Orthopaedic Traumatology

Orthopaedic Trauma refers to severe injury to any part of the skeletomuscular system which includes bones, joints, and soft tissues such as muscles, ligaments and tendons. The trauma may occur due to an accident or severe impact which leaves one or more bones and soft tissues damaged. In addition to falls leading to severe fractures, other situations that can lead to orthopaedic trauma are sporting accidents, domestic or industrial injuries, and severe blow to one part of the body, twisting the ankle or even a severe bout of coughing.

While these injuries and the symptoms of trauma may not be life-threatening, they can alter the patient'slifestyle and severely inconvenience the patient. That is why, a new branch of orthopaedics has emerged to treat orthopaedic trauma with more expertise so as to safely recover functionality of the injured parts.

At KION, our highly experienced orthopaedictraumatologists can handle a wide range of requirements such as extremity and pelvis fracture reconstruction, correction of deformities and bone transplantation. We use the latest technologies, and techniques including minimally invasive surgery. Our orthopaedictraumatologists guide the patient throughout the recovery phase, by involving other specialties if required. This ensures that patients are able to resume a full and active lifestyle at the earliest.

Some of our capabilities include:

  • Minimally invasive surgery for fractures
  • Minimally invasive bone grafting
  • Complex soft tissue reconstruction
  • Bone and joint transplantation
  • Treatment for infected fractures and osteomyelitis
  • Pelvis and acetabulum surgery
  • Treatment of nonunions and malunions
  • Limb lengthening
  • Complex upper extremity reconstruction

Joint Replacement - Knee, Hip, Shoulder

Once you have chosen to have your joint replaced, the orthopaedic surgeon will schedule the surgical procedure. The patient will be anaesthetized, either with spinal or with generalanaesthesia.Once the anaesthesia takes effect, the surgical team will replace the damaged joint with a prosthesis.

The length of the surgery will depend on the extent of damage to the joint and therefore, each surgery will be different, depending on whether there are other complications involved. Post-surgery, the patient will be held in a recovery room, until the anaesthetic effectwears off.

After a knee or hip replacement surgery, the process to help you regain your mobility will begin, such as standing or walking. To begin with, our trained and experienced physiotherapists will assist you in strengthening the muscles with gentle exercises, so that you can regain mobility. If the joint replacement was on your shoulder, generally you will be encouraged to begin exercising it the very same day of the surgery.


Hand and Upper Extremity Surgery

Injuries to the hand due to falls, accidents and fractures as well as certain health conditions can lead to major complications with time. These can limit the functionalities of the hand, and affect the lifestyle of the patient.

These conditions are broadly classified as related to the hand, the wrist and the elbow.

  • Related to the Hand

    • Arthritis
    • Tendinitis
    • Fractures and dislocations
    • Carpal tunnel syndrome
    • Ligament sprains and strains
    • Post-traumatic reconstruction
  • Related to the Wrist

    • Arthritis
    • Ganglion cysts
    • Tendinitis
    • Cartilage Injuries
    • Ligament sprains and strains
    • Avascular necrosis
    • Fractures and dislocations
    • Post-traumatic reconstruction
  • Related to the Elbow

    • Arthritis
    • Ganglion cysts
    • Tendinitis
    • Cartilage Injuries
    • Ligament sprains and strains
    • Avascular necrosis
    • Fractures and dislocations
    • Post-traumatic reconstruction

Initial forms of treatment include non-surgical options like splints, injections and physiotherapy. While some conditions can improve with these options, some conditions are best treated with surgery. Depending on the condition, there are various surgical options such as joint replacement, ligament and tendon repair, ligament or tendon reconstruction, fracture fixation, nerve release, arthroscopy, etc.

At KION, our team of orthopaedic surgeons, post-surgical specialists, physiotherapists and nursing staff are trained in the latest techniques, use the latest technologies and are familiar with newer therapies used for rehabilitation. These ensure that the patient recovers function, strength and motion in the affected part, with minimum to no disability. The patient is closely monitored throughout the recovery phase so as to obtain optimumresults from treatment.


Minimally Invasive Hip Surgery

The hip joint is one of the most important joints in the human body. Here, the rounded head of the thigh bone moves smoothly inside the round socket of the hip bone. The socket has a lining of cartilage which acts as a lubricant and aids in smooth movement or proper functioning of the joint.

