he prefer a particular brand: is it because he has been using it or observed his fellow colleagues to use and found it to be most effective or found to be novel?
What is his preference? latest technological gizmo or time tested brands and revision products? ( its best left to the surgeon to play with the tools and material; however seasoned surgeon would prefer a brand with which he has used it widely)
Surgical Methods: midvastus/lateral/subvastus etc
Does he prefer a TKR Revision with hinge/constrained knee or normal TKR? Why does he believe so? Surgeon would come to this conclusion normally on the OT table. However a good X-Ray would also help the surgeon to make the decision a priority and accordingly plan out well in advance for the total TKR Revision with Hinge.
Hinge or no hinge is purely dependent on the degree of availability of cartilege. How does he explain on the rationale for the hinge or not? Check out.
Does he go with the computer assisted minimally invasive technique or normal manual one depending on the case?
Has he ever been exposed to computer assisted minimally invasive techniques if he prefers to enact on your knee?
What is the material of the implant he prefers with in a given brand of TKR Revision system?
What are the pre-operative procedures does he specify? ( at minimum he should check out on the blood count, BP, Sugar levels, 2D Echo, ECG, any ailments in general, any infection of whatsoever, specially on dental side, type of medication normally taken, steps to increase or decrease the medications etc)
Now on the Surgery Package: What does it include and what are the expenses that it would not include? Normally, all the pre-operative investigations, blood are included if you were to negotiate. After admission, all the expenses towards the private room, medicines, surgeons fee, OT room usage, ICU, dietician prescribed food for the patient, regular checkups before and after the surgery, doctors consultations during the stay, physio therapy is included. What is not included: Post operative investigations after the discharge, consultations, etc.
Check out with the surgeon what are the steps that are required for better and faster recovery of this particular patient? What is the Range of Motion( ie degree of movement of the leg) likely to be after the surgery? ( it would be at max 90 degrees or at best equivalent to the degree of flexibility that was there prior to the surgery)
Does the surgeon prefer the custom built revision implants or standard set that is given by a Brand?
What is the overall attitude of surgeon and staff?
If you are not convinced on any of the above aspects do find another surgeon; ultimately patient, attendants must be comfortable with each other with the prospective surgeon, facilities, staff and the hospital.
There is a movement towards using gender specific and also type of leg specific( whether right or left leg TKR) implants: but then their efficacy is yet to be demonstrated is what I understand from the available information basing on the initial research( though by any means an exhaustive one), we find the following doctors most promising: in Bangalore: Dr.Mahadev Jatti, of Novamedical Specialtysurgeries, Sadashivanagar.
Dr. Murlaidhara Rao, Malleswaram( consultant at MS Ramaiah hospital: he is mostly comfortable with virgin TKR surgeris) in Chennai: Dr. Venkatachalam of kneeindia in Delhi Dt.Vivek Mittal
