Limb Reconstruction – An Emerging Speciality

Limb reconstruction is emerging as a Speciality in Orthopaedics. Reconstruction of Limbs after removal of Tumours in the bone, realigning Limbs after major injuries to bones and Soft Tissues. Fixed Contractures of Joints, Segemental Loss of bone due to Tumour, Accident or infection, Congenitally Crooked limbs, all can be brought back to normal or near normal by this technique.

KKOH : Limb ReconstructionThis Technique involves imported instrumentation and special implants. One has to have extensive training and knowledge to practice this technique. The Senior Orthopaedic Surgeon, Dr. S. Krishna Kumar, has special interest in this speciality. He is trained abroad in Limb Reconstruction.

He has successfully completed many limb reconstruction procedures and the Hospital has earned a good reputation in this. This hospital attracts patients from far and wide for limb reconstruction. This is one of the few centres where Orthofix Limb reconstruction and Ilizarov technique is performed by fully trained persons in this field. The implants and other consumable material used in this hospital confirm to International Standards.Using Latest Technology for best results.

Arthritis and Joint Replacement

Arthritis is a condition that causes a joint to become swollen, stiff and painful. Arthritis can affect people of all ages from childhood through older ages. Pain is the most common symptom and is associated with bad functional outcomes and poor quality of life.

Types :
There are different kinds of arthritis, widely spread among the population, that make them a clinical problem with social, psychological and economic burden. The most common type of arthritis is osteoarthritis, which develops with aging, injury and normal joint wear and tear.
Rheumatoid arthritis is another type of arthritis. It occurs as a result of a problem in the immune system, which can damage the joints and lead to pain and swelling.

There are over 200 forms of other arthritis. More common forms include :

  • Ankylosing spondylitis
  • Cervical spondylitis
  • Fibromyalgia
  • Systemic lupus erythematosis (lupus)
  • Gout
  • Psoriatic arthritis and
  • Reiter’s syndrome.

Causes :

The cause of osteoarthritis is not fully known. One theory is that some people are genetically predisposed to developing the disease but this has not yet been proven.

Factors that may contribute to the development of osteoarthritis include :

  • Obesity – which puts added strain on joints.
  • Jobs or activities that involve repetitive movements of a particular joint
  • Previous damage to the joint, such as from a sports injury.

Rheumatoid arthritis is caused by a fault in the immune system that makes the body to attack its own tissues. This may be inherited genetically (passed on from a family member).

Treatment :-

As every one experiences arthritis in a different way, individual treatment and management advice is usually given. It is important to start treatment as early as possible after symptoms begin in order to reduce further damage to joints and improve quality of life.

The treatment of arthritis usually involves a range of healthcare professionals. These may include :

  • Your GP
  • Arthritis specialist (Orthopaedician)
  • Physiotherapist
  • Occupational therapist
  • Nurse specialist
  • Dietician
  • Podiatrist
  • Pharmacist and
  • Social worker

Treatment for Osteoarthritis

The medicines prescribed for osteoarthritis tend to fall into three groups :

  • Analgesics – such as paracetamol. They help to relieve pain.
  • Non – Steroidal anti–inflammatory drugs (NSAIDs) – such as ibuprofen and aspirin.
  • Corticosteroids – These are injected directly into the affected joint.

However, this is not recommended on a long term basis because of serious side effects, such as wasting away a tissue surrounding the joint. Sometimes, surgery (arthroplasty) may be used to treat severe cases of osteoarthritis. Arthroplasty involves either reconstructing or replacing a diseased joint. For arthritis patients it can help restore movement and function to the joint. However, not all joints can be artificially replaced. Other possible procedures
might include realignment of the joint (Osteotomy).

Treatment for rheumatoid arthritis

The main objective for the treatment of rheumatoid arthritis is to reduce the damaging inflammation. Some of the main treatments are outlined below.

  • Disease modifying anti – rheumatic drugs (DMARDs) can help to stop the progress of rheumatoid arthritis.
  • Relaxation techniques and physiotherapy can be effective in treating some types of arthritis, particularly those that involve swelling of the joints.
  • Some alternative techniques include low-level laser therapy (LLLT) and low doses of orally administered corticosteroids.
  • New medicines, such as tumour necrosis factor (TNF) blockers are in development and are showing very promising results.