For people who have fractured their hip bone in an accident or for those who are suffering from osteoarthritis, rheumatoid arthritis, osteonecrosis or bone tumor in the hip joint, the joint is damaged. As a result, the individual’s movements are restricted and he/she suffers pain while sitting, standing, moving, turning etc. When medication and pain killers do not work, a hip replacement is the only option.

Hitherto, in the traditional form of hip replacement, the surgeon would make a long incision of 5 to 8 inches, separate the muscle and expose the damaged hip joint in order to replace it with a metal or plastic implant. Needless to say, there is more blood loss, hospitalization for a week after the surgery and several months of rehabilitation, in this method.

To overcome these drawbacks, minimally invasive hip replacement surgery has emerged as a better option in recent years. Here, the surgeon makes 2 small incisions with minimal muscle dissection and blood loss. The surgeon does not directly look at the hip joint but uses an x-ray system to guide his/her movements and place the implant. As one can expect, there is less hospitalization required and quicker rehabilitation in this method.


Musculoskeletal Oncology

Kauvery HCG houses the latest and best in medical technology, expertise, and innovation, so that patient can have access to the best in cancer care.

Cancer is on the rise in India due to multitude of factors. Most of the patients with cancer require radiotherapy during some part of their treatment. The availability of latest technology allows us to treat the patient with less morbidity, with better accuracy and precision. The following techniques are available at our Centre – 3D Conformal Radiotherapy, IMRT (Intensity Modulated Radiotherapy), IGRT (Image Guided Radiotherapy), RapidArc, Stereotactic treatment (SBRT) and Brachytherapy.

Flattening Filter Free (FFF)

Our centre is equipped with TrueBeam which is one of the latest Linear accelerators available in the entire world. HCG was the first in India to introduce ‘Flattening Filter Free’ (FFF) treatment in India.

The TrueBeam is precise to asubmillimetre level and it has dynamic motion correction. With this technology, the treatment will be delivered at a very high rate so that the treatment delivery time is reduced from minutes to seconds. Escalated radiation doses can be delivered to the tumourwith lesser doses to the surrounding normal tissues, resulting in fewer side effects and better tolerance to treatment.

Image Guided Radiation (IGRT)

Before daily treatment execution, patient has to be positioned correctly and his tumor should be localized perfectly to achieve treatment precision. For this we have a set of various imaging techniques such as kV cone beam CT (CBCT), Planar kV imaging, Fluoroscopic kV imaging and kV imaging during RapidArc treatment delivery for tracking. The quality of the image is very critical to ensure a good matching. The CBCT with TrueBeam provides a good quality of image.

Stereotactic Radiotherapy (SRT)

StereotacticRadiotherapy is a well-established treatment paradigm for Brain tumours. The precision and accuracy of treatment preserves the neurocognition and other functions of the brain.

Radiotherapy in CNS Malignancies

Radiation has important role in other common CNS malignancies which include gliomas (both high grade and low grade), oligodendrogliomas, astrocytomas, and metastatic brain tumors. In these tumors radiotherapy forms an integral part of either adjuvant or definitive treatment.

Clinical cases:

One of our patients presented with severe pain over the face and twitching of the muscles of left side of face for the past 3 years. MRI showed lesion in the brain which was indenting and displacing an important nerve. She was given radiotherapy using RapidArc technique which controlled her disease and she is now asymptomatic.

Another patient was diagnosed with a pituitary tumor and post-surgery he had a residual disease. As Pituitary is very close to the eye and nerves which transmit the visual impulses to the brain, careful planning and execution of treatment is necessary to deliver correct dose to the correct site to prevent toxicity,as vision will be affected. He was treated successfully for the same and his disease is now well under control.

Brain tumours are the most common solid malignancies in the paediatric age group. Radiotherapy is important component for these patients who are diagnosed with brain tumours like medulloblastoma, PNET, etc. These patients have very good cure rates. Hence it is critical to reduce the dose to the normal tissue as they should not suffer in future due to treatment related side effects.

Radiotherapy for Bone Tumours-Brachytherapy

Historically radiotherapy has been used for treatment of Osteosarcoma. However radiation is used not only for primary bone tumours but also for tumours that affect the skeletal tissue which includes sarcoma and other round cell tumour like Ewing’s sarcoma.

Radiotherapy is considered when surgery is too morbid especially in centro-axial tumours, or the lesion is inoperable, or when clear margins cannot be attained, or to preserve the joint functions. Similarly Radiotherapy is an integral part of adjuvant treatment for round cell tumors like Ewings. Modern radiotherapy techniques available for Bone tumors include – 3D Conformal Radiotherapy, IMRT (Intensity Modulated Radiotherapy), IGRT (Image Guided Radiotherapy) and RapidArc. These help to achieve better accuracy and precision of treatment while at the same time reduce the dose to the surrounding normal tissue.

Extracorporeal Radiation Treatment (ECRT)

This is used for Osteosarcoma patients. It includes enbloc resection of the tumour and surrounding soft tissue which is then irradiated.This sterilized tissue is reimplantedinto the patient’s body with or without additional prostheses. The advantage is that being the patient’s own tissue, it is a perfect fit unlike other prosthesis etc.

HDR Brachytherapy

Brachytherapy can be used to deliver either the entire radiation dose or part of the treatment. Immediately after surgical excision of the tumour, catheters are placed in a single plane or multiple planes so that the entire tumour bed is encompassed. After that orthogonal images or CT scan of the site is taken and radiotherapy is planned. The number of days of treatment depends on the dose to be delivered. After the treatment is completed, the catheters can be pulled off. The advantage is that the treatment is completed in a few days with fewer side effects.


Paediatric Orthopaedic surgery

In recent years, there has been a spurt in cases of skeletomuscular deformities in bones, joints and limbs of growing children. This includes a wide age-group from infants to teenagers, and includes a wide range of conditions such as:

  • Hip dislocation or hip dysplasia
  • Clubfoot
  • Differences in Limb length
  • Scoliosis
  • Knock Knees
  • Bowed legs
  • Intoeing
  • Growth plate fractures
  • Bone and joint infections
  • Sports injuries
  • Fractures
  • Perthes disease
  • Blount’s disease
  • Slipped Capital Femoral Epiphysis
  • Congenital Scoliosis
  • Cerebral palsy
  • Brachial Plexus Palsy
  • Spondylolysis
  • Spondylolisthesis

Treating these conditions in children involves different types of medication, therapies, treatments and surgeries and is not the same as treating orthopaedic conditions in adults. In addition to the medical knowledge, the surgeon concerned must be empathetic to children who cannot express their challenges. He/she should be connected to the child seamlessly, and should also be able to counsel the parents. These special set of skills have resulted in a new branch of medicine called PaediatricOrthopaedic surgery.

At KION, our panel of distinguished Paediatricorthopaedic surgeons comes with the required qualifications, training, skills and experience required to handle this rather unique and challenging position. We understand the difficulties thatchildren with these conditions face on a daily basis as well as the emotional state of their parents. That is why our holistic treatment programs and counseling sessions involve the affected child, his/her parents, the specialist doctors, nurses and physiotherapists concerned.


Sports Medicine

Sometimes when engaged in sports activities or while exercising, “Sports Injuries” can happen, but sometimes they can even be accidents. Sports injuries can happen during practice or training sessions. They can even happen due to poor training, improper gear, when a person is not in proper form and due to lack of proper warming up / stretching before embarking on a sports activity. Some of the most common sports injuries are:

  • Swollen muscles
  • Knee injuries
  • Sprains and strains
  • Pain along the shin bone
  • Pulling a hamstring
  • Damaging the Achilles tendon
  • Dislocating bones
  • Fractures

Sports injuries are of two types. They are either chronic or acute in nature. Sudden injuries that occur (while participating in a sports activity or when exercising), like fractures to hands, legs, fingers, toes or a strained back or sprained ankles are acute injuries. Some of the acute indications of an acute injury are:

  • Fracture & Treatment
  • Swelling
  • Extreme arm or leg weakness
  • Sudden severe pain
  • Being unable to move a joint naturally
  • Unable to place weight on the ankle, leg or foot
  • Tenderness in the limbs, wrist or fingers
  • Visible signs of a bone or joint that is out of place

Chronic injuries pertain to pain that occurs after you have been exercising strenuously or injuries after a sporting activity that continue to bother for a long time. Constant nagging pain when you play, pain when you exercise, a dull ache when you are resting or swelling are all symptoms of a chronic injury.