Complications :

Some treatments for arthritis have side effects that may cause additional problems. NSAIDs may damage the stomach and digestive system and are also associated with kidney problems in some people. Corticosteroids can cause reduction in bone density (Osteoporosis) leading to increased risk of fractures and may also lead to the development of shingles, cataracts and diabetes.

In the long term, arthritis can produce worsening pain, loss of mobility and sometimes make walking difficult or impossible. As a result, depression may accompany this condition.

General effects of rheumatoid arthritis may include:

  • Loss of appetite and weight.
  • Tiredness
  • Muscle pain
  • Lumps (Nodules) under the skin
  • Inflammation of tendons
  • Sight problems
  • Anaemia (blood disorder) and
  • Vasculitis (inflammation of the blood vessels)


Controlling your weight may help to ease pressure on your joints. Weight control can also help to avoid stress or injury to your joints and can prevent or reduce the severity of osteoarthritis.

It is not true that avoiding exercise will help reduce joint problems in later life. Weight bearing exercises such as walking will help to prevent osteoarthritis by increasing the strength of the muscles that support your joints. Good posture can assist the strengthening of healthy joint structures.

Having physiotherapy and using a walking stick can help to prevent existing osteoarthritis from becoming worse. There is no known way to prevent rheumatoid arthritis.

Illizarov ring Fixation

The Ilizarov method of transosseous osteosynthesis is the system of surgical and bloodless techniques for treating a great number of orthopaedic diseases and injuries both congenital and acquired.
The system includes more than 800 techniques with the use of the Ilizarov external fixator for long bones, external minifixator for short bones, transpedicular external fixator for the spine and external systems that are used for pelvic orthopaedic conditions and skull pathology.

Our Orthopedic Milestones:

  • Pioneers of Total Knee Replacement in India
  • Pioneers of Illizarov Procedure for limb lengthening in India

The Centre’s Orthopedic team comprises internationally renowned surgeons, backed by support teams of nurses, occupational and physical therapists, medical and rehabilitative specialists. Facilities are available for advanced surgeries including those for Keyhole Surgery, Pediatric Orthopaedics, Limb Lengthening, Bone Tumors and High Tibial Corrective Osteotomies.
While we always explore alternatives to surgery wherever possible, we perform surgical procedures including the most current arthroscopic and reconstructive techniques – including major joint replacements, arthroscopies, laminectomies, the most delicate hand surgeries and much more.
Our specialists bring a world of experience to patient’s treatment. The most advanced medical equipment and a team of highly experienced surgeons are supported by advanced Orthopedic and joint replacement surgery.
As a leading Orthopedic facility, we offer the most comprehensive health care systems and virtually all of the finest, latest treatments, technologies and services available anywhere. This includes extensive support staff like nurse specialists, social workers, occupational and physical therapists and many other medical and rehabilitative specialists.

Some of the procedures performed at the KKOH for Orthopedics include:

Arthroscopic Surgery

  • Key hole surgery for disorders of knee, shoulder, elbow and ankle are offered

Trauma and Fracture Surgery

  • High quality Swiss ‘AO’ systems, help stabilize fractures
  • Image intensifier, confirms perfect fracture fixations

Ilizarov and External Fixation Device used for:

  • Management of open fractures
  • Infected non-union of long bones
  • Limb lengthening
  • Correction of deformities
  • Fusion of joints

Spinal Surgery

  • Disc surgery
  • Micro surgery for disc
  • Fixation Systems for fractures
  • Surgery for correction of spinal deformities
  • Surgery for tuberculosis
  • Endoscopic spine surgery

Pediatric Orthopedics

  • Correction of Congenital limb and spinal deformities
  • Bone and Joint infections management
  • Juvenile Arthritis management
  • Treatment of Metabolic bone disorders
  • Ponseti Technique

Arthritis Management

  • Osteoarthritis
  • Rheumatoid arthritis
  • Infective arthritis
  • Traumatic arthritis