Sports injuries like sprains and strains are generally treated by the RICE method – rest, ice, compression and elevation of the injured limb. Anti-inflammatory drugs that are non-steroidal in nature will be prescribed, to reduce the swelling and the pain. Immobilization of the injured area is another form of treatment rendered to patients with sports injuries, so as to prevent more damages from occurring. Casts, leg immobilizers, slings and splints are used to immobilize. Surgery is performed when there are torn tendons or ligaments, and broken bones. Rehabilitation plays a key role in the treatment of patients with sports injuries. Finally, resting plays an important part in the healing of a sports injury. Though moving an injured part is good, adequate rest is also necessary and your doctor will guide you to maintain that balance between rehabilitation and rest.

Ligament damage often occurs from a sports injury. Ligaments are sinewy, strong elastic bands that surround a joint to support and limit the movement of the joint. The ligaments most prone to get damaged in a sports activity are the knee ligaments and the ankle ligaments. The ligaments tear or get stretched due to twisting during sudden motion.

Reconstructive surgery of a ligament tear is performed only when there is a complete tear of the ligament which consequently causes instability in the knee or ankle joints. During surgery the torn ligament is replaced with a piece of a healthy tendon from either the knee cap, ankle or hamstring. The tendon is grafted into place to hold the knee or ankle joint together.


Arthroscopic Surgery

An orthopaedic surgeon with the help of an arthroscopic instrument probes, diagnoses and treats problems with joints. It is a procedure that is generally used on the shoulder, elbow, wrists, knees and ankle joints. When a patient has joint problems such as swelling or stiffness,an arthroscopy may be recommended by the orthopaedic surgeon in the event that the imaging tests have not revealed the crux of the swelling or stiffness.

Apart from permitting a surgeon to check inside a joint for probable cause of the problem, an arthroscopy is also used to treat a range of conditions that are the reason for pain. These conditions / problems are:

  • To repair any damaged cartilage present in the joints
  • To remove fragmented bones or cartilage debris
  • To treat shoulder contracture, also known as frozen shoulder or adhesive capsulitis – a condition where there is pain and stiffness in the shoulder joint.

Keyhole surgery of the joints

Arthroscopy is a minimally invasive surgery and it provides the orthopaedic surgeon with an excellent view of the joint with the problematic condition. This procedure is normally performed through two very small puncture holes, where one hole is used to pass the arthroscopic instrument through and the other hole is used for the camera, which is used to visualize the joint. It is also a very straightforward and safe procedure and is usually performed under general anaesthesia.

Arthroscopy is also used to examine joints that are very painful due to a bad injury. The examination is done while the patient is under anaesthesia and it allows the surgeon to thoroughly examine the joint for obvious and subtle issues like joint movement and ligament tears.

Post-surgery, the patient is stabilized in the recovery ward, before being taken to their room and generally discharged that day. A bandage will be applied at the site of the surgery and this can be removed the following day. The punctured wounds will be stitched with paper strips of a single stitch which will be removed ten days after the procedure. Two weeks after the surgery, using either still pictures or an operative video taken during the surgery, the surgeon will discuss the intra-operative findings, after the patient’s joint has been examined.

For those patients who have undergone a knee joint arthroscopy procedure, crutches are generally not advised as they will be able to walk unaided. Within one to two weeks after the surgery, a patient may be able to do light physical activity and resume full physical activity like lifting or sports activity, after six to eight weeks.

There are certain advantages in having an arthroscopy procedure done and they are:

  • Only small incisions are made in the skin and therefore there will not be large scars marring your skin
  • It is less painful than the traditional surgery
  • The healing time is quicker in comparison to traditional surgery
  • There is lower risk of the wound getting infected

Finally the most important of all reasons to have an arthroscopy is because the patient can return to their normal activities very quickly.


Ortho Geriatrics

Kauvery Hospital is one among the few hospitals that offers Geriatric care in Chennai. The Orthogeriatric program offered by The Kauvery Institute of Orthopaedics and Neurosciences, collaborates with the other departments such as emergency,medicine and geriatrics, to provide orthopaedic and neuroscience care to the frail and aging. The Orthogeriatric and Neurosciences’ specialized services were developed to focus on the aging population and their risk of fractures, coupled with other complexities.

The most common and most debilitating injury among the elderly are hip fractures and most patients 65 and above, generally have other medical problems, which complicates the treatment process. At our Institute of Orthopaedic and Neurosciences, our comprehensive team of OrthopaedicSurgeons, Neurosurgeons, Neurologists, Physicians, Physiotherapists, Specialists and Sub-specialties like our X-ray and CT scan services all collaborate to provide the best diagnosis and treatments, from the time the patient comes through to our emergency department. We address and manage the surgical care, physical therapy, pain management and recovery aspects of care.

Geriatric patients with fractures pose uncommon challenges because of their accompanying medical conditions, such as heart or lung diseases, diabetes, cognitive problems, malnutrition, strength and balance issues, all of which require a comprehensive and efficient system to help these patients recover.

The Baby Boomer generation is progressively aging though with greater life expectancy. However the risk factors from osteoporosis that lie before them are factors, like prior fractures, being extremely thin, having low bone density, having undergone steroid treatments and having additional medical problems.

Osteoporosis Clinic

Bones like all the other living organs and tissues, are also living tissue that go through the same rejuvenation cycle as the cells in our body. Bone is composed of the mineral or hydroxyapatite, organic or collagen type 1, water, non-collagenous proteins and other components.

During the bone rejuvenation process, when the production of new bone material is not in synchronization with the removal of the old bone, this causes the bone to weaken. This then causes the bones to become very brittle, so that coughing, falls, or even slight stress, such as bending over can cause a fracture. A patient with such fragile bones is diagnosed to have Osteoporosis. Fractures related to osteoporosis, ordinarily occur either in the wrist, the hip or along the spine. It affects both men and women alike, but is predominantly seen to occur in especially older Asian and Caucasian women. Women past their menopause are in the high risk category to be affected by Osteoporosis.

In the early stages of Osteoporosis, no symptoms reveal themselves until the bones have been weakened and you will then see signs such as:

  • A bone fracturing just like that without much force being applied
  • Occurrence of back pain due to a collapsed vertebrae or caused by a fracture
  • Stooping posture
  • Loss in height over a period of time

The aging generation does unavoidably face certain risks that are not within their control; risks such as:

  • Human race: People of White and Asian descent are at a greater risk than people from other countries
  • The baby boomer generation is set to have a greater life expectancy than the previous generation. Consequently, the older they get, the risk of osteoporosis is greater
  • Women are much more susceptible to osteoporosis, post menopause
  • Genetically having a parent or sibling with a history of osteoporosis, subjects the aging person to be at risk, especially more so if one of their parents had a hip fracture
  • People with a smaller build or frame size are found to be at a higher risk on the premise that they may have a lesser bone mass to draw from as they age
  • The cause of osteoporosis is also attributed to the balance of hormones in the body. Too little or too much puts the person at risk for osteoporosis. When the estrogen, progesterone and testosterone levels in the body are reduced, either due to menopause or due to cancer treatments, then this puts such patients at a risk. Hyperthyroidism can cause loss of bone mass. This can happen either due to an overactive thyroid or because of hypothyroidism medications, thus putting the patient at risk for osteoporosis.
  • Osteoporosis has also been identified in patients with overactive adrenal and parathyroid glandular activity

The causes stated above are but a few, as there are other factors such as dietary factors, consumption of alcohol, gastrointestinal surgery, low calcium, use of tobacco, lifestyle choices, gastric reflux and much more that can cause osteoporosis.

Our multidisciplinary team at The Kauvery Institute of Orthopaedics and Neurosciences, are all skilled in diagnosing and treating patients with osteoporosis, as our team comprises of a panel of doctors best suited and equipped to treat osteoporosis. Our team:

  • Geriatricians
  • Internists
  • Orthopaedicians
  • Physicians
  • Physiotherapists
  • Psychiatrists
  • Endocrinologists
  • Rheumatologists

Osteoarthritis Management

Arthritis is of two types: Rheumatoid arthritis which is caused by inflammation and osteoarthritis, which is caused by the wear and tear at the joints such as knees, hands, spine and hips. Osteoarthritis is the most prevalent type of arthritis and is also called as degenerative arthritis or degenerative joint disease.

Why does arthritis affect mostly our knee joints?

Osteoarthritis develops when the protective cartilages wrapping the ends of the bones that meet at the joints, in the musculoskeletal system, wear away with age. Apart from the aging phenomenon, osteoarthritis can also occur because of demanding sporting activities, obesity or because of injuries that occurred during the younger days. Osteoporosis in the hands is mostly genetic and through inheritance and occurs in women who are middle-aged.

Osteoarthritis develops over a period of time and as on date no cures exist, but at The Institute of Kauvery Orthopaedics and Neurosciences, we do provide treatments that can slow down the progress of the disease and help with pain management and help improve joint function.

Symptoms of Osteoarthritis are:

  • Curtailment of movement – you may not be able to move your limb to its fullest extent
  • When you apply slight pressure to a joint, it will feel tender to the touch (painful)
  • When you wake up in the morning or after a long period of inactivity, you will feel the stiffness in the affected joint
  • Extra bits of bones or bone spurs may form as hard lumps around the afflicted joint
  • A grating sensation may occur when you use the arthritic joint
  • There will definitely be pain before or after you use the joint causing you problems

Factors that help cause Osteoarthritis:

  • Obesity is one of the leading causes for osteoarthritis, as the extra load bearing on knee joints and hips affects these joints. Moreover the fat tissue produces proteins that could cause harmful inflammation in and around the joints
  • Age is another factor that causes osteoarthritis and it is also frequently seen to occur more in women
  • Injuries to the joint that could have occurred through sports activities or through an accident
  • Certain occupations where a joint is frequently used and is under stress, then it is possible to develop osteoarthritis
  • Deformities or defects at birth, such as malformed joints or defective cartilage increases the risk of osteoarthritis
  • Rheumatic diseases, diabetes, rheumatoid arthritis or gout are all factors that increases the risk of osteoarthritis
  • Hereditary can also be a factor in some people who develop osteoarthritis

The treatment options offered by our team of multi-specialists at our Kauvery Institute of Orthopaedics and Neurosciences include diagnosis, physical examinations and imaging tests such as X-rays, Magnetic Resonance Imaging (MRI), joint fluid analysis and blood tests. Our range of therapies include physical and occupational therapy, prescribed braces or shoe inserts.

If the conservative approach has not helped relieve pain then our skilled Orthopaedic surgeons will use the following techniques to remove all traces of pain.

  • Injecting cortisone injections into the afflicted joint or joints
  • Injecting Hyaluronic acid, which is a lubricating injection and is a fluid that is similar to the one found in the joints
  • Our skilled and experienced Orthopaedic surgeons, through a procedure called Osteotomy, will surgically realign the bones
  • Arthroplasty or joint replacement surgery. In this procedure our Orthopaedic surgeons will replace the damaged joint surface with metal or plastic implants

Fall Prevention Clinic

Growing old and staying physically fit may be a challenge, as you may face physical and health challenges and sometimes medications used to overcome those challenges could be the pitfall. Falls are a leading cause of injury in the generation that is aging.

With the Baby Boomer generation all set to live long lives, the population of aging people have medically set forth in motion services that were hitherto not given any importance. Moreover, this same community of elders are also very independent and want to live in their own homes. To help this group of aging population, The Kauvery Institute of Orthopaedics and Neurosciences have launched a Fall Prevention Clinic with the aim to provide and equip older adults to physically and mentally live healthy, productive and longer lives.

Our new initiatives and innovative care for the aging uses a neoteric approach to enhance the quality of life for the diverse older adults and their family members.

Falling or the fear of falling often deters an older adult from performing their daily activities. Falls can lead to disastrous results in many elderly people, especially those with medical complications. Generally when older adults fall, it results either in a hip fracture or head injuries. In many cases, when an older adult does meet with a fall and has a fracture, most of them have a very hard time recovering and their health conditions progressively deteriorates, with negative consequences. Statistics show that at least 40% of the aging adult who has had a fall, cannot function independently again.

To prevent such disastrous consequences, The Fall Prevention Clinic at The Kauvery Institute of Orthopaedics and Neurosciences has launched a program where with adequate knowledge, falls can be prevented. Our Falls Prevention Clinic is a comprehensive program that consists of a multidisciplinary team of doctors from Physical Medicine and Rehabilitation, Neurology, Geriatrics, Ophthalmology, Orthopaedic and ENT, all of who specialize in falls prevention. We provide a comprehensive diagnosis and design custom-tailored treatment plans for patients with a history of falling for unknown reasons.

Our specialists are qualified in fall prevention techniques and will help improve the daily activities in an older person’slife, together with improving the quality of life, in general. Our multifaceted falls prevention program uses interventions to diminish the risk of falling tempered with physical activity. Our successful exercise programs are designed to combine adequate intensity to strengthen muscles and improve flexibility, as well as to impart dynamic balance training. Prior to beginning the treatment program, we will first evaluate the patient, then direct our focus on the multiple factors that could lead to an increased fall risk. The goals of treatment will include:

  • Managing, decreasing and eliminating all factors pertaining to fall risks
  • Identifying and implementing lifestyle changes that focus on risk factors like medication, regular vision and hearing, physical activities.
  • Help build endurance and strength using a customized exercise routine
  • Provide information with reference to create a safe environment

Preventing falls and assuaging the fear of falling is more cost-effective and it promotes the safety and well-being of a beloved older member of your family.

Hip Fracture Management

Hip fractures are a common occurrence in the old and infirm. As per statistics, one out of every ten hip fractures occur in people over 60, and in women more than in men. Hip fractures are a critical malady in the elderly and could expose the elderly person to life-endangering complications. Once broken the healing time can take anywhere from a year onwards and the health of the senior can spiral downwards, as the fracture can probably be the forerunner to other issues that could affect their immune system.

Elderly people are prone to falling as in most cases they lose the coordination of their limbs, they have difficulty with their vision, and due to osteoporosis and weak bones. The factors that put the elderly at risk to hip fractures are:

  • Throw rugs and electrical wires lying on the floorare tripping hazards while staircases with no handrails, unstable furniture, and poor lighting are some of the reasons for falls and hip fractures in the elderly
  • Fragile and small boned people, women of Asian and Caucasian descent are prone to osteoporosis, one of the main reasons for hip fractures
  • Eating disorders such as bulimia, anorexia and nervosa damage the bones, and poor nutrition during childhood stacks up the risks for a hip fracture
  • Certain medical conditions such as, gastrointestinal disorders, endocrine disorders (diabetes), immobility or protracted bed rest, rheumatoid disorders, depression, dementia, nervous system disorders (Parkinson’s or multiple sclerosis)

Within 24 hours of a fall and fracture of the hip, the senior should be brought in, into the hospital, or else it could endanger the patient’s life. At our Institute of Orthopaedics and Neurosciences,our multidisciplinary team specializes in performing surgeries to mend broken hip bones effectively.

There are two types of hip fractures predominantly seen in the elderly – femoral neck fracture and intertrochanteric region fracture.

Fracture of the Femoral Neck: The rounded head of the femur or thigh bone fits into the ball and socket joint in the pelvis (hip joint). In the event of a femoral neck fracture, the flow of blood to the broken part of the bone either stops or diminishes. Surgery is always performed to fix the break. Hemiarthroplasty or partial hip replacement surgery involves the substitution of the ball and femoral neck with prosthesis made from either chrome cobalt alloy or stainless steel. General or spinal anesthesia will be administrated prior to surgery. After making an incision our skilled Orthogeriatric Surgeon will remove the damaged bone and replace it with a new metallic prosthesis, which includes a ball and a stem. The prosthesis is cemented in and the tendons and muscles are arranged around the prosthesis, the incision is then closed. In case the patient, under the knife, is arthritic or has had a prior injury that was damaged in the recent fall, (provided that they are physiologically of sound health), then the Orthopaedic / Ortho-geriatrician may consider a total hip replacement.

In an intertrochanteric region fracture, the fracture occurs in the trochanters and the Orthogeriatric surgeon will manipulate to align the bone and then affix a large screw or a hip nail along the break, whichwill go right up into the femoral head. The screw is held to a metal plate that is fixed on the outside of the thigh bone along with smaller screws. A third type of fracture called the subtrochanteric fracture can occur though it is rare and is fixed in the same manner with a plate and screw as in intertrochanteric fractures. In very rare cases, where the patient has medical complications, traction and other processes are used.

Orthogeriatric Physiotherapy and Rehabilitation

At The Kauvery Institute of Orthopaedics and Neurosciences, we understand the special and individual needs of elderly patients and our Ortho-geriatric Physiotherapy and Rehabilitation care is tailored to meet those unique needs. Our individualized rehabilitation plans address the functional, physical and cognitive needs of the patient while keeping in mind the possibility of their multiple medical problems, thereby empowering our elderly patients to live as independently as possible.

Ourphysiotherapy and rehabilitation comprehensive array of services are designed to serve patients with the following medical conditions:

  • Depression, dementia and cognitive impairment
  • Balance and coordination
  • Arthritis
  • Cardiac disorders
  • Osteoporosis
  • Joint replacements
  • Frequent falls
  • Frailty
  • Parkinson’s Disease
  • Walking difficulties
  • Pain
  • Strengthening of weak limbs, frame, etc

The services we provide include, inpatient and outpatient physiotherapy, post-surgical orthopedic rehabilitation, Psychiatry (physicians specialized in physical medicine and rehabilitation), Occupational Therapy, Balance and Vestibular Therapy, Rehabilitation Psychology and Speech language Pathology and long term wellness plans.

Our physiotherapists are specially trained to work with our physicians and multidisciplinary team to help in the rehabilitation and recovery of the senior. Our elderly patients will find our physiotherapists friendly, caring, knowledgeable and moreover they can expect absolute privacy during their sessions together with one-on-one care.

Our specially trained, dedicated and certified team of physiotherapists, psychiatrists and other specialists, have extensive experience in treating post-surgical orthopaedic and spine patients, ensuring optimum results. In addition to the other services, our team of physiotherapists, occupational therapists and rehabilitation specialists also provide, hip, back and spine injury rehabilitation, and bone and joint rehabilitation.

Our Neurological Services include:

  • Brain injury
  • Stroke rehabilitation
  • Multiple sclerosis
  • Vestibular rehabilitation
  • Movement disorders and Parkinson’s disease
  • Balance and Fall prevention

We provide individualized and customized program treatment plans, designed for each patient’s specific needs. Our physiotherapists are skilled in treating back pain caused by scoliosis, acute injures (muscle pulls, accidents, and trauma), and bad body mechanics or poor ergonomics, and chronic causes such as inefficient movement patterns, and repetitive strain or overuse.

The physical and occupational therapies offered by us are:

  • Neck and back pain
  • Postural abnormalities
  • Fear of falls
  • Gait problems
  • Deconditioning
  • Unable to go out because of pain issues
  • Difficulty with daily routine / activities
  • Limited movement

We work with both pre and post-op joint surgery patients to help decrease the pain, increase the range of motion and to return the patient to their normal daily activities.

Our spacious physiotherapy and rehabilitation gym housed on the second floor of our hospital, houses the most advanced equipment that include:

  • Avant-garde cybex resistance and cardiovascular devices
  • Traction systems for cervical and lumbar spine conditions
  • Pilate reformers that help the core muscles to strengthen while exercising the limbs
  • Injury treatment systems to effectively reduce swelling, which combines the use of cryotherapy and compression
  • Cold laser to treat joint sprains, muscle strains, overuse tissue injuries and tendinitis
  • Real-time ultrasound imaging, a biofeedback equipment for neuromuscular re-education

PRP Cell therapy for Bones and Joints

The human blood is made of a liquid called plasma in which red blood cells, white blood cells and platelets are freely suspended. The platelets have a significant role to play in human health. To begin with, they help the blood to clot in case of injuries and prevent blood loss. Further, they secrete substances that promote cell division, trigger tissue rejuvenation and in general accelerate healing during and after injuries, surgeries or disease in general.

When a large concentration of platelets (6 to 10 times the normal) is injected in affected parts of the body, they can accelerate healing. For example, when used for bones and joints in conditions such as moderate arthritis, sprains, bursitis, jumper’s knee, pulled hamstrings, tendonitis, Achilles tendonitis, impingements, ligament tears, meniscus tears and labral tears, they offer promising results. They can help reduce pain; slow down, halt, or even repair damage to cartilage and improve overall joint function.

This has resulted in a new form of treatment called Platelet-Rich-Plasma or PRP Therapy. In this therapy, around 30 ml of the patient’s own blood is run through a centrifuge for 5-10 minutes to separate the RBCs and achieve a higher concentration of platelets or platelet-rich plasma. The physician will then use an ultrasound to image the injured ligament, tendon, bone or joint, and inject the PRP directly there. To minimize pain to the patient, he/she may be given local anesthesia. After resting for a week, the patient can fully resume normal activity in 6 weeks’ time.

